s*^**
?»•*£•«
►.(-4*•."""' »'S1
• l''&TPH.*


:'- ?-
Wi
■&A-%.
•?*>:

'X-rj
%
i  *•'
j&-
*&r
*vm 
UNITED STATES OF AMERICA
^  .  .
FOUNDED 1836
WASHINGTON, D. C.
B19574 
m" 13 1217   i 
 
O/r' J^u^ty {fa  r/\  & /oc^/a^

l^^^y^  rjf-r*^^^   **S
ls*~s 7fr^<fi&£' «i*
/* A<w$*/zArz^/ — fJCa> £,0^/? 0ffTAz?C«'6 sO

& is-
 
*r
*
fr- 
A
TREATISE
ON
PHYSIOLOGY
APPLIED   TO   PATHOLOGY.
                                      BY


                    F.  J. V. BROUSSAIS,  M.  D.

Knight of the Royal Order'of the Legion of Honour, Physician-in-Chief and First Professor in the
     Military Hospital of Instruction of Paris, Member of the Royal Academy of Medicine,
          of the Royal Medical Society of Madrid,  of the Patriotic Society of
               Cordova, Corresponding Member of the Society of Emulation
                  of Liege, of the Medical Society of New Orleans, and
                      of the Medical Society of Louvain, &c. &c.
                   TRANSLATED FROM THE FRENCH,

                                      BY

                          JOHN BELL,  M.  D.

Lecturer on the Inititutes of Medicine and Medical Jurisprudence in the Philadelphia Medical
       Institute ; Senior Prescribing Physician to the Philadelphia Dispensary; Professor
              of Anatomy in the Pennsylvania Academy of the Fine Arts, &c.
                         R.  LA  ROCHE,  M.  D.

Member of the Academy of Natural Science^ of Philadelphia, Corresponding Member of the
           Academy of Medicine of New York, One of the Editors of the North
                   American Medical and Surgical Journal, Sec. &c. &c.
                 PHILADELPHIA:

H. €.  CAREY  AND I. LEA.—CHESTNUT  STREET.
1826 

Eastern District of Pennsylvania, to wit :

  BE IT REMEMBERED, That on  the 30th day of October, in the fifty-first
year of the Independence of the United States of America, A. D. 1826, H.  C.
Caret a.id I. Lea, of the said district, have deposited in this office the title of a
book, the right whereof they claim as proprietors, in the words following, to wit:
  " A Treatise on Physiology applied to Pathology.  By F. J. V. Broussais, M. D.
Knight of the Royal Order of the Legion of Honour, Physician-in-Chief and First
Professor in the Military Hospital of Instruction of Paris, Member of the  Royal
Academy of Medicine, of the Royal  Medical Society of Madrid, of the Patriotic
Society of Cordova, Corresponding Member of the Society of Emulation of Liege,
of the  Medical Society of Louvain, &c, &c.  Translated from the French,  by
John Bell, M. D. Lecturer on the Institutes of Medicine and Medical Jurispru-
dence in the Philadelphia Medical Institute, Senior Prescribing Physician to the
Philadelphia Dispensary, and Professor of Anatomy in the Pennsylvania Academy
of the Fine Arts; and R. La Roche, M. D. Member of the Academy of Natural
Sciences of  Philadelphia, Corresponding Member of  the Academy of Medicine
of New York, one of the Editors of the North American Medical and Surgical
Journal, Sic. &c. &c.

  In conformity to the Act of the Congress  of the United States, intituled  "An
Act for the encouragement of learning, by  securing the  copies of maps, charts,
and books, to the authors and proprietors of such copies, during the times therein
mentioned."  And also to the act  entitled, " An act  supplementary to an act,
entitled, ' An Act for the encouragement of learning, by securing the copies of
maps, charts, and books, to the authors and proprietors of  such copies, during
the times therein mentioned,' and extending the benefits thereof to  the arts
of designing, engraving, and etching, historical and other prints."
                                                      D. CALDWELL,
                               Clerk of the Eastern District of  Pennsylvania.
MIFFLIN AND  PARRY,  PRINTERS. 
                          TO

        F.  J. V.  BROUSSAIS, D. M. P.

                         WHO,
BY HIS FELICITOUS APPLICATION OF THE  KNOWLEDGE OF THE HEALTHY
      TO THE INVESTIGATION OF THE DISEASED STATE OF MAN,
 HAS CONFERRED THAT SERVICE  ON THE PRACTICE OF MEDICINE,
  WHICH BICHAT, IN HIS GENERAL ANATOMY, RENDERED TO

                    PHYSIOLOGY;

 AND  WHO THUS ENTITLES THE FRENCH SCHOOL TO THE  GRATITUDE OF  THE
    REFLECTING AND DISPASSIONATE OF ALL COUNTRIES  AND CLIMATES ;
                THE FOLLOWING PAGES,
      BEING AN ENGLISH VERSION OF  HIS  OWN WORK,
             ARE RESPECTFULLY DEDICATED, BY

                                 THE  TRANSLATORS. 
\ 
TABLE  OF  CONTENTS.
                              PART I.
                             CHAPTER I.                        P
Preliminary Observations.
Idea of Man.    ........
                            CHAPTER  II.
Of the Composition of the Human Body.      ....
                            CHAPTER  III.
Of the Vital Properties of the Tissues; Vital Power; Vital Laws.
                            CHAPTER IV.
History of the Functions of Relation.  General Observations.
A Summary View of the Relations.
                            CHAPTER V.
Examination of the External Surfaces of Relation,  or the External
                Senses.     .      .....
Sect.   I.—Of the Skin.      ......
Sect.  II.—Of the Senses of Sight and Hearing.
Sect. III.—Of the Sense of Sight.    .....
           Of the Mechanism of Vision.      ....
           Of the Local Phenomena of Vision.  Of the Sympathies
                observable in the Occular Apparatus.
           Of the manner in which the Local Phenomena of Vision
                degenerate into Disease.    ....
           Of the Sympathetic Phenomena of Vision developed in
               other parts.   ......
Sect. IV.—Of the Sense of Hearing.  .....
           Of the Mechanism of Hearing.    ....
           Of the manner  in which the Local Phenomena of Hear-
               ing degenerate into Disease.
Sect.  V.—Of the Sense of Smell.     .....
           Of the Mechanism of the Olfactory Sense.
           Of the manner in which the Olfactory Sense may be-
                come Diseased in Executing its Functions. '.       . '
Sect. VI.—Of the Sense of Taste.    .....
           Of the  Mechanism  and Sympathies of  the  Sense of
                Taste.      ....       .
           Of the manner in which the Sense of Taste  becomes
               Diseased in the Exercise of its Functions.
                            CHAPTER  VI.
Examination of the Encephalum, and of its Spinal Prolongation.
                           CHAPTER  VII.
Examination or Study of the Sensations, of Instinct, and of the Opera-
              . tions of the Intellect.       ....
Sect. I.—Development of these Propositions.       .      .       .
Sect. II.—Of the Phenomena of Instinct in general.  .
Sect. III.—Enumeration of the Phenomena of Instinct.
Sect. IV.—Of the Intellectual Faculties.      ....
Sect  V.—Of the Passions.    ...... 
Vi.                            CONTENTSl

                            CHAPTER VIII.                        Page
Of Laughter, Ennui, and Sleep.                                         147
Sect. I.—Of Laughter.        ......      147
Sect. II.—Of Ennui.   .......      149
Sect. III.—Of Sleep.   .......      154

                             CHAPTER IX.
Corollaries on the Intellectual Operations, and on the Passions.             161
                              CHAPTER X.
Of the manner in which the Exercise of the Intellect, the Affective
                Movements, and the  Passions, become Causes of
                Disease.      ......      174
Sect. I.—Of the manner  in which the Exercise of the Intellectual
                Faculties Disorders  Health.        .       .       .      176
Sect. II:—Of the Morbid Effects of Lively Emotions, and of the Passions,
                united to the Exercise of the Intellectual Faculties.        179
Sect. III.—Each Passion exercises a Morbid Influence over certain
                Organs.     ......      186
Sect. IV.—Of Painful Passions without Reaction.     .       .      .      189
Sect. V.—Of Painful Passions with Reaction. ....      193
                             CHAPTER X.
Sect. I.— Of the  Muscular Apparatus of Relation, and of its Depen-
                dencies.      ......      200
Sect. II.—In what manner the Exercise  of the Muscles may occasion,
                or become cause of,  Disease.       .       .      .      213
                             CHAPTER XL
A Summary of the Functions of Relation.     .                           220
                               PART  II.
                              CHAPTER I.
Of the Organic Functions in General.   .....      22?
                              CHAPTER II.
Of the Nerves destined to the Organic Functions.     .       .      .       229
                             CHAPTER HI.
Of Respiration.         .......       250
Sect. I.—A summary Description of the Respiratory Apparatus.            251
Sect. II.—Action of the Respiratory Apparatus in general.    .      .      254
Sect. Ill —Of the Aeration of Blood in the Lungs.   .       .      .      254
Sect. IV.—.Mechanism of Respiration, or the Aeration of the Blood.       255
Sect. V—Modifications of the Mechanism of Respiration.     .      .      257
Sect. VI.—Of Aeration in particular.  .....       260
Sect. VII.—In what  manner the Mechanism  of Respiration may be-
                come the Cause of Diseases.       .       .      .       264
Sect. VHI.—Diseases resulting from Derangements  in the  Aeration of
                Blood in the Lungs.  .....       267
                             CHAPTER IV.
Appendix—On the Functions of the Cerebrum and Cerebellum, a*s
                tending to throw light on the action of the Respira-
                tory Muscles.        .....      270 
CONTENTS.
VU
                              CHAPTER V.
Function of Assimilation.        .....
Sect. I.—A summary Description of the Digestive Apparatus.
Sect. II.—Ot the Functions of the Digestive Apparatus; Hunger—
                Thirst.        .....
Sect. HI. - Action of the Digestive Apparatus—First Assimilation.
Sect. V.—Of Defecation.—Encephalic Relations of the Large Intes
                tine. .       .      .      .       .     '".
Sect. VI.—In what manner the Exercise of the Organs of Digestion
                becomes the cause of Disease.
                              CHAPTER VI.
Of the Absorption of Nutritive Substances.
Sect. I.—A summary Description of the Chyliferous Apparatus.
Sect. II.—Of the Functions of the Chyliferous Apparatus.
Sect. III.—Of the Diseases which result from the Action of the Chyli
                ferous Apparatus.    ....
                             CHAPTER VII.
Of the Circulation of the Blood.         ....
Sect. I. —Description of the Heart.    ....
Sect. II.—Of the Functions of the Heart in the Adult.
Sect. III.—Foetal Circulation.   .....
Sect. IV.—Of the Arteries.    .....
Sect. V.—Structure of the Arteries.    ....
Sect. VI.—Vital Properties of the  Arteries.  .
Sect. VII.—Of the  Functions of the Arterial System.
Sect. VIII.—Of the Capillary Circulation.
Sect. IX.—A summary View of the Phenomena of the Capillary Cir-
                culation.      .....
Sect. X.—Summary Description of the Venous Apparatus in general
                and of its Divisions.         .       .      .
Sect. XI.—Of the general Structure of the Veins.
Sect. XII.—Of the Functions of the different Venous Apparatuses, or
                of the Venous Circulation.
Sect. XIII.—A Summary of the Phenomena of the Circulation.
Sect. XIV.—Of the Alterations of the Heart.  .
Sect. XV.—Alterations in the Arteries.
Sect. XVI.—Disorders of the Capillary Circulation.
Sect. XVII.—Changes in the Veins.    ....
                             CHAPTER VIII.
Of the Depurations.     .      .       .      .       .      .
Sect. I.—Of Cutaneous Depuration.    ....
Sect. II.—Renal or Urinary Depuration.
Sect. III.—Physiological Action of the Kidneys.
Sect. IV.—Of the Excretion of Urine.
Sect. V.—Function of the Bladder.    ....
Sect. VI.—Pulmonary Serous Elimination and Depuration.
Sect. VII.—In wha' manner the Action of the Depurating Organs be
                 comes the Cause of Disease. . 
Of the Secretions.
 CONTENTS.

CHAPTER IX.                        1'auf.
                                       417
Sect. I.—Of the Cutaneous Secretions.        ....      418
Seot. II.—Of the Mucous Glands.      .....      419
Sect. in.—Of the Lachrymal Gland and its Dependencies.    .      .      420
Sect. IV.—Secretors for Digestion.   .....      421
           Of the Parotid Gland.     .....      421
           Of the Submaxillary Gland.                           ,      421
           Of the Sublingual Gland.  .....       422
           Of the Liver.     ....                    422
           Of the Pancreas.  ......      423
Sect. V.—Of the Functions of the Organs of Secretion.    .             424
           Of the Action and Use of the Sebaceous Follicles.      .      427^
           Of the Action and Uses of the  Mucous Glands.  .      .      427
Sect. VI.—Of the Secretion of Tears.        .      .      .      .      428
Sect. VII.—Of the Physiological Action of the Salivary Glands.    .      429
Sect. VIII.—Of the Physiological Action of the Liver.      .      .      431
Sect. IX.—In whatManner the Secretions become Causes of Disease.       433
                             CHAPTER X.
Of the Internal Exhalations.   ......      446
Sect. I.—Of the Tissues charged with the Internal Exhalations.    .      448
Sect. II.—Of the Physiological Action and  Uses of the Serous, Adipose,
                and Medullary Tissues.     ....      450
Sect. III.—In what Manner the Internal  Exhalations become causes of Dis-
                ease.  .......      454
                            CHAPTER XI.
Of General Absorption.       ......      463
Sect. I.—Summary Description of the Lymphatic or Absorbent System.   464
Sect. II.—Physiological Action of the Absorbent  System.    .      .      465
Sect. III.—In what manner the Absorbent System becomes disordered.     470
                            CHAPTER XII.
Of Nutrition.    ........      481
Sect. I.—In what manner Nutrition becomes a cause of Disease.    .      488
                           CHAPTER  XIII.
Of Generation in General.      ......      495
Sect. I.—A Summary Description of the Genital Organs of Man and Woman. 496
Sect. II.—Physiological Action of the Genital Organs.       .      .      500
          Of the Union of the Sexes.        .      .      .      .      500
Sect. III.—In what Manner the Action of the Genital Organs becomes the
                Cause of Diseases.   .       .      .      .      .      516
Sect. IV.—Of the Diseases of the Foetus.     .                   .      528
                            CHAPTER  XIV.
Of the Development, Consistence, and Decay of Man.—Of the Various
                    Temperaments. .....      528
Sect. I.—Of the Temperaments.      ......      539
Sbct. II.—Application of the Temperaments to Age  and  Sex—Dis-
                    eases thence resulting.         .      .            545
Sect. III.—Of the Alterations in  Temperaments by the Influence of
                the Circumfusa,  Habits, and Regimen.     .             555 
A TREATISE
                      ON




APPLIED   TO  PATHOLOGY.
                       CHAPTER I.

                 PRELIMINARY  OBSERVATIONS.

Physiology is the science of life ;  it is applied to vegetables and
animals, in a state of health or disease.  Our intention, in the pre-
sent work, is to apply it to man in health and in disease;  because,
the functions in the former are often elucidated by those observed
in the latter, and because the lesions noticed in the functions, dur-
ing disease, are only modifications of those observed in health.
  Physiology presents to our view  an assemblage of mechanical
and vital  phenomena.   We shall pay more particular attention to
the latter, as  furnishing more data to pathology than the former:
these, however, will not be overlooked, whenever they appear to
contribute to the same end.

                        Idea of Man.

   Man is an organized being, enjoying, in common with all  that.
lives, the faculty of developing and preserving himself during a cer-
tain space of time: this he performs, first, by appropriating to himself,
and submitting to the laws by which he is governed, a certain pro-
portion of materials which he derives from the other bodies of na-
ture; secondly, by rejecting all  that he has taken beyond his na-
tural wants, and which, having  served  his  purposes, has lost the
property of being  longer serviceable. 
10                      IDEA OF  MAN.
   In common  with all perfect animals,  man enjoys the faculty
of recognising at a certain distance those  things that arc necessary
for the maintenance of his functions ; to search for nutritive mate-
rials, and to deposit them in a central  cavity, where they receive
a preliminary assimilation, and whence a portion  penetrates into
the interior of his tissues,  whilst  the other is rejected as superflu-
ous.   Plants and  zoophytes select their  nutritive materials from
among those bodies that are within their reach; but they do not
move in order to search for them, and do not deposit them in a
central cavity.
  Man, also, in common with other animals, is formed of a mat-
ter which we shall denominate  animal, and which presents itself
under a certain number of forms convertible into each other: these
forms of animal matter are gelatine, albumine, and Jibrine; they
possess the property, during  their spontaneous decomposition, of
affecting the olfactory sense in a peculiar manner.   Animals, more-
over, present other forms  in their immediate materials;  such  are
the adipose matter, the  oils, mucus, and milk; but these are less
essential—are found in the fluids  only, and  must all necessarily
assume the forms of the three first, in order to become constituent
parts  of the tissues.  The derangements of the assimilative faculty
cause many other forms of animal matter to appear;  but these do
not necessarily constitute part of the texture of the animal.  Finally,
to the three essential forms of animal matter (gelatine, albumen,
and fibrine) are found associated alkalies, acids, and certain salts, as
the phosphate of  lime,  &c, most of which are discovered in a
great  number of inert bodies.
  Man is distinguished from all other animated beings, first, by a
peculiar, form and attitude; secondly, by more multiplied relations
with the bodies of nature; thirdly, more particularly by the power
of reflection, or the faculty of perceiving  his own relations, of ob-
serving himself whilst he observes every thing else, and of being
impelled to this by a pleasure which appears to be independent of
the gratification, at least immediate, of his physical wants : hence
arise  in him wants of a purely intellectual nature.  Thus in  the
brute, relations take place only for the  gratification of the wants
of the  organs, or in  order to  avoid  the causes of destruction.
Whenever it ceases to  be stimulated by these motives, it remains
in a state  of immobility, or falls  asleep; whilst, on the contra-
ry, man, after having  provided for his physical  wants, still  re- 
IDEA  OF MAN.
11
mains awake, and  is called  to action by an irresistible desire of
contemplating the spectacle of the universe, and of observing him-
self whilst  occupied in that contemplation.   This constitutes his
intellectual faculties;  faculties which are peculiar to, and serve to
distinguish him from all created  beings.
  We intend, in the present work, to study man in relation with all
that is capable of producing  an impression upon him, as well as in
relation with himself; and we do this  in the  hope of discovering
the source of his diseases, and  the means of preventing or curing
them.   The subject of our investigation,  therefore, is not that of
the simple, but of the medical naturalist—of the man who endea-
vours to employ every moment  of his life, in searching  for those
means that are adequate to the  preservation and re-establishment'
of his health, and that of his fellow creatures.
  We are not acquainted with any work specifically directed towards
the accomplishment of this  double end.  It was formerly the  cus-
tom to study physical man,  or, in other words, to decompose him;
and physiologists endeavoured to ascertain the action of his organs,
and determine how he lived in health; but rarely to learn how he
became diseased, and  maintained himself alive in spite of the mor-
bid condition of his system.  When they attempted to discover,
in the study of physical man,  some causes of disease, these were
sought for, in a majority of instances, in the defects of structure,
in the division and displacement  of parts, and in other physical
derangements.   In this sense alone, the application of physiology
to medicine was made with some success. Authors, such as Baglivi,
Rega, and some others, who endeavoured to discover the cause
of  disease in the  simple play of the functions, independently of
mechanical causes, never attained the object they had  proposed
to  themselves.   This  want  of success arose from  the  circum-
stance, that physiology, which at first was too mechanical, had sub-
sequently  become too metaphysical, and that pathology was  still
too superficial and abstruse.   It was acknowledged, that  physi-
ology ought to  serve as the basis of pathology;  but this was felt
in a confused way, and no one  had succeeded in demonstrating it.
Of all the authors on physiology,  Bichat, in our  opinion,  is  the
only  one who  viewed this science in  the most correct light;
but he did not live sufficiently long to connect it completely with
medicine.   He has  pointed out the means of accomplishing this
 task; and, if he has not done it himself, it is because the phenomena of 
!••:
IDEA  OP  MAN.
disease were presented, in authors, under an aspect totally dissimilar
from the phenomena of health.   This proposition, which I have
already demonstrated in  the  Examen des Doctrines, will appear
more evident from the npp oximations wc shall have occasion  to
point out in the subsequent parts of this treatise.
  I have read with extreme pleasure the article on the Trisplaneh-
nic nerve,  written  by professor Lobstein, and contained in  the
Dictionnaire des Sciences Medicates.  The author there considers
the ganglionic nerves under a point of view which  appears to  me
highly interesting, and approaches nearly to the idea I had already
formed of them  (See Journal Universel des Sciences M&dicales,
t. XII. 1818,  and the Examen des Doctrines).  Such essays abound
in useful application  to practical medicine,  and are worth many
long treatises.
  The mere attention to the study of the organs in  relation with
their modifiers,  will  always  constitute, for physiologists,  a fruit-
ful  and inexhaustible source of new truths;  from this then  wc
intend to draw.   It is for having  isolated symptoms, not mere-
ly from the organs,  but also  from the agents which  modify these
latter before, and during the whole course of, the  disease,  that
physicians  have  created those  entities,  which, as  we  have  al-
ready proved in  the  Examen des Doctrines, disfigure the science
of medicine.  The same  error has been committed in physiology.
Functions have  been made too independent of those modifying
agents by which they are maintained; owing to which the change
from the physiological to the pathological state, has not been hither-
to completely discovered;  or, in other words, it is owing  to this,
that medical physiology has not been created.
  The same error having hitherto existed in the method of study-
ing and teaching these two sciences,  or rather these  two branches
of the  same  science, it is evident that as soon as  the one has  as-
sumed the right  path, it is  natural the other should  follow.
  It is not my  intention,  then,  to present here a history of  the
functions, viewed abstractedly; but rather to give the history of
the physical life of man.   Our  object is to know the appearances
that the animal  matter of which  he is composed  assumes,—to
discover the  organs that  are  formed from it,—the  order in which
these organs  are presented  to the action of external bodies,—the in-
ternal changes that are brought about, when those bodies we  de-
nominated modifiers  (modificateurs) are placed in connexion with 
•
              COMPOSITION OF THE HUMAN  BODY.           13

the organs—the manner in which organs primarily modified, mo-
dify others; and, if these latter operate on a third series, to ascer-
tain the nature of this action and when it will cease.
  It is impossible that, in this study, we should not comprise that
of the functions;  indeed, it even  appears evident to me, that  the
history of the  functions, when studied according to our method,
must be more clear, and less clogged  by repetitions,  than it can
possibly be when investigated  in any other way.   On the other
hand, as the functions will  sometimes deviate from the  rhythm
which constitutes health, it naturally follows, that in our history
of health," we must include that of the causes of disease,  or  the
whole science of etiology.
                        CHAPTER II.

           OP THE COMPOSITION OP THE HUMAN BODY.

  The animal matter which enters into the composition of the hu-
man body, is distinguishable into, 1. the fixed animal matter, con-
stituting the texture of the organs; 2.  into the moveable animal
matter, or the fluids.   The former is arranged in such a way as to
leave, in its interior, intervals or cavities of greater or less dimen-
sions, in which the latter is kept in a perpetual state of motion.
Independently of these cavities, the  fixed  animal  matter is perfo-
rated on its external surfaces, and on such of its internal surfaces
as are in relation with external bodies,  by innumerable  openings
through which these bodies penetrate, or through which  molecules
that constituted, before, a part of the fixed or of the moveable ani-
mal matter, escape.
  Gelatine, albumine,  and  fibrine,  are the  principal  forms of
fixed animal matter.   They exist in various proportions in the dif-
ferent organs or apparatuses  (appareils).   They assume in  the
greater portion  of the body the form of lines or filaments, more
or less distinct from each other, and to which the name of fibres is
applied.
  By the word organ we are to understand  a portion  of animal
matter, arranged in such a manner as to render it capable of perform- 
11
COMPOSITION OF THE HUMAN BODY-
 ing at least one of the acts which contribute, in a manifest degree,
 to the maintenance of life.   Whenever several organs are united
 together, and associated for the accomplishment of a same object,
 they constitute an apparatus.  The common aim of this associa-
 tion of organs, and of the acts depending upon  it, is a function;
 and the object as well as the common result of the assemblage of
 the functions, is the maintenance of life.
   The principal functions are confided to internal apparatuses, de-
 nominated viscera.  There exist  also assemblages of organs, di-
 rected to the  accomplishment of the same end, which are not  con-
 tained exclusively in internal cavities, but which from  these cavi-
 ties extend to various regions of the body.   They are denominated
 indiscriminately organic systems or apparatuses; such for exam-
 ple as the vascular and nervous.  The name of organic system is
 also applied to different tissues, which, without having among them-
 selves any communications, yet resemble each other both in their
 structures  and in their vital actions: thus,  the diaphanous mem-
 branes, or sacs  without openings, which cover the  external sur-
 face of the viscera contained in the three cavities, in order to facilitate
 their movements, are  designated  collectively by the term serous
 system.   It is in this sense likewise, that we apply the word syno-
 vial system, when we wish  to represent the assemblage of those
 little sacs without openings, which facilitate the gliding of the mov-
 ing surfaces of the joints,  and of the  sheaths of the tendons.   Bi-
 chat, from whom we have derived these divisions and this language,
 has classed together the  ligaments that are  destined  to strengthen
 the joints, or suspend bones or other organs of considerable weight
 —the periosteum,  a kind of membrane which is spread upon the
 bones,  and which, wherever there is no insertion of tendons or liga-
 ments, separates them from the other tissues—the more or less solid
 envelope of certain viscera, as the proper tissue of the spleen, of the
 kidneys, that which contains the  apparatus of the eye and gives it a
 spherical shape (the sclerotica)—the external envelope of the caver-
 nous bodies; to these organs  he  has applied  the name of fibrous
system.  The bones, which are almost all in  connexion with each
other, are designated by the double terms, osseous system or appa-
ratus; but the cartilages, and fibro-cartilages, are merely the appen-
dices of this organic system.  Finally, the muscles, or locomotive
powers, have received also the name of muscular system or appa-
ratus.   It would appear, however, that the  assemblage of these 
r
              COMPOSITION OF THE HUMAN BODY.           15

organs does not deserve the name of apparatus, and that this term
should  be restricted to the union of the muscles with the bones,
cartilages, and ligaments; these constituting together the locomo-
tive apparatus.
   In the early periods of life, all these organs, as regards the ap-
pearances of the matter which constitutes them, are homogeneous—
nothing being distinguishable in  them but a whitish albumino-
gelatinous matter.  In the progress of time,  however, the  three
principal forms of animal matter become more distinctly marked,
and each enters into the composition of a series of particular organs.
The bones which constitute the basis of the edifice, present nothing
but a mass of gelatine, combined with a saline substance (phos-
phate of lime).   The cartilages, ligaments, and articular capsules,
organs partaking of the osseus  parenchyma,  and constituting the
appendices,  complements, and means of union of  the  various
pieces composing the skeleton, are formed of a gelatine combined
with a smaller proportion  of saline matter than that of the bones.
The tendons, a kind of appendices  by which the muscles terminate,
and  which affords  them  a means of union with the bones, are
also composed only of gelatine.  The same may be said of the apo-
neuroses which assume the form of membranes, destined either to
contain the muscles submitted to the power of volition, or to afford
them points of insertion; but the muscles, properly so called, pre-
sent themselves to our observation as bundles of greater  or less
dimensions of red fibres; and these consist of that animal matter
at first denominated gluten, but which, owing to the  fibrous  form
which it constantly assumes, has received the name of fibrine.
This matter is found  in the muscular tissues, whether they  obey
the power of the will, or are independent of it and belong only to
the viscera.   The hollow cylinders which act as the conductors of
the blood  in its passage from the heart to the different organs, and
are designated by the name of arteries, consist partly of gelatine,
and  partly of a fibrine assuming a peculiar aspect; but those that
carry the blood and lymph to the heart, present little else than ge-
latine,  except perhaps in that part of their course where they are
more voluminous,  and nearest  the heart; for here, in some ani-
mals, fibrine is discovered.
  Albumen, which derives its name from its resemblance to the
white of an egg, is contained only in the brain and spinal marrow.
The whole mass of  these organs, however, does not consist of it; 
16
COMPOSITION OF THE HUMAN BODY.
 *ince in them, as in other parts of the body, the small vessels, arte*
 rial or venous, are merely cylinders of gelatine: this matter consti-
 tutes also the tissue of the arachnoid, or of the membranous sac
 without opening, which lines the internal surface  of the cranium
 and spinal canal, and is reflected over the medullary mass and its
 principal convolutions.   Gelatine  is also found  in that portion
 of cellular tissue, which, under the name of pia mater, supports the
 vessels of the brain and spinal marrow.   The nerves appear to be
 formed of gelatinous cylinders;  and if albumine exist in them, it
 can only be in a small proportion.   Fibrine is said to have been dis-
 covered in  the ganglions of the great sympathetic nerve.   The skin
 and the internal membranes of the hollow organs, both by their pro-
 per tissue, and  by the vessels and nervous extremities with which
 they  so plentifully abound,  are gelatinous; nevertheless,  as  these
 nervous extremities appear, in them, to be in a pulpous state, we
 might be led to infer that there exists also some albumen, since it is
 found in the cerebral pulp.  To the chemists, therefore, we are to
 look for certainty on this  subject, by their well separating  these
 tissues, before submitting them to analysis, from all foreign matter.
 The cellular tissue, which is also called laminated or areolar,  is
 the most simple form of organized animal matter;  it appears to be
 the matrix of all the organs; that which is first formed,  and in the
 midst of  which all the others are developed.  It supports, unites,
 isolates them, facilitates their movements, and appears in all their
 interstices.  This tissue, which is so universally spread and so impor-
tant, is composed of gelatine nearly in its pure  state.
  From  the  preceding observations, it is easy to perceive,  that
none  of  the  parenchymatous viscera  and  secretory glands are
 composed exclusively of one of the forms of animal matter.  All,
in fact, being furnished with blood and lymphatic vessels, excreto-
ry ducts, nerves, and cellular tissue—many of them possessing, be-
sides these tissues, a serous, muscular, and mucous membrane, it is
evident that the three principal forms of this matter must necessa-
rily be found in them.
  These  three forms predominate  likewise in the fluids,  or, in
 other words,  in the free and circulating animal matter, known com-
 monly under the name of blood.   There exists, besides, a red co-
 louring matter, which, in the greater number of animals, appears
 to be associated with fibrine.   We likewise find in the blood those
 saline substances,  or at least their  elements, with which  certain 
             VITAL PROPERTIES OF THE TISSUES.           17

gelatinous tissues become encrusted: but what seems most worthy
the attention of philosophers, in the history of the animal fluids, is,
that with gelatine, albumen, and the fibrine of the blood, certain or-
gans have the power of engendering new forms of animal matter.
Thus the follicles of the skin produce a sort of fat or wax, somewhat
analagous to that found in the interior of the bones, and in the adi-
pose tissue.  These liquids bear some analogy to vegetable oils.
The follicles of the internal membranes of relation, form the mu-
cus, which appears to be nothing more than a modification of gela-
tine.  It is in this way also that the kidneys fabricate urea; the liver,
adipocire; 4the breast, milk, &c.; without mentioning "the more or
less extraordinary forms, which animal matter can assume  in in-
flamed parts and on suppurating surfaces.   It is worthy of notice,
that if all these varieties become the prey of some carnivorous  ani
mal, his digestive powers and the secondary assimilation soon con
vert them into gelatine,  albumen, and fibrine.   These three prin-
cipal forms of animal matter are, therefore, those which merit prin-
cipally to fix our attention; and that, too, so much the more, as to
them alone nature has attached what physiologists have denominated
vitulproperti.es.
                       CHAPTER  III.

OP THE VITAL PROPERTIES OP THE TISSUES; VITAL POWER; VITAL
                            LAWS.

  The  tissues  are  endowed with  only one  apparent  property,
which manifests itself by the condensation of the animal matter,
at the moment this latter is placed in relation with an external
body.   If this property  be examined in each fibre  in  particu-
lar, it is easily discovered to consist in a simple shortening.  Phy-
siologists have called it contractility.
  Whenever the fibre contracts in consequence of being  touched
by some agent, it is inferred that it has felt the presence of this
agent; from this is derived the term sensibility.  Hence physio-
logists have  attributed to the living fibre both sensibility and con-
tractility.   But, if  the true meaning of these two words may  be
                             3 
lb
VITAL  PROPERTIES
understood thus, "thefibre has contracted because it has been im-
pelled to do so by a cause," it naturally follows that  the  first of
these properties is a necessary  consequence of the latter.   For if
the sensibility of the fibre be rendered evident only by  its contrac-
tion, when we say that the fibre is sensible, we imply  that it has
contracted.  I see no reply to this argument.   The  truth  of this
remark has long been felt; but it has been combatted by objections,
which have  prevented it  from  becoming  universally admitted.
These objections will be solved in the course of these observations.
   Contractility exists in different proportions, in the various forms
of animal  matter.   Fibrine  possesses it in the  most eminent de-
gree; consequently, when  nature wishes that an apparatus should
execute extensive movements, she places in it a large proportion of
fibrine. Fibrine possesses naturally so large a share of contractility,
at least in the condition in which it is  found placed in  the living
body, that  it tends continually to condensation, or, if we pay regard
to each of its fibres in particular, to become shorter. For example,
if the bones  are softened or broken, the muscles  become shorter;
if we divide these  latter in a transverse direction, each of their ex-
tremities retires towards its points of insertion:  and, in respect to
the hollow muscles, every one  knows that they continually  tend to
obliterate their cavities, which are maintained only by foreign bo-
dies interposed between their parietes.
  This contractile property is inherent in fibrine, whether this lat-
ter constitutes a part of a muscle, or circulates in the interstices of
the tissues; but this latter can exercise it only when it ceases to be
subjected to the movement of the circulation.  The state of life is,
therefore,  opposed to the complete condensation of the fibrine of
the blood, as it is to that of the organized fibrine;  and, undoubtedly,
nature, or rather her author,  employs this tendency for the  accom-
plishment  of important purposes, with  which,  however,  we are
not yet entirely acquainted.  As soon  as the blood is at rest, the
molecules of the fibrine, which were before  scattered in that fluid,
approach each other and separate from the serosity, carrying along
with them, in their interstices,  a large  quantity of gelatine, a less
proportion of albumen, and all the colouring matter; it is this which
constitutes the coagulum of the blood.  The greater part of the al-
bumen remains in  the serous fluid, which the fibrine  seems to ex-
press from its pores, by being condensed  like a  sponge; as if this
matter was a dissolved  flesh, containing the other fluids in its inter- 
OP THE TISSUES.
id
fetices, in the same way that it is itself contained in those of the or-
ganized tissue.  It is on this account that the name of circulating
flesh (chair coulante) has been applied to the blood.
   When separated  from the body, the muscles do not lose their
contractile power;  it continues to be  developed  by a number of
mechanical and chemical agents, and still more powerfully by the
influence of galvanism.  It would be useless to endeavour to dis-
tinguish this property from that developed in those tissues through
the influence of life; it belongs essentially to  that form of animal
matter called fibrine, and can only be destroyed by its spontaneous
or artificial decomposition.
   The fibrine of the muscles, when considered in the state of life
and  organization, is often impelled to a degree of contraction greater
than that it manifests in its habitual state,  and which  necessarily
depends upon its chemical composition.  It is from this impulse
that movements of a certain magnitude,  the voice, and  more espe-
cially locomotion, are produced.  The  nerves  are the natural con-
ductors of the influences determining  this increase of muscular
contraction.  We shall  speak of them  in another place; but it is
necessary to  advert here  to the fact,  that the difference in the
nerves  acting upon the fibrine of the muscle,  does not  change,  in
the  least  degree, the  nature of their  contractility.    Hence  the
words animal contractility—sensible organic contractility, do
not express  different properties; but can only serve,  in the actual
state of the science, to represent two circumstances,  under which
a property,  that is invariably the same,  is manifested.   For exam-
ple,  let us suppose that the visceral muscles were placed in relation
with the nerves of the encephalic apparatus; in this case they would
be endowed with animal contractility;  whilst on the contrary, in
the muscular fibres of a palsied limb, the organic contractility alone
remains, because the limb is deprived of all communication with
the cerebro-spinal nervous apparatus.
  Next to the fibrine,  the form of  animal  matter, endowed  with
the greatest share of contractility, is gelatine;  but, unlike what is
perceived in fibrine, considerable differences  are observed in it,
according as it is more or less pure,  in  the various regions of the
body.  The cellular and laminated tissues are contractile, and even,
like  muscular fibres, constantly tend, though with much less energy,
to condensation; but they return slowly to their former state.  When-
ever nature  designs that the organic  gelatine should be  more  con- 
50                   VITAL PROPERTIES
tractile than it commonly is, she combines with it a small portion of
fibrine; as we observe in those cylinders constituting the vascular ap-
paratus.   In some instances, however, they are, to a certain extent,
endowed with this contractility without such aid.   For example, I
am not aware that fibrine has been discovered in the small veins,
in the lymphatic vessels, and in a number of excretory ducts, the
contraction of which is very evident;  nor is it said to have been
found in the skin, the contractility of which, during a chill, is often
manifested with  great promptness.
   If the cellular filaments situated under the peritoneum, and be-
tween its  duplicatures, are susceptible of becoming shortened af-
ter being elongated, it is  not the less certain, that this serous mem-
brane, as well as that of the lungs,  is enlarged and  condensed, in
order to  conform itself  to the volume  of the viscera which it
envelopes.
   The gelatine of the ligaments and aponeuroses does not appear to
possess extensibility  or contractility; which, however, depends less
upon the crossed direction of the fibres of these tissues, than upon their
combination with certain saline  principles.   The same remark  is
applicable to the tendons, which  in youth retain for a long time
some  degree of contractility.    In respect to the  cartilages  and
bones, their contractile power becomes apparent, whenever, owing
to a morbid  state, they are deprived of the calcareous  phosphate
with which they are  naturally encrusted.
   Of all the  forms of animal matter, albumen is that endowed with
the least degree  of contractility;  nevertheless, in  a great number
of instances, it is possible to show that it possesses some.  When
raised  mechanically, not only by the  impulse of the blood sent
with violence  by the heart through all the encephalic vessels, but
also by the effect of expiration, the cerebral  mass regains imme-
diately its pristine state, by means of a movement of condensation
directed from all parts towards its centre and basis.   Such also  is
the direction of those lines of medullary matter which converge to-
wards the mesocephalum (medulla oblongata).  We moreover ob-
serve, in the encephalic apparatus, duplicatures and surfaces corres-
ponding to each  other,  and  the contact  of which is rendered more
easy by means of a serous  membrane analogous to those that line
the other visceral cavities.   This is sufficient to prove to us that
the organs contained in  the encephalum execute movements of
friction (glissemens), and  even  displacements of some extent. 
OF THE TISSUES.                     21
which can be explained only by supposing the organized albumen
to be endowed with a degree of contractility peculiar to it
  We do not discover an extensive or rapid contractility to be mani-
fested by the nervous cylinders denominated neurilema, and which
are regarded as  a continuation of meninges or enveloping mem-
branes of the brain; but we know, that these small tubes, which are
joined together and contained  in the same envelope, are formed of
gelatine, which, like that contained in many other organs, is endow-
ed, owing to its  being combined with some inorganic substances,
with a slow contractility.   In respect to the almost or quite  fluid
matter which is discovered in the interior of each of the little ner-
vous cylinders, I do not know whether it is constituted of an  albu-
men analogous to that forming the intra-cephalic or spinal white
lines, or of a peculiar form of fixed or free animal  matter, which
has not hitherto been obtained separately or submitted to a  special
analysis; but I find that this interior of the nerves is, of all the tis-
sues of the economy, that in which the  fibril  form and contrac-
tility are with  the greatest difficulty shown to exist  It appears
to me, moreover, that we are  reduced to the necessity of admitting
both, purely by means of induction.  However this may be, I do
not believe, even if we were to discover a movement of condensa-
tion in those cylinders (hollow or not) which constitute the nerves,
that this discovery would teach us what we wish to know respect-
ing the mode of action of the nervous system.  Every change oc-
curring in  the minute extremities of the fibres, vessels,  &c, or, in
other words, in the interior of the tissues, when their molecules
are placed in relation with those of the circulating fluids, is situated
beyond the reach of our  senses.   We perceive the movements of
contraction in the forms of animal matter which nature has entrust-
ed with extensive movements; but it is absolutely necessary, that,
anterior to these great condensations, there should be molecular
movements, by which the former are determined.   These  latter
movements, even when they occur in the interior of masses of fibrine,
are entirely unknown to us; how could we pretend, therefore, to dis-
cover and  to investigate the movements which take place in the in-
terior of the encephalo-nervous apparatus;  or, in other words, in
that form of animal matter which excites all the others to action?
   From the preceding facts and observations it results, that, with
the exception of the molecular movements, which, as we shall see,
 are placed within the domain  of vital chemistry (chimie vivante), 
*£
VITAL  PROPERTIES
   all those that are discovered  in the organized animal matter, are
   reducible to  the exercise of contractility.   This  latter  is conse-
   quently a vital property.   It may, perhaps, be objected thaVit is~
   not purely vital, since it continues to be manifested, for some time,
   in those portions of organized matter that have been detached  from
   the body; but this should be viewed as a vain subterfuge; for such
   a property has been given to this matter,  in order that it should
   assist the exercise and maintenance of the  functions which contri-
   bute to the preservation of life. The name of vital must, therefore,
   Ptill be applied to it.   Let us now endeavour to  determine what
   idea we should form of sensibility.
    We have already seen that local sensibility, or,  in other words,
  that which is considered purely and simply in the fibre that contracts'
  through the influence of a stimulating agent; that sensibility which
  is not transmitted to the mind (moi), and of which, consequently,
  we are not conscious; that sensibility, in a word, which Bichat has
  designated under the name of organic, was a mere abstraction of the
  mind—a conclusion drawn from the movement of contraction, and
  viewed as the effect of the stimulating  agent.   It results from this,
  therefore, thatwecannot, with propriety, regard itas a property of tis-
'  sue; but, can we refuse this name to the sensibility of which we are
  conscious, and in virtue of which we experience pleasure andpain?
   Pleasure and pain doubtless indicate  to us the movements that
  occur m our tissues, whenever  these movements attain a certain
  degree of intensity; but from  this are  we to conclude  that  there
  exists a property inherent in  matter, and so widely  different from
  contractility, as necessarily to compel us to separate it from  the
 latter ?   With  a view of answering this question,  let us offer an
 example.   A man  punctures his finger;  the organic contractility of
 the part is increased, or, in other words, the movements are more
 precipitate in it than before.   If the nerves of the hand no longer
 communicate with the brain, the individual is free from pain  whilst
 on the contrary, pain is felt if this  communication exist; are not
 the viud  properties in both cases the same?_but let us  proceed
 Suppose that the pain resulting from the puncture has continued
 during the course of the day;  atnight a different state of thecentre
 of relation supervenes; the patient falls  asleep, and no longer feels
 the  pain    Let me again  ask whether  the vital properties of the
 punctured part,-of the nerves through the medium of which this is
 made to communicate with the brain, or of the brain itself, are dif. 
Of THE TT93TJES-
23
ferent under these two circumstances ?  Every one, I am convinced,
will answer in the negative.   Besides, what  should we think of a
moveable property ?  Is it thus with  regard to contractility ? It
never abandons the tissues  endowed  with  it,  unless  they have
lost their natural chemical composition.  It is very evident, there-
fore, that sensibility is not a property  that can be placed on a pa-
rallel with contractility.
   If sensibility, and even that too of which we are conscious, is not
of that nature, we  can view it only as a condition, manifesting it-
self in a transient manner, in the organised animal matter; and it
can be demonstrated that this condition is ftself subordinate to the
different  states  of contractility.   Thus,  organic contractility has
been exalted in the punctured  finger we have alluded to.   If the
brain be in a state of wakefulness, and in health, the nerves which
establish  the communication between  the wound and that viscus,.
excite in  it another increase of contractility, analogous to that pro-
duced in the wounded finger, and  pain is felt.  It is not risking
too much to assert, that the brain experiences  an increase of organic
action or contractility;  experience proves this to be the fact; for
if the pain be acute, the blood accumulates  so abundantly in that
viscus,  that the face partakes of its congestion, and the excitement
it experiences is spread very quickly  to a number of nerves, pro-
ducing  similar changes in the structure and functions of the  mobile
tissues.   Hence this influence will excite  convulsions in the mus-
cles—congestions of blood in the viscera and secretory organs—su-
per-secretions—extravasations—hemorrhages, &c. &c.; phenomena
depending essentially  upon an acceleration in the contractility of
thp smaller vessels, or, in other words,  in an increase  of organic
contractility.   To this  it will perhaps  be objected,  that in those
cases in which pain does not develope these phenomena,  it is not
productive of an organic excitement in the  brain.  In  answer to
this, however, it may be observed, that pain invariably produces
this effect;  for even in those instances in which the patient would
possess sufficient command of himself to suppress all complaints,
and not execute the most limited  muscular  movements,  his fea-
tures would be  altered,  the colouration  of his face would change;
and assuredly these are external organic movements,  the direct re-
petition, not of those occurring in  the wounded finger,  since they
do not  follow whenever the nerves of the hand no longer commu-
 nicate with the brain, but of the organic movements excited by the 
24
VITAL PROPERTIES.
pain, in this viscus itself.   But this stoic whom we thus represent
as feigning to be insensible to bodily suffering,  experiences more-
over painful sensations in the epigastric region.   Now  these sen-
sations indicate changes to have occurred in the circulation of the
interior of the stomach, analogous to those observed upon the face;
and indeed these changes are so  real, that his digestive functions are
affected—the secretion of the bile  is deranged, &c.; phenomena
which necessarily imply the existence of an alteration in  the organ-
ic contractility of that viscus.
   It will perhaps be maintained, as a farther objection to this opin-
ion,  tha£ these disorders take place in such instances only in which
pain becomes violent, and that  their absence during slight pain or
pleasure is sufficient to show, that sensibility can be exercised with-
out an increase in the contractility of  the brain.   I must confess,
however, that I cannot conceive that a  change should occur in the
condition of the brain, capable of giving rise to pleasure or pain,
and  yet be unattended with organic movements,  and without  an
afflux of fluids towards the modified  part  I even maintain, that
the derangements of contractility to which I have already alluded,
are only, and can be nothing more than, the exaltation of these same
changes of the brain, and that by increasing them  they prove their
existence, in the same way that the  microscope, in augmenting all
the dimensions of small objects, enables us to appreciate their form.
   Let us now  have recourse  to another series of  facts,  capable of
determining the  true  character of sensibility.   We have already
seen that the properties of the  tissues  could not have changed du-
ring sleep, which suspends the pain  felt by a man in a wounded
finger.  Nevertheless, it  is sufficiently known,  to all  observers,
that if this pain be very acute,  and has had time to excite a local
inflammation of some degree of intensity, the arm,  during  sleep,
will preserve some heat—the pulse will also be accelerated__fever
will supervene, and the brain will be so much excited, that the pa-
tient may even become affected with convulsive movements.   The
same occurs in a man, who is kept in a state of  sleep  by the in-
flammation of an internal organ.  Both these individuals at the in-
stant they awake will complain  of pain in the  inflamed part; but
they will both declare, that it completely disappears during sleep,
although we have the proof that their brain  is  at the same time
much excited.   If the organic  excitement of  the part,  therefore,
does not cease to be repeated in the brain, although the pain dis' 
VITAL  POWER.
25
appears during sleep,  we are naturally led to the conclusion, that
pain is not an invariable  result of the excitement of the brain; or,
in other words, that the organic action of the brain may be power-
fully excited by a focus of excitement situated in some other parts
of the body, although there does not  necessarily result a develop-
ment of  sensibility.   From all this, we may once more draw the
conclusion,  that sensibility cannot be  regarded  as  an inseparable
property of the tissues, and placed on a parallel with contractility.
   In what manner,  then, are we to view sensibility? As one of the
results of the exercise of our functions—a result immaterial and in-
comprehensible in its nature, accompanied, in all instances, with an
exaltation of contractility, but which is not inseparable from it.
We must also view it as a violent condition of our economy, which
must necessarily be intermittent, and the continuance of which, as
we shall have occasion to demonstrate in our pathology,  consti-
tutes a true disease.   As this phenomenon will again fix our atten-
tion, when we come to speak of the history of the relations, I shall
abstain from further remarks upon  it now, and proceed to the
subject of the vital power.
   The words vital power (force vitale) can offer to the mind only
the idea of that power which presides over the formation, deve-
lopment, and preservation of the individual.   Does this power re-
side solely in contractility, the only property of tissue which, of
all those admitted by authors, we have acknowledged?
   The power which  presides over the formation, development,
and preservation of the body, is that  which accomplishes the  assi-
milation of nutritive substances—extracts from them gelatine, albu-
men, and fibrine—regulates the form, consistence, volume, and dura-
tion of our organs, and re-establishes them in conditions requisite for
the state of life and health, whenever, in consequence of the action
of a morbid cause,  they have deviated from these conditions.  Let
me now ask, whether contractility  would be competent to produce
all these effects ? As well  might we say, that contractility creates
itself; since we have seen,  that it essentially belongs to the form
of animal matter which the vital power is alone  capable  of cre-
 ating.  Contractility, therefore, can only be viewed as one of the
 products of the vital power; as a means it employs to execute those
 movements that must co-operate to the maintenance of the func-
 tions.
                              4 
26
VITAL  LAWS.
  The vital power or force, therefore, necessarily exists anteriorly
to the properties, or rather anteriorly to the fundamental property
of the tissues; it first creates it, and next employs  it as an instru-
ment for the purpose of procuring  materials with which it works
continually to the composition  of the living body.   Contractility
and sensibility of relation, which, however, I have proved cannot
be placed on a parallel, are consequently evident proofs of the ex-
istence of the vital power; but they do not constitute it.
  In relation to the essence of this power, we are entirely ignorant;
for it is a first cause; but it manifests itself to our senses by changes
of form  in matter.  These  changes consist  in. a special  modifi-
cation occurring in the molecular affinities, which preside over the
chemistry of inanimate bodies;  in other words, it manifests  itself
by chemical phenomena—but of a chemistry proper to each of the
living  bodies.  This vital chemistry (chimie vivante)  is the most
remote  of the phenomena which strike  our senses:  doubtless it  is
not the vital power, properly speaking, but rather its first, its invisi-
ble,  its immaterial instrument, of which  we are made acquainted
by the exercise only of our reasoning faculties; in a word, it is the
instrument,  by means of which the vital  power creates, in its ac-
tion on  matter, the secondary instruments which are purely mate-
rial, and perceptible to our senses, and  in which  we can discover
what we denominate the vital properties of tissue.   To me it ap-
pears evident, that we cannot extend further our researches into the
vital power, without launching into the boundless field of hypothesis.
  The vital laws consist  in  a  certain number of general pheno-
mena, common to all the tissues, and which are discovered with so
much constancy and regularity,  in all animals, that we are led to
regard them as laws inseparably connected with the state of life.
They are, in some sort, general functions, or facts, constituting a
part of the  great function, which is  life  itself.  I shall  now notice
those that appear to me most striking, and a knowledge of which
is indispensably necessary, in order to study, with advantage, the
history of living man.                              >
  I.  The first circumstance,  constantly noticed in the system, is,
that contractility is modified, or, in other words, is made to deviate
in a greater or less  degree from its actual  mode, by all external
bodies applied to the economy.   Are we to view these  modifica-
tions as the result only of a pure and simple augmentation or dimi-
nution of the contraction or motion, whatever it may be, of our 
VITAL  LAWS.
tissues ?   Be this as it  may, there always exist several possible
modes in the deviation of contractility, which  cannot be pointed
out in a general way, unless by saying that each modifying agent
produces one peculiar to  itself.
   II.  When the organic  movements of contractility are accelerated
in a portion of the living tissue, or of the fixed organic matter—in
other words, when action or motion augments in a part, the fluids
or moveable organic  matter are attracted towards it;  from this has
arisen the axiom, ubi stimulus, ibi fluxus.  But if the con-
traction, although increased, becomes permanent, so that the fibre
remains  tense and  shortened, without motion, or  at least less
agitated than  before, this extraordinary attraction  of free  fluids
does not take place.  It even appears probable that a contrary state
occurs, and that the  fluids are repelled from the part in which this
fixed and  permanent contraction exists.  This constitutes the state
of spasm.
   III. Whenever the organic movements of contractility are in-
creased, and the fluids attracted, in a region of the  economy, the
density, and even the volume of this part increase, and it assumes
dimensions that are  determined  by tissues  destined  to that effect.
These constitute the vital erections, the degrees of which are  as
various as the form and vitality of the organs.   All elongations and
tumefactions that are not the  effect of muscular actions, or of the
forced retention of the fluids,  are to be regarded as vital erections.
Consequently there  does not exist, as many authors  have asserted,
and as some physiologists still believe, any expansive power inhe-
rent in the elementary fibre.   Vital erections are continually ex-
cited in the economy; since all prominent organic movements—all
those which determine locomotion, must be numbered among them.
These vital erections, when they have attained a certain degree of
intensity, are denominated irritation, super-irritation, or super-
excitement.
   IV. In all vital erections there is an increase in the phenomena
 of vital chemistry;  as for example, of temperature, of secretion,
 when the part  is endowed with this  property, and of nutrition;
 phenomena which depend,  in fact, on the  transformation of the
 fluids, and imply the occurrence of changes, brought about by the
 vital power, in the  molecular affinities.
   Hence, in  order  to connect here all that we have already re-
 marked,  we shall say, that contractility and the vital chemistry are 
J&
VITAL  LAWS.
 the fundamental phenomena of the animal economy, and that when-
 ever they become more apparent in one part than in another,this local
 increase in their intensity receives the name of vital erection.
   V.  Vital erections  subside  after a  longer or shorter space of
 time;  under these circumstances, the vital phenomena are generally
 less  evident in the affected part, than  before the development of
 these erections;  or else they are changed into a state of constriction,
 by which the fluids are repelled; in other words,  into an organic
 spasm; or, finally, they attain the  degree of inflammation and of
 sub-inflammation.
   In  all we have hitherto  said, the vital  phenomena have been
 viewed only locally; we must now advance further.
   VI. Whenever vital erections, irritations, excitations, and super-
 excitements, are developed in any part of the system, they cannot
 attain a certain degree of intensity without being transmitted to
 other parts: but here many differences are remarked, either in re-
 lation to the primary seat of the vital erection, or to the part to
 which it has been transmitted.  These differences depend on  the
peculiar  nature  of the different organs.   In those  that  are  not
encrusted with calcareous phosphates, the vital erections progress
more rapidly, and attain sooner that degree of intensity, at which
the transmission towards  another  point  must  take place, than
in those in which  this encrustation  exists.  In  parts abounding
with blood-vessels,  and with nerves, the vital erections progress
with still greater rapidity, and are much sooner transmitted. If we
examine now the vital  erections in  relation to the part to which
 they are transmitted, we perceive that the tissues of the last series
are the first affected, (the cause of which  we shall presently see,)
 whilst, on the contrary, the tissues composing the two first series,,
 are affected with extreme difficulty.
   VII. The transmission of vital erections, or of  irritations, is ef-
 fected through the medium of the nervous tissue, which is specially
 destined to that use.  Thus, in  perfect animals, nervous cords, pass-
 ing from the different organs to the cerebro-spinal marrow, are in-
variably found to exist.  In  proportion,  therefore,  to  the abun-
 dance with which an organ is supplied with these nerves, will be
 the rapidity with which the irritations developed in it  are trans-
 mitted, either to the cerebral  or spinal centres, or to other organs
 equally well supplied with nervous cords; whilst, on the contrary, 
VITAL  LAWS.
29
the irritations of organs, in which the number of these cords is
limited, are invariably transmitted late, and with difficulty.
  VIII.  The transmitted is of  the same nature as  the primary ir-
ritation ;  it is always essentially the same phenomenon, whether
examined in the part primarily  affected, whether it be traced along
the nerves that transmit it, or viewed even in their common centre;
or,  finally, whether examined in the organ in which these nerves
create, secondarily, a vital  erection similar to the first  But this
requires to be developed.  When I maintain that  the irritation is
of the same nature, notwithstanding the difference existing in the
tissues in which it manifests itself, or in the changes it produces in
them,  I wish to convey the idea, that it is invariably the result of
the action of an agent, which has exaggerated, or rendered more
evident, and better marked, the phenomena that point out the state
of life.  The following may be  adduced as proofs of the correctness
of this assertion.
  When the irritation, originating in a focus of vital erection, tra-
verses the nerves, it increases  their action and attracts the fluids
into them;  it produces  the same effect  in the encephalum  and
spinal  marrow, as well as in the other tissues to which it has been
reflected by these organs.
  IX.  Those agents that develope the phenomena of vitality in our
tissues, as well as in those of the greater number of warm-blooded
animals,  may be divided into two series.    Those of the first exalt
these phenomena in a direct manner; whilst those of the latter, first
diminish them, or render  them less apparent, after which they
reappear with a greater degree  of intensity than they  manifested
before their diminution.   We  are consequently compelled to re-
cognize,  in perfect animals, the existence of a law, by virtue of
which the  power presiding over life reacts against debilitating
causes; it is this which constitutes vital reaction.
  X. Caloric is the first and  principal excitant of vitality;  it  is
this agent that gives to the germ the faculty of appropriating to
itself nutritive materials, and employing them for its development.
It continues to fulfil the same object during the whole course of
life; whenever it is wanting, other stimulants no  longer produce
their accustomed effect,  and death is the consequence.    The  pro-
perties of the tissues continue, it is true, to manifest themselves for
some time; but they can no longer suffice to the maintenance of life;
finally, chemistry of inorganic substances succeeds in  destroying 
3u
VITAL LAWS.
them, and, together witli them,  all the phenomena  capable of re-
calling to the mind the idea of life disappear.   The embryo is sup-
plied with caloric  from all the  bodies that possess more than it,
and, as is the case in the more perfect animal, by its mother.  After
this, life elaborates, in the same embryo,  those organs which must
procure it caloric,  by deriving it, during the  whole course of its
existence, from the atmosphere.
  XI.  Next to caloric, we discover a great number of agents ca-
pable of exalting the phenomena of life.   The principal are those
which nature has destined to the maintenance of. the functions, and
more especially those that contribute to the nutrition of the animal.
They act in an immediate manner, or else through the medium either
of the air or of light; and constant relations are established  between
them and the different  organs on which  they are  to produce an
action.   At any rate,  whatever may  be the agent or the organ
which receives its  impression, the result  of their relations invaria-
bly consists in excitement.   I shall not enter here into a  detail of
these agents, in order  not to lose sight of the principal  object of
this treatise; but they shall be mentioned afterwards, whenever the
knowledge of their  action will furnish  some data to physiology,
pathology, and therapeutics.
  XII.  The causes of the diminution of the vital phenomena are
either positive or negative.   The principal  among them  is cold,
which,  according to natural philosophers, is nothing more  than the
absence of caloric, and must, consequently,  be classed among the
negative causes.   When cold acts upon the animal  economy, the
vital phenomena are diminished on the surface which is deprived
of its caloric; and, if we study the first results of this impression,
we  are forced to divide animals, in relation to this effect, into  two
principal classes.   Those  that are  cold-blooded do not react; they
are benumbed or die: those in which the lungs are large, and the
blood abundant, react, in a greater or less degree.   Some, as for
example the hybernating animals, sleep until the  return of heat;
others experience  pain in the part exposed to cold,  and this  pain
becomes a stimulating  agent, that reanimates all the vital pheno-
mena.    The reaction of the  vital power  against  cold  constitutes,
therefore, a law of the animal economy: this reaction, however,
has  a limit, beyond which the  non-hybernating animal,  like the
hybernating, becomes torpid; and,  if the subtraction of the caloric
continues, they both finally die. 
VITAL  LAWS.
31
   XIII. Among the other causes of the diminution of the vital
phenomena, we must place the subtraction of nutritive materials, as
well as of the fluids, and all the agents necessary for the exercise of
the functions; and it will be constantly observed, that the power
which regulates life, reacts, in like matter, against the debilitating
modification resulting from their absence.  This reaction, however,
although precisely of the same  nature  as that which resists the
impression of cold, is less powerful than it; consisting, as  it does
always, in an  exaltation of the vital phenomena.
   XIV. When the reaction of the vital power against debilitating
causes, cannot succeed  in re-establishing vigour in  the debilitated
part, it is directed to other parts,  and produces in these, notwith-
standing the general  diminution of the quantum of strength and of
vitality, a super-excitement
   XV.  The positive agents that  occasion the diminution of the
phenomena of life, are much less known than the  negative.   They
have been denominated, by a particular sect of physicians, contra-
st imulants; but I believe them less numerous than those physi-
cians imagine.  As we should not class among them such as act
by subtracting caloric from the living body, I am of opinion that
they are reducible to a very small number.   Brown thought that
they could act  upon the body only by a mode of excitement repug-
nant to the laws of life.   His opinion deserves a serious discussion;
but it must be deferred until we treat of pathology.  It may be ob-
served here, however, that mucilage is the most remarkable among
these agents;  but as in some cases it is employed by the vital pow-
er for the purposes of  nutrition, I am inclined to believe  that it
is endowed with a peculiar  mode  of exciting  property.   The
same remarks  maybe made in  regard to water.  Acids cannot be
viewed in any other light than  as excitants; since, when introduced
into the system in their concentrated state, they produce a violent
excitement.   Be this, however, as it may, the vital power or force
does not react  against mucilage and water as energetically as  it does
against cold, when they are applied to it at the degree of tempera-
ture of the  body; a  condition  which  is necessary for preventing
them from acting as excitants,  or in order that the sedative  effects
may not be explained by the subtraction of caloric.
  After having seen the relations existing between the vital and
chemical laws, in the influence of caloric, and of all the external
bodies  which  are applied to the external and internal surfaces of 
32
VITAL LAU'S.
 the body, in order to be made use of for the purposes of respiration
 and nutrition, we must examine these same laws in their relations
 with the physical ones.
   XVI. The  physical laws are modified, in the living economy,
 by those of vitality.   The attraction of masses is first presented to
 our observation: let us examine it as it affects the whole body, and
 each of its parts.  This power tends to apply the mass of the living
 body to the  surface of the earth ; but by means of muscular con-
 traction  a part of its effects is annulled, and the  animal is thereby
 endowed with the faculty of elevating himself in part, or in total-
 ity; whence result walking and leaping.   Whenever the action of
 the cerebral  centre is suspended, as for example during sleep, the
 power of attraction resumes all its empire,  and the body remains
 immoveable  upon the surface of the ground.  If, by some muscu-
 lar effort, the animal body has separated  itself from that surface, it
 is once  more  attracted  towards it as soon as  this effort is ex-
 hausted.  If the point of support of the living body fails it, the at-
 traction of the  centre of the earth draws the body immediately
 towards  the point of its surface which  is nearest to that centre, ob-
 serving constantly a perpendicular line.   As the living body is en-
 dowed with  elasticity, the earth can  repel it, when,  by virtue of
 the power of attraction, it is  applied to it, with a certain degree of
 violence; but the effect of this percussion  is finally annulled by the
 power of attraction, which always  succeeds in bringing the body
 in apposition with the surface of the  earth.  Physical attraction
 overpowers, in all cases, the  power of  vital contractility.
   XVII. The phenomena noticed in  respect to the effects of at-
 traction on the entire mass of the body, are also observable in each
 of its parts, when these are viewed in relation with each other; but
 as it is not necessary to dwell on this subject here, we shall proceed
 to notice attraction as it acts  upon the  moveable animal matter  or
 fluids.
   XVIII. Attraction tends continually to draw  the  fluids to the
 lowest region of the living body ; but the contractility of the heart
 and vessels, offering a resistance to this  power, marks out for them,
 in the interior of these organs, a route they are compelled to follow:
 this constitutes another vital  law.   We have already noticed one,
 by virtue of which the fluids, circulating in the interior of the ves-
 sels, are diverted from the direction which the contractility of these
vessels tends  to impart to them, in order to flow towards those 
VITAL  LAWS.                       33
 parts where irritation is developed; from which results what we
 have denominated vital erection.
  When the contractility of the vessels diminishes, a less degree of
 resistance is offered to the power of attraction; under such circum-
 stances the fluids are attracted towards the lowest portion of the
 vascular system, in which they circulate.  Hence arise those pas-
 sive engorgements—those congestions from debility, which  must
 be discriminated with accuracy from those engorgements and con-
 gestions that are the consequences of vital erections.
  XIX. The atmosphere, in consequence of its weight, tends con-
 tinually, from the pressure  it  exercises on the living body,  to fa-
 vour the efforts of attraction.   Its action is first resisted by muscu-
 lar power; hence locomotion is  performed with much greater fa-
 cility in a light atmosphere,  as,  for example,  that of mountains,
 than in the heavy air of low countries.   Owing to  the same rea-
 son, this pressure of the atmosphere upon the surface of the skin
 tends  to occasion a condensation of the body, and to diminish its
 bulk;  but this effect, as it regards the visceral cavities, is counter-
 balanced by that portion of the same atmosphere which penetrates
 into the lungs and  digestive tube; and  as the  introduction of air
 in these cavities is the effect of  muscular power, it  follows that
 this latter contributes here also to the preservation of the  volume
 of the  body.
  The contractility of the heart and blood-vessels, by maintaining
 the fulness of the circumference,  contributes to the same end.  So
 considerable, indeed, is this power, that when the ambient air loses
 a part  of its weight, the former forces out upon the cutaneous sur-
 face a  portion  of the fluids  that have reached  the circumference.
 In this way it  is that the skin is suddenly  covered with sweat,
 whenever a man, after exciting his circulation by a violent  exer-
 cise in the open air, enters, without resting, a room, the atmosphere
 of which is lighter  than that in which  he was placed the instant
 before.
  Consequently it is in virtue of a vital law, depending upon the
 exercise of contractility, that we are enabled to resist the pressure
 of the  surrounding atmosphere.  All these facts will find their ap-
 plication in bur pathology and  therapeutics.
  XX. The imponderable fluids, known under the names of elec-
 tricity and galvanism,  and which are perhaps only modifications
.of general attraction, exercise, upon the living body, some influences
                               5 
Ci'l
VITAL  LAWS.
 that are modified by the power of life:  tins affords Us an Oppor-
 tunity of pointing out new vital laws.
   Electricity and galvanism manifest,  upon the animal body, ex-
 citing effects, that are observed  primarily in the nervous system,
 and secondarily in the tissues to which these nerves are distributed.
 These powers  traverse the nerves,  and determine an  increase of
 contractility in the fibrine of the muscular,  and in the gelatine of
 the vascular apparatuses.  They occasion muscular contractions
 and vital erections, against which volition cannot exercise the least
 obstacle.   When applied slowly, and in  a limited quantity, elec-
 tricity increases the mobility and power of the muscles—accele-
 rates the circulation to such a degree as  to occasion frequency of
 pulse, and  a considerable increase of caloric;  it revives,  with so
 much energy, the power of  absorption, that lymphatic  engorge-
 ments  are  sometimes  dissipated  in the space of  a  few minutes.
 Hence the  first vital law observed in relation to the  effect of elec-
 tricity, is a very manifest increase of contractility, and of its trans-
 mission from one part  to another; or, in other words, an increase
 of the sensibility of relation and of sympathies, which, as we have
 already shown, are the results only of contractility.
   XXI.  Whenever electricity acts with greater energy, and more
 suddenly, its effects, like those of galvanism, being more marked,
 it  gjves rise to violent  convulsions  in the  muscular system—to
 profuse extravasations, secretions, and excretions:  it is in this wav
 that galvanism excites hemorrhages, brings on a return of the men-
 strual discharge in women, and,  when it acts  in the direction of
 the digestive canal, occasions the sudden evacuation of the excre-
 ments. These modifications are merely an excess of those we have
 already noticed in the preceding paragraph.
   XXII. The excitement of contractility, produced  by galvanism
 and electricity, does not  fail,  when intense and often repeated, to
exhaust this property;  under such circumstances, the body is lan-
guid—the power  of  attraction predominates over that of vitality,
and, in general, nearly overpowers  the vital chemistry.   If  this
modification attain a  certain degree  of  intensity,  life is extin-
 guished,  and the  spontaneous decomposition  of  the body takes
 place with  much greater  rapidity  than after ordinary  deaths.  It is
 worthy of  remark, that caloric acts  in an analogous  manner;  and
that all deaths occasioned by  an excess of irritation, whatever may
be  the agent producing this, invariably dispose  the  body  to a 
          HISTORY OF  THE FUNCTIONS OF  RELATION.        <*•'

speedy decomposition.  From these circumstances we are led to
class galvanism and electricity among the most energetic excitants
of the animal economy.
             CHAPTER IV.

HISTORY OF THE FUNCTIONS OP  RELATION.
                     General Observations.

   Physiologists, of the present day,  are all agreed in admitting
in animals, two grand series of functions.   The one  destined to
 promote  their relations with  external bodies; whilst the  other
 consists in those acts,  the combination of which contribute to the
 maintenance and preservation of the individuals, and of the species.
 The first series is referred by them to the encephalo-spinal nervous
 apparatus, viewed in its centre, and  in its sensitive and motific ex-
 pansions; in other words,  to  the brain—to  its prolongation occu-
 pying the spinal canal—to the nerves of what  I denominate exter-
 nal senses, and also to those  of the locomotive, respiratory, and
 vocal muscles, which are all attached to the skeleton.  They assign
 the second, or functions of  nutrition and  reproduction, to the tho-
 racic and abdominal viscera.
   This division, which at first view  seems so clear and  satisfac-
 tory, offers, nevertheless, great difficulties when we endeavour to
 apply it to the study of physiology; because the phenomena of rela-
 tion are  far from being limited to the tissues, in which their domain
 has been placed by authors;  and beeause those of nutrition, commen-
 cing in the viscera,  are continued in  the nervous and locomotive
 apparatuses.
   The same  difficulties have arisen when physiologists have en-
 deavoured to study each function in particular, since there is  no
 apparatus that is not charged with the performance of several func-
 tions.   Be this, however, as  it may, we should not  be discouraged
 by such difficulties, depending, as they do,  upon the nature of the
 subject itself.  All the acts of vitality  are  united  and linked  to- 
 26                    HISTORY OF Till;
 getherin the economy; consequently,  we are frequently obliged
 to examine the same organ under several points of view; and, in
 some instances,  we are brought back again to the point whence we
 started, before we have succeeded in surveying the entire circle of
 phenomena presented by the state of life.
   From this arose the unconquerable difficulties encountered  by
 the ingenious Bichat, in his attempts to draw a  satisfactory line of
 demarcation,  between the functions of relation, which he  deno-
 minates animal life, and those of nutrition, which he calls organic
 life.  Without pretending here  to criticise this  author, and those
 whom he has copied,  or who have adopted him  as their model, I
 shall proceed to  examine the  functions in the manner I may think
 best calculated to convey a correct idea of them.  As our functions
 constitute an uninterrupted chain, from  our relations with bodies
placed at a distance from us,  to  the phenomena of composition or
decomposition, which occur in  the  interior of  our organs,  it ap-
pears  to me, that we should endeavour to examine all the links of
that chain—commencing with the most  apparent,  and  advancing
by degrees to those that become  imperceptible to our senses.
  I shall, therefore, commence  the history of  our  functions by
noticing  the relations which  connect us with external bodies; I
shall trace those  bodies as  they approach and  penetrate within us;
and study the influences they exercise  on our organs,  until that
point  at  which reasoning  and induction can no longer afford me
their assistance.
  I shall commence by presenting a summary view of the rela-
tions,  and next examine them in  the different media through which
nature procures them for us.

             Summary View of the Relations.

  I take man in  a state of perfect organization, deferring the study
of the development of his organs until this subject becomes natu-
rally linked to those I shall have already examined.
  Placed in the midst of the universe,  man lives and  preserves
himself by virtue only of  his relations with external bodies.  In
order  to be able to derive from them the means of subsistence, and
distinguish among these bodies  such as are proper for him from
those  that are useless or hurtful—to appropriate to himself the first
and reject the latter, it is absolutely necessary that 'he should be en- 
FUNCTIONS OF RELATION.
37
'lowed with organs destined  to correspond with them;  hence the
cause of these relations, as well as the means of exercising them,
are found within himself.  The cause of his relations are his wants,
whilst the means consist in the organs which present themselves
first to the action of the external bodies.
  The wants take their origin in the very exercise of life;  they
are perceived, in man, by the centre of relation; but if the external
bodies by  which they are to  be gratified are not in a state of cor-
respondence with the external surface, and if the centre of percep-
tion is not as yet apprized of them, there results from these wants
nothing but a vague sensation of uneasiness, difficult to define, but
which compels us to agitate ourselves without any evident motive.
Such  probably are  the  motions of the foetus, especially when he
approaches the period of his expulsion—such are doubtless the cries
he utters after his birth, and the irregular movements of his little
limbs.  We may moreover place on the same line, the uneasiness,
the sighs, and emotions of young pubescents who have been brought
up in entire ignorance of, and separated from, the objects capable of
gratifying their first desires.
  As soon as the external bodies necessary to the gratification of
our wants arc placed in relation with the external surface, the sense
with which this latter is endowed  gives  information of their pre-
sence to the  centre of perception—this latter immediately recog-
nises them—the perception is conveyed back to them,  and becomes
clear  for the animal that experiences the desire  of  appropriating
them  to himself.   During the earliest periods of infancy, and in all
instances where the nervous  centre is not restrained by any other
perception,  the  movements  necessary to the gratification of the
wants are commanded  and executed without delay.   Hence the
newly born infant directs instinctively his mouth towards the nip-
ple, as soon as the breast of his mother is  presented to him, or even
is  placed within his reach.   The child continues  always to allow
no interval to exist between the perception of his want and the
execution  of those acts proper to gratify it, until consciousness
(moi) is  developed and  sufficiently  exercised in him, and  until
his memory is so amply stored with recollections as to enable him
to  find motives for suspending the  acts solicited by his wants.
  Another question now presents itself.  What takes place in the
perception of the wants, and  in the acts solicited and  commanded
for their gratification, likely to be  evident to the senses of  th*> oh- 
3g                     HISTORY OP THi;

server ?  In order to answer this question, it is necessary to trace
the impressions  from the external senses to  the interior of the
viscera.
  The acts which, in virtue of the impressions  made on the exter-
nal senses, are solicited by the wants, and commanded by the cen-
tre of relation, are invariably a result of the actual condition of these
organs at the moment these impressions are made.  Let us illustrate
this by a few examples.
  An aliment is presented to the sense of sight, hearing, or smell;
if the stomach be in want of it, the perception is agreeable, and the
desire of appropriating the aliment is developed with energy.  If,
on the contrary, the stomach be full  or diseased, the perception is
disagreeable; the aliment inspires a  sensation of disgust, and the
centre of perception determines, or tends to determine, movements
proper for removing it.  The same is found to  be the case in  re-
spect to the  sensations relative to the propagation of the species—
to the impressions of heat and cold, and even  to respiration; for
we experience a reluctance to breathe a disagreeable and unwhole-
some air; whilst, on the contrary, the thorax dilates  amply, and with
a sensation of pleasure, when  suddenly we pass from a warm and
heavy air, filled with injurious vapours, into a free, pure, and cool
atmosphere.   It is very certain, therefore, that the centre of per-
ception judges of the impressions of external bodies only from their
relations with the viscera which these impressions can interest.
  But let us  proceed.   In order that this judgment should take
place, it is indispensably necessary, that the impression received
by the external senses, and transmitted  by the nerves to the centre
of relation, should be immediately reflected, by this latter, to  the
viscera.
  This mechanism is without  doubt indispensably necessary; but
we  are met by another  question: are  the impressions  reflected
only to the viscera which they specifically affect ? Does the odour
of the aliment affect the stomach alone? Is the  sensation resulting
from the sight and odour  of the female, and from  the sound of her
voice, directed,  by the centre of perception, to the genital organs
alone? Reason rejects the admission of this unity of direction to-
wards this or that organ;  for it would lead to the supposition, that
the impression is weighed and judged by the centre of perception
at the instant it reaches the brain; whilst we have  just proved, on
the contrary, that  it has no  influence on it until after the viscera 
FUNCTIONS OF RELATION.
39
have responded: at any rate, this is merely an induction, and as I
can offer more direct  proofs of the correctness of my opinion, I
shall not rest satisfied with it.
  The impressions relative to our wants, which are received by the
external senses, are reflected by the cerebral  centre to all  the vis-
cera, and even  traverse with the rapidity of lightning the whole
extent of the nervous system.   The following may be adduced as
proofs of this assertion.   Let us suppose that a carnivorous animal,
the wolf for example, is placed in a situation, from which he can
discover at the same moment his female and a sheep;  in this case
he receives only the impression of the external form of these two
animals; but the judgment made by the brain is of two  kinds—
the sight of the female will excite the genital  organs,  whilst that
of  the sheep will awaken his appetite.  If the want of food pre-
dominate, the animal will seize his prey in order to  devour it—
if, on the contrary, the want of coition be greater than the sensation
of appetite, he will approach the female with the view of gratifying
it.  Hence the impression made on the sight of the wolf, has reach-
ed at the same time the digestive organs as well as those of gene-
ration.   If it were objected,  that the two impressions, although
produced on the same sense,  were, nevertheless, different,  the
9ne being excited by one animal and the other by another,  I should
answer, that their difference is  only the result of the  slight shade
produced on them by the genital and digestive organs.   So true,
indeed, is this, that were the wolf castrated, he would invariably
neglect his female in order to seize the sheep.  At any rate, the
following example appears to me still more satisfactory; since it
consists  in an impression precisely similar, which is judged by  two
animals differing in their viscera.  Place a ewe between a wolf and
a ram; the one will approach it for the purpose of devouring it,  and
the other to cover it.  The  following fact is still more satisfactory.
Bring together, and  suddenly, two tigers of different sexes; if it be
not at the period of rut, (as  always happens in our climate, where
these animals never breed,)  they will become furious, and, as was
observed a few years ago in the Menagerie of Paris, when  attempts
were made  to excite the two  large tigers of Bengal  to the act of
ropulation,  they will mangle each  other; and doubtless, had they
met during the  season of their love, and in their native climate,
the acts  excited by the impressions they received  from each other
would have been widely different. 
 40                     mvroHY of the

   But to conclude:  since  the  same  impressions give rise to acts
 differing according  to the  condition of the viscera, we arc led to
 the conclusion, that  they are invariably reflected at the same time
 to all the viscera; and that such among these as are more imme-
 diately interested in each  impression,  act  more powerfully upon
 the mind, and determine  the  degree of the impression and  those
 acts which it will be necessary that  the centre of  relation should
 cause to be executed by the locomotive  apparatus.
   Among the many demands  that  are made  upon the centre  of
 perception, by those viscera interested in the approximation or re-
 moval of bodies that have acted on the external surfaces of relation,
 and the  acts,  which, in consequence,  the  centre determines, or
 tends to determine, we meet with the phenomena of intellect.  So
 long, indeed,  as the animal allows no interval to exist between the
 perception of the want  and the movements necessary  for grati-
 fying it, it manifests nothing but instinct.   Consequently,  instinct
 alone acts in animals of the lowest order: we hardly recognize any
 thing more, even in those endowed with the most perfect organiza-
 tion, at the moment of their birth; and  man himself cannot be ad-
 duced  as arv exception to this  rule.   In proportion, however, as
 his brain enlarges, his consciousness  (moi)  is manifested—his  in-
 tellect becomes developed;  and, when  it has attained its  highest
 degree  of perfection, the  impressions  relative to  his  wants  no
 longer  exert  on him the   same degree  of influence as  before.
 The acts solicited by the first wants,  are finally  modified  in a man-
 ner peculiar to him;  he experiences another series of wants in ap-
 pearances unconnected with those, the object of which is  the main-
 tenance of life; and yet the impressions  produced by them,  operate
 upon  the nervous system  in the same manner as  those that are
 referable to instinct.
  In maintaining that the impression  is  reflected from the brain to
 the viscera, it  is evident, that for the purpose  of conveying my
 meaning, I make use of a figurative expression.   All I wish to
 convey is, that the irritative movements excited on the external
 senses  by foreign bodies,  are transmitted by the nerves to  the brain,
 and thence to the viscera, by following  the direction of the nerves
distributed to these latter: finally, that  the  movements  that take
 place in the viscera, when they experience  the effects of the im-
 pressions, are perceived by  the centre of relation, and  produce in
 it a sensation,  from which results desire  or aversion. 
FUNCTIONS OF RELATION.                 41
  These movements, when considered in a purely physical point
of view, cannot be regarded otherwise than as a play of contracti-
lity, combined, as I have already shown, with an afflux of fluids;
they are then  true vital erections.   Consequently,  whenever the
viscera make known a want, there is primarily a vital  erection in
them;  and next the same effect is produced in the brain, where the
phenomena of perception are  manifested.  This erection  is again
repeated in the viscera, when  they are  consulted; in consequence
of this, the centre again experiences a new perception, which is
always the effect of a vital erection.   Finally, it is by means of a
vital erection that the brain acts  upon  the nerves of the muscles;
and also by the  same process, developed by these latter  in the mus-
cles, that they  excite them to  contraction.
  Directed by  the centre of perception, the  muscles execute the
movements necessary for the gratification of the wants.  External
bodies arc placed upon the internal surface of the viscera; and from
this moment a new series of  relations  is developed, which  takes
place between these and the centre of perception, and the  physical
effect of which is invariably a vital erection.
   Although the erections which result from the relations existing
between the centre of perception and the viscera touched by bodies
recently introduced into them, be internal, they nevertheless exert
an influence upon the manner in which the centre of perception will
judge  of the impressions made by external bodies.  Here the phe-
nomena I have already cited, are again presented; for, if the stomach
be full, the aliments offered to the external senses will produce on the
cerebral centre an impression,  which will be judged very differently
from what it would be were this viscus empty: the  same remark is
applicable to the other wants.  We  may consequently observe an
uninterrupted  chain of relations existing between us and  external
bodies.
   The vital erections that take place during the performance of the
relations with external  bodies, are the phenomena by which the
history of what  may  be  denominated the  internal or organic
life must commence.   Hence it may be perceived, that it is im-
possible to give a satisfactory idea of  it, without having first studied,
 in detail, all the relations.   I shall, in consequence, proceed with
these  details; presenting in succession to the attention  of my read-
 ers, the external surfaces,  by the aid of which we are  placed in re-
 lation with foreign bodies.
                               -G 
4'2
                      CHAPTER  V.

EXAMINATION OF THE  EXTERNAL  SURFACES  OF RELATION, OR
                 OF  THE EXTERNAL SENSES.
                  Section I.—Of the  Skin.

  The skin is the most extensive of the sensitive surfaces; it is the
first sense observed in animals;  and among those of the lowest or-
ders, it is even the only one. Viewed in its relations with the zoolo-
gical scale, it constitutes the universal sense, in which all the others
are traced, and finally developed.
  The skin presents to the observer two series of phenomena: the
first are relative  to the connexions which, on the one part,  exist
with the external bodies, and, on the other, with the centre of re-
lation.  The second belongs to the organic functions.   The skin
manifests the former of these series of phenomena, by means of the
modification of the nerves with  which it is supplied;—it gives rise
to the latter, by  means of the  modifiers of the contractility of its
vascular sj^stem.   In the former, it acts, therefore, as a sensitive
organ; and, in the latter, like a secreting or exhaling organ.   Al-
though these two series of vital phenomena are intimately linked
together, we shall only offer, in this chapter, a complete develop-
ment  of the former; reserving the other, as much as  possible, for
the history of the internal or organic functions.  I say as much as
possible, for it will be difficult to study the results of the sensations
of the skin, without discovering in them some modifications of vas-
cular  contractility.
  All these functions being  equally the  result  of the  structure of
the skin, I shall describe it in a very cursory manner.  The basis
and principal tissue of this envelope consists in a fibrous net-work,
composed of filaments, that leave between them  spaces of greater
or less extent, according to the part in which it is examined: this
tissue has received the name of Chorion, or Derma. The filaments
of which it is composed are continuous with the sub-cutaneous cel-
lular  tissue, or with aponeuroses and ligaments.   The  intervals ex-
isting between them  afford a passage to arteries, veins, and lym- 
EXTERNAL SURFACES OF RELATION.
43
phatic vessels—to nervous filaments, and to  cellular  tissues; the
whole of which, after having penetrated externally through the der-
ma,  are finally expanded upon its external  surface.   When we
examine this surface, we discover in it,  first,  a mucous net-work,
which has been regarded as entirely fluid, and denominated a mu-
cous body; but which, when discovered to be  a true organic tissue,
received the name of reticular', secondly, eminences  which have
been  designated under the name of papillae.   The reticular body
and the papilla; are nothing more than the vasculo-nervous appa-
ratus of the surface of the skin,—an apparatus which no anatomist
has hitherto succeeded in dissecting.   It is impossible, indeed,  to
isolate in this tissue a vein, or an artery; and  the neurilema can no
longer be detected: all we can see is, that the  papilla; are endowed
with a greater degree of consistence than the  reticular or mucous
body, in the  midst of which  they form, particularly in those re-
gions of the skin where the sense of touch is most delicate, a promi-
nence, more or less apparent; whilst, in other  parts, it is very diffi-
cult, and even impossible, to perceive them.
   It is invariably observed, that those parts of the skin in which the
papilla; are most numerous, are supplied with  a greater quantity of
nerves of relation; from this circumstance many have been led  to
imagine that the  papilla;  consisted in nothing more than  nerves
terminating in kinds of nervous pencils or tufts; but a more attentive
examination enables us to discover in  them so large a quantity of
blood, that some  authors have regarded them as purely vascular.
This leads me to believe, that these papilla;  are composed of a ner-
vous substance intermixed with sanguineous capillary vessels; whilst
the reticular body is a tissue more vascular than nervous, in which,
together with blood, is found a considerable quantity of white fluids.
It is from this tissue that the fluids  of insensible and sensible per-
spiration are exhaled; the latter  of which is, in all probability, no-
thing more than the former exhaled in too abundant a quantity  to
be transformed entirely intoa vapour atthe moment of its elimination.
As respects the papilla;,  it is certain that they are destined to the
sense of touch.
   In some+egions of the skin, small follicles are discovered, which
furnish a fatty, oily, and  inflammable humour.   In other parts it is
impossible, although the  oily matter is secreted in them,  to ascer-
tain the existence of these small  bodies. 
41                  EXAMINATION OF THE
  The hair takes it origin under the skin, in small capsules, hav-
ing the form of sacs, and which some anatomists have regarded a»
the secretory organs of the sebaceous or oily humour.   The  hair
passes through the interstices, existing in the fibrous texture of the
skin, and reaches the exterior by means of small apertures made in
the epidermis.   If the  oily matter  be formed  in the small  sacs
which  produce the  hair,  it reaches the surface of the skin, by
sliding along the  cylinder of the former.  Finally, we discover,
Upon  the surface of the skin, the epidermis,  which constitutes its
external covering: it consists in an inorganic tissue—a true secre-
tion, which coagulates and hardens after its formation.   It serves to
protect the cutaneous surface from the action of external  bodies,
and to  moderate the impressions produced by the touch, as with-
out it they would almost always be very painful.
  The epidermis is formed neither of gelatine, mucus, albumen, nor
fibrine; it consists in a peculiar animal matter, analogous to the nails
and to horn, and whicli, when removed, is regenerated like every other
inorganic substance, unless the vascular apparatus of the cutaneous
surface, by which alone it is produced, be destroyed.
  The nails are nothing more than a product analogous to the epi-
dermis, of which they constitute merely a modification appropria-
ted for certain uses.
  The more we read and meditate the authors who have investiga-
ted the structure of the skin,  the less certainty do we  acquire on
the subject of its  intimate  texture.   Some have distinguished in
it, 1. fleshy buds (bourgeons charnus), which are only vascular
bunches; 2. between these pimples and the  epidermis, a deeper
whitish layer (couche albide proficule), consisting, according to
them, of white vessels;  3.  over this layer a dark coloured  line re-
sulting from small bodies that cover the summit of the buds,  and
which  have been designated by the name of gemmulas; 4. finally,
just beneath the epidermis, a second colourless layer, consisting of
serous  vessels,  and denominated by them superficial whitish layer
(couche albide superficielle); this layer is thought to be charged
with the function of serous exhalation.
  Other anatomists admit in the skin: 1. the derma;°£. the pa-
pillae;  3.  the epidermoid membrane  of  the papilla;, which is
the deep whitish layer of the preceding writers; 4. a. coloured lay-
er; 5.  a horny layer, which corresponds to the superficial whitish
layer;  6. and lastly, the epidermis. 
              EXTERNAL SURFACES OF  RELATION.            *J
  Others again content themselves with establishing two divisions
in the skin: 1. the derma, which embraces all the organic elements
of this membrane, between which it is impossible to establish any
distinction; 2. the epidermis or inorganic portion.
  On this subject the reader may consult the additions with which
professor  Beclard has lately enriched the new edition of Bichat's
JInatomie Generate, and from  which I have extracted the pre-
ceding  details.   Be  this as it may, I  conclude, from these re-
searches, what I have already advanced, that  there exists on the
surface of the skin a capillary tissue,  which  is  vasculo-nervous,
cannot  be dissected, and  the  papillary  portion of which,  being
the most plentifully supplied  with nervous matter,  is entrusted
with the functions of touch,  and the sympathies of relation; whilst
all the rest is devoted to the various secretions and exhalations dis>-
covered on the cutaneous envelope.  We must also admit the ex-
istence, in the skin,  of the  sebaceous follicles, and of  the pilous
capsules.   I believe that, with these elements, we can sufficiently
well explain the functions of the  skin; I  shall, consequently, offer
an exposfc of its relations.
   The skin procures  to man the perception of the temperature of
external bodies—of the condition of their surface, which is either
smooth, polished,  or rough—of their form, of  which it enables
 us to judge, by passing  over their surfaces, and  grasping  them
when not  too voluminous—of their consistence,  volume,  &c.
From these  sensations there result  clear  ideas,  which  furnish
 to the mind materials for judging of the external and physical quali-
 ties of bodies; but the skin  does not decompose nor analyse them,
 in order  to convey to us an idea of their chemical  properties, and
 enable us to  foresee their effects on the  system as nutritive mate-
 rials:  other senses are charged with this function;  hence it makes
 us correspond with the masses that are applied to our body.
   Whilst the skin furnishes, to the centre of perception, materials
 calculated to  enlarge the boundaries of our intellectual  faculties,
 this membrane acts sometimes,  and in the following way, on  the
 viscera.   The sensation caused  by polished and  elastic bodies, of
 a moderate degree of temperature, is agreeable; it constitutes a plea-
 »ure which is felt, not only on the cutaneous  surface, but also in
 the principal departments of the nervous apparatus of relation.  It
 is in this way, that  touching the  body  of a female re-excites into
 activity the  genital organs—accelerates the action of the hearty 
46
EXAMINATION OF  THE
 causes a sensation of voluptuousness in the epigastrium,  and even
 in the interior of the muscular tissue.   Under these circumstances,
 organic  phenomena  associate themselves with those of relation.
 The seminal fluid is secreted in greater abundance—erection takes
 place, not only in the genital organs, but also in the mouth, which
 reacts on the salivary glands—the eyes become red and sparkling.
 The  colour, secretion, and  even sensibility  of the skin (for  we
 often experience a kind of chill), are modified.
   Phenomena nearly similar to these are manifested during the ef-
 fect of certain frictions, applied slowly,  and  always in the same
 direction, by the hand of another person. There results from these
 a kind of relaxation of the brain—a sluggishness of thought—a ten-
 dency to sleep, and a langour of the muscular  apparatus-, the circu-
 lation becomes more regular—pain is mitigated or removed—the
 whole surface of the skin partakes of the modification of the por-
 tion touched, and a mild  heat and more uniform temperature is
 established over the whole surface of the body.   Such are  often
 the effects produced by the touchings of the magnetisers, who de-
 rive from them their power of fascination, and the occasional real
 success they obtain  in nervous  irritations, occurring  in sensible
 and delicate individuals.   The tepid bath procures often effects
 nearly analogous to the preceding.
   Whenever the skin is touched and rubbed a long time with rough
 bodies, it transmits painful sensations to the centre of perception.
 The individual experiences a sort of aversion—a tendency to iras-
 cibility,  and anger—a disposition to  execute such movements  as
 are necessary for repelling the irritating  cause; and, in some in-
 stances, even violent convulsions supervene.   The  touching of dry
 bodies covered over with small asperities, such, for example,  as
 cork,  gives rise, in many individuals, to a sensation of aversion,
 attended with chilliness.
  Tickling  developes a number of sensations more or  less acute;
 an accelerated  action of the heart, an involuntary agitation, and
 even real convulsions, which may suspend the functions of respira-
 tion and circulation, produce thoracic and encephalic congestions,
 and even death.
  The phenomena of relation attached to the tactile functions of
 the skin are, therefore, of three species; those of the first relate to
 the intellect—those of the second to instinct, and,  finally, those of
the third are manifested in  the distribution of the fluids, and in the 
EXTERNAL SURFACES OF  RELATION.
47
disorder of the organs charged with the performance of the various
secretions.
  Hence, in this first relation of our body with external agents, we
verify what has been said above,—that the sensations are not judged
by the centre of perception alone and a priori; but after this latter
has reflected them to the sensible parts of the system, and particu-
larly to the viscera.  If we wish to see here, in the clearest man-
ner, the influence exercised by the viscera upon the determination
of the centre of  perception, and  successively the triumph of the
mind  over the viscera, and of the viscera over the intellect, let us
suppose a person endowed with lively sensibility, and submitted
to the process of titillation.  If it be practised at first feebly, the
patient experiences an inclination to laugh and to escape from the
person who tickles him; but he retains the power of resisting, and
when he is determined to do so,  he  will succeed.   If the action
be more powerful, he can no longer resist;—he becomes agitated—
he laughs out, and, when the titillation is applied with greater vio-
lence, he flies into a passion, and struggles with great violence;
finally, we are no more able to resist this singular  sensation than
the impulse, by  which we are led, after  suspending  a long time
the function of respiration,  to dilate the thorax, in order to pro-
cure a supply of air.
  The respiratory function—defecation—vomiting,  &c. are, there-
fore, not endowed exclusively with the privilege of overcoming the
power of the will.   The same effect is produced by every sensa-
tion carried to excess; and it is always the result of its very ener-
getic repetition  in the principal viscera.  As regards titillation, it
acts also in the same manner;—the sensation which it produces is
conveyed to the brain, which  reflects it to the epigastric centre;
and it is the  sensation  which the brain perceives  in this region,
that compels it  to  command those hurried movements of which I
have just given a sketch.  This mechanism is proved in the follow-
ing manner.  If  a person sensible to titillation be attacked with apo-
plexy, he no longer experiences the sensation in question.  If the
stomach be inflamed, he feels the sensation, but is neither inclined
to laugh, nor to  struggle in order to avoid  it. I have had many op-
portunities of noticing this fact, in my daily visits  at the Val-de-
Grace.   The man attacked with gastritis, and whom I could touch
without inconvenience at the first visit,  often becomes ticklish the
next day, when, by means of one application of leeches, the irrita- 
43
EXAMINATION OP THE
tion of the stomach has disappeared; and if he experience a relapse
he can again suffer  his sides to  be felt without feeling an incli-
nation to laugh or to struggle. A slight attack of gastritis produces
often the contrary effect.
  The sensation of titillation may also be annulled  by  a point of
irritation situated in another tissue—as for example pneumonia.
In this case the centre of perception, being attentive to another sen-
sation, is not affected by the former.  The same thing occurs in pro-
found meditations and grief; while, on the contrary, if we enjoy a
lively disposition, the effects of titillation are more acute than under
ordinary circumstances.  Certain exaltations of the sensibility of the
abdominal viscera increase also this kind of susceptibility; such is,
for example, the hysterical state, which can produce laughter without
the aid of any moral cause.
  All these  facts concur in proving, that stimulations exercised on
the cutaneous sense, can act on the viscera only through the medium
of the brain;—that the movements determined  in the  muscles of
locomotion by the brain, are invariably the effects of the sensations
which it perceives  secondarily in the  viscera;—finally,  that the
organic movements are  in all instances influenced both by the sen-
sation, and by the exercise of the muscular contractility.
  All we have hitherto said in  relation to the sensations of the
touch, is applicable to those produced by the action of  contusing,
cutting, or tearing bodies; by that of burns—of excessive cold—of
distension—of the twisting of ligamentous parts;—in a word, by
pain, considered in  a general  manner, whatever may be the form
it assumes.   Pleasure is always the effect of the stimulation of a
sensitive surface; but pain,  independently of this cause, may be
produced by others acting in the interior of our tissues, provided
these be supplied with  a sufficient quantity of nerves.   Now, the
pain is conveyed to  the centre of relation, which, if not occupied
by another perception,  and if the part of the brain where it resides
be not diseased, reflects it back to the viscera; and the brain acts in
virtue of the secondary sensations it perceives in them. The follow-
ing are the demonstrative  proofs of this fact.
   When the digestive  organs  are in a healthy condition, the pain
occasioned  in  another part of  the body, by the mechanical causes
we have already enumerated, may be borne with great fortitude,
if the will endeavours to  moderate the violence of the  acts which
the sufferings tend to excite; but if the  stomach be affected with 
EXTERNAL SURFACES OF RELATION.
49
inflammation, the pain is felt much more acutely.  An intolerable
sensation originates in the epigastrium, and gives rise to impatience,
grief,an«i;er,and fury; and, howevepstrong may be the determination
of the patient to remain tranquil, he yields in most instances to the
acutencss of these new sensations, and abandons himself to impetu-
ous movements.  It is in this way, that gastritis perverts the moral
feeling, transforming into an impatient,passionate, and furious being,
one who  previously was mild, firm, and the most proper to endure
physical and moral sufferings. This, assuredly, could not occur,were
not the sensations reflected to the viscera before being judged by
the centre of perception.  These preliminary positions will aid us
in explaining the phenomena of relation that take place by means
of the exercise of the other external senses.

      Section  II.—Of the senses of Sight and Hearing.

   When examined in a general point of view, these two senses
manifest a great analogy;—both are destined to make us correspond
with bodies placed at a certain distance from us;—both enable us to
procure clear and distinct ideas, and consequently subserve effica-
ciously our intellectual  faculties;—finally, one of these senses can
supply the deficiency of the other, and  furnish us with nearly the
same notions, as is.so conclusively shown by the education of the
blind, and  of the deaf and dumb. Yet, although these two senses
afford so powerful an aid to the development of our moral faculties,
they are  far from being unconnected with the internal functions and
organic movements;—they even modify them very efficaciously; so
that they may be viewed in a  double  sense; 1. In relation to the
instinctive faculties, and first  wants;  2. In relation to the purely
intellectual faculties.

             Section III.—Of the sense of Sight.

   Structure of the sense of Sight.—This sense resides in a very
complicated apparatus, which nature has located in a hollow situated
in the cranial and facial bones.   Its principal and fundamental part
consists in a nervoso-vascular expansion,  denominated retina.   It
would be in vain to endeavour  to discover in this the structure of
what we call nerve;  nor is it possible to find in it the gelatinous
and firm membranes known under the appellation of neurilema—
                               7 
50
EXAMINATION of Till.
membranes which exist only in the conductors of the nervous appa*
ratus, but which are found neither in the cerebral substance nor in
the sensitive expansions.  The  retina consists of a tissue impossible
to dissect, but which is certainly composed of nervous matter and
sanguineous capillaries. This structure appears to us to be analogous
to that of the cerebral substance, to which the sensitive expansions
bear considerable analogy,—as we shall prove hereafter.   A large
nervous cord, passing from the brain to the retina, establishes the
communication between  both  these tissues; it  consists of a white
substance presenting a linear disposition, and containing but few ves-
sels; whereas the retina contains a large number.
   The retina is expanded into a convex membrane,  the external
surface of which corresponds to  the choroides,—a  vascular tis-
sue, containing  no nervous matter, and  the colour  of which is
black.  These  two  membranes are enveloped by the sclerotica,
which consists of a capsule of  a very solid fibrous texture,  having
the shape  of  a vessel the  bottom of which corresponds to the
cavity of the orbit, where it is perforated by the entrance of the
optic nerve, and the opening of which presents itself in front, be-
tween the two  eyelids.  The external  surface of the sclerotica is
connected to various muscles,  to some cellular tissues, and to a mu-
cous  membrane; its  internal surface is lined by the  choroid  coat.
The cavity formed by the retina is filled with a vitrious humour,
which constitutes a large portion of the mass of the eye: this humour
is not loose in this cavity, but retained by a laminated tissue, ex-
tremely fine in its texture, and as transparent as itself. This tissue
produces the humour in question, in the same way that the arachnoid,
pleura, pericardium, peritoneum, and synovial capsules produce the
humours by which they are lubricated.
   It is not our object  here to examine  the peculiarities observed
in the structure of this laminated  tissue ; but we must remark, that
at the anterior  and  middle portion of  the vitrious  we find the
crystalline humour,  which  is much less abundant, but of  greater
density;—having the appearance  of a small transparent globe,  set
in the anterior part of the larger one, which is the vitrious humour,
and immediately behind  the opening by means  of which this appa-
ratus is made to communicate with external  bodies, destined to
produce the sensation.
   This opening, which is denominated the pupil, is situated in a
membrane placed transversely, and like a kind of diaphragm, in 
EXTERNAL SURFACES OF RELATION.
51
the anterior part of the globe of the eye, which it divides into two
sections of unequal dimensions, called chambers.  The posterior Or
smaller one corresponds  to  the  cavity we have just described,
whilst the anterior and much larger chamber  forms a slight  pro-
jection on the external surface of the ocular sphere.
   The diaphragm in which the circular opening or pupil is made,
consists of a membrane,  which, in consequence of the different
colours it  exhibits on its external surface, is denominated iris:
it is composed of a fibrous vasculo-nervous tissue, of  the class of
those called erectile; it adheres by its circumference  to the part
where the sclerotica terminates, and where is inserted a solid horny
tissue, having  some resemblance to a watch-glass: this substance
forms, as it were, a small segment  of  a sphere, projecting on .the
anterior part of the globe  of the eye—it is called the  cornea, and
consists of a transparent  tissue, seen between  the opening of the
lids, and  behind which the iris and pupillary aperture are disco-
vered.  The space situated  between  this cornea, the iris, and its
aperture, constitutes the  anterior chamber of  the eye; it  is filled
with an albuminous and transparent fluid, which is free, because
it  is not contained, like the crystalline  or vitrious humour,  in a la-
minated tissue.  In consequence of this,  it is renewed, when, in
consequence of an accidental puncture of the  cornea, it has been
evacuated; whereas, on the contrary,  the  crystalline  and  vitrious
humours, which  cannot be  evacuated  but with their secreting tis-
sues,  can never be reproduced.
   I shall not dwell on the  peculiarities of structure  of all  these
tissues, or on  the direction of the  vessels and nervous filaments
distributed to them; it will  be sufficient for my present purpose,
if  the reader can  form some idea of the general  shape and structure
of the eye, as well as of the  difference  existing between the prin-
cipal tissues of which it is composed.
   Such as  we  have just described  are the essential organs of the
sense of vision.  The accessary ones are, 1. six muscles, which are
inserted by one extremity into various parts of the orbitar cavity,
and by the other into the sclerotica;—they are destined to move
the globe of the eye; 2. two prolongations  of the skin,  forming the
eyelids, which consist of  a kind of moveable curtains, that nature
has placed for the protection of the  anterior part of the eye.   These
prolongations  are supported by two cartilages  denominated tarsi,
and moved by muscles corresponding to their posterior or internal 
53
EXAMINATION OF  THE
surfaces.  At the edge of the eyelids, the skin changes'into a mu-
cous membrane, called conjunctiva : this latter deserves really this
name; for after being reflected behind the skin of the eyelids, and
lining the internal  surface of the tarsi and a part of that of the pal-
pebral muscles, it passes over the anterior part of the eye, which it
covers,  as far as the  point of insertion of the cornea; in other words,
it  terminates at the circular opening of the  sclerotica: it serves,
therefore, as a means of  union between the skin and the globe of
the eye.  In a state of health, the colour of this membrane is white,
though  small vessels are invariably observed in it.
   Behind the conjunctiva,  at the external angle of the eye, and in
a small osseous cavity, we discover a gland, called lachrymal gland.
Several small canals,  resulting from the union of the much smaller
excretory vessels of that gland, open  on the  conjunctiva, and  de-
posit on it the humour secreted by that organ.   This  humour lu-
bricates the two corresponding surfaces of the conjunctiva, and  the
external surface of  the cornea.   It serves to facilitate the gliding of
the eyelids over the globe of the eye.  The lachrymal gland, more-
over, manifests sympathies which render it very remarkable.


                 Of the Mechanism of Vision.

   Such is a general sketch of the apparatus of vision, the  local ac-
tion and numerous  sympathies of which, merit the entire attention
of physiological physicians.   Light is the natural stimulus adapted
to the sensibility of the sense of vision.  Many other writers hav-
ing described the  mechanical  phenomena  of  vision,* we shall
content ourselves with  studying this sense in  relation to vitality;
since it is this which offers the  greatest degree of interest to the
physician, who endeavours  to discover in physiology the  expla-
nation  of pathological phenomena.
   We  shall first examine the local phenomena of vision,—in other
words, those that take place in the apparatus of the sense; and next
trace the results of the sensation in the brain, and in the different
 apparatuses of the  economy.
  * I refer more particularly to the Treatise on Physiology by M. Magendie,
and to the Memoirs on Vision, inserted in bis Journal de Physiologic Experimental. 
EXTERNAL SURFACES OF RELATION.
53
Of the Local Phenomena of Vision.—Of the Sympathies ob-
              servable in the Ocular Apparatus.

   In the function of vision, we discover several sympathies, which,
although exercised  through the medium of the  cerebral centre of
perception, are,  nevertheless, manifested in the apparatus we have
just examined.   Light, on reaching the  sensitive expansion  or re-
tina, occasions on it a stimulation, from which result organic  and
animal sympathies.  The former consist in the  contraction of the
pupil,  and in an  increased secretion of tears; the latter, in the move-
ments of the globe of the eye, executed  by the  proper muscles of
that organ, in order to direct it  towards luminous bodies, or turn
it away if the light be too intense; and in the movements of the  pal-
pebral muscles,  which tend  to the same effect, since they serve to
close the  eyelids when the  rays of light are too vivid, or  to sepa-
rate them if they be weak or few.  These four sympathies depend
always on the same cause;  they are determined by the centre of
perception; since they are not excited when the brain is engorged,
or during sleep, which, as every one knows, may allow the eyelids
to remain half open, and the rays of light to penetrate into the eye.
In a majority of instances, instinct alone presides over them;  which
means, that the  centre of perception determines them without the
participation of  the will, and  even in spite of that  faculty.   But
these sympathies offer this  difference; that the  two first, or vital
erections of the  iris and lachrymal gland, cannot be modified by the
power of volition; whereas the other two, consisting as they do, in
muscular  movements,  are subjected, though conditionally, and in
the following manner, to this modification.  When light is not too
vivid, we  are not under the necessity of turning aside the globe
of the eye, or closing the eyelids; but, if it be intense, it is no longer
in the power of the will to prevent these movements.   The same
remark may be made, whenever a foreign body, applied to the con-
junctiva, occasions pain.   Hence, the proper muscles of the eye,
and those of the lids, have the same relation with  instinct and the in-
tellectual  faculties, as  those of respiration.  When instinct  is not
absolutely in need of them, they are  placed at the disposal of the
will; but, under all other circumstances, they are removed  from its
influence.
   In all instances in which we  observe muscles under the control
partly of the will, and partly of a sense, whether internal or exter- 
54
EXAMINATION OF THE
nal, we may rest assured, that these muscles  are supplied, at the
same time, with cerebral and ganglionic nerves.   This is observed
to be the  case, as regards the ocular apparatus: ganglia, consti-
tuting a link in the chain of the great sympathetic, unite behind the
eye, and furnish small branches, that twine around the arteries  of
that organ: on the other hand, we find it supplied with filaments,
derived from the cerebral nerves, and  more particularly from the
fifth pair.

Of the manner in  which the Local Phenomena of Vision de-
                    generate into Disease.

  An excessive stimulation of the retina may carry the vital erec-
tion in it to the point of inflammation, or exhaust its organic action,
and throw it into a state of paralysis.  In a majority of instances,
however, the effects  of  this super-excitement are developed in the
tissues,  in which the organic sympathies of this sensitive expansion
are  exercised.   Hence,  owing to this cause,  the iris, the lachrymal
gland, and  the conjunctiva, are sometimes inflamed, whilst the re-
tina remains unaffected.  Whenever inflammation originates in one
of these tissues, it may, if the individual predispositioa favour its
progress, invade all the others.  In our pathology, we shall  point
out the  disorders occasioned by these phlegmasia;.
  The eye, when deprived for a length of time of the influence of
the ordinary degree  of light,  but powerfully exercised by the will,
acquires, occasionally, so great a degree of excitability, that the in-
dividual is enabled to distinguish  objects with the aid of the small
number  of luminous rays that penetrate into obscure places.  In
such cases, the pupil is  invariably  found considerably dilated, and
the iris loses sometimes, to such a degree, the erectile faculty, that,
if the eye be exposed to the light of day, the  pupil no longer con-
tracts, and this disposition, combined with the extreme susceptibili-
ty of the retina, gives rise to a state of blindness, often difficult to
cure.   This  arises from the  circumstance, that, like the cavernous
body of the penis, the iris has for its basis a  fibrous tissue, disposed
in lines, which,  from all the points of ^ts insertion into the sclerotica,
converge towards the pupil; these lines, which may be consider-
ed  as so many  small cavernous bodies, manifest a perpetual dispo-
sition to contract, and can only be elongated, advance  towards the
pupil, and  diminish its diameter, by means of the afflux of  blood 
EXTERNAL SURFACES OP RELATION.
55
which is attracted  into their capillary vessels, through the medium
of the sympathetic influence of the retina.   With these facts before
us, it is not difficult to understand, that if, during a length of time,
a state of erection be not excited in these small bodies, their fibrous
tissue finally loses its extensibility, and, like the penis which has
remained  too long in a state of inaction, they become inadequate
to the performance of the function for which they were intended.
  Finally, the eye,  when too powerfully excited, takes on a state
of inflammation or sub-inflammation,—becomes engorged and dis-
organized in all its tissues; whilst, on the contrary, when it is  al-
lowed to remain without exercise, it becomes dry, stiffened, with-
ered, and atrophied.  Such as we have detailed are the causes of
the diseases of this organ, viewed independently of the influence of
the principal viscera; but the irritations it contracts by the action
of a too powerful  degree of light, are susceptible  of  being trans-
mitted to  these latter, and more particularly to the brain.  The ex-
ternal air can disorder the  conjunctiva by the particles  it holds in
a state of suspension;—such for example are certain mineral dusts—
acids in a state of vapour—smoke—fine sand—the miasmata of cer-
tain  fogs—the vapour of ammonia—formic  acid, &c.   From these
causes there may result acute and chronic inflammations.

Of the Sympathetic Phenomena of  Vision, developed  in other
                            Parts.

  It appears to me difficult to explain the sensation resulting from
the stimulation exercised on the sensitive expansion called retina,
by the rays of light.   Consequently I shall  not attempt to account
for it by  the  purely mechanical laws  of optics,—in other words,
by supposing an image to be represented on the choroides by the
luminous  rays that are reflected from each object, as is observed in
the camera obscura.  It is impossible to deny, that the rays pene-
trate through the pupil;—that, in passing through the transparent
contents of the eye,  they converge and diverge in various degrees;
that they  fall  in pencils on the  retina: but all  this does not ap-
pear to  me to explain the almost infinitely numerous  shades of vi-
sion.  All that is satisfactorily demonstrated is, that in consequence
of the  stimulation exercised by the luminous rays upon this ner-
vous expansion, a perception takes place  in the cerebral centre: 
56
EXAMINATION OF THE
 and this will suffice to enable us to prosecute the researches which
 form the principal object of this treatise.
   The sensation is referred to the bodies from which the luminous
 rays have been  reflected; and the acts resulting from it are invaria-
 bly proportioned to the relations that exist between our economy
 and those same bodies. Whenever the cerebral centre and the eyes are
 in a state of health, we constantly judge in the same  manner of the
 respective colour, form,  dimensions, and distances of these bodies.
 These judgments are expressed by language in a clear manner, and
 memory can invariably retrace them with equal clearness.  This
 is the intellectual part:  but these different bodies, with the exist-
 ence of  which  we are made acquainted through  the medium  of
 the sense of sight, are more or less intimately connected with our
 first wants, by means of eternal and immutable relations; and it is
 in consequence  of these relations that we experience a desire for
 some,  an aversion for many, and that we remain almost indifferent
 to some others.   From this results the difference  existing in the
 acts determined  by the  will,  in consequence  of the perceptions
 transmitted to us by means of the sense of sight; but as all this  is
 equally noticed  in  relation  to the  sensations procured to us by
 the other senses, I shall  postpone the developments I intend offer-
 ing, until I  have presented  a description  of the  organs entrusted
 with these senses.

           Section IV.—Of the sense of Hearing.

  Of the Structure of the Auditory sense.—However delicate the
 sense of vision may be, that of hearing is still more so.   We have
 seen all the precautions  which the Author of all things has taken,
 for protecting the sensitive expansion of the eye against all other
 exciting influences except that of the luminous rays; yet these rays
 penetrate as far as the sense itself, and are lost  in the substance  of
 the choroid coat.
  The same circumstance,  however, does not occur in respect  to
 the sense of hearing.   Its natural stimulus, the air, does not pene-
 trate as far as the nervous matter of the acoustic expansion; and this
latter,  which is much more delicate and soft in its texture than the
 retina, and bears an exact resemblance to the cerebral  pulp, receives
only a vibratory action, communicated  to it, not by the air itself,
but by tissues which serve  to protect it from its  immediate con- 
EXTERNAL SURFACES OF RELATION.
57
tact.  The portio mollis of the acoustic nerve  (which alone pre-
sides over the sensation, for the portio dura is only a nerve analo-
gous to the cerebral pairs destined to sensibility, in general, and to
muscular movements)  is situated in the centre of the hardest of
all the bones.   This  portion of the temporal bone,  denominated
petrous, contains several cavities communicating with each other,
and  distinguished by the names of cochlea, semicircular canals,
and  vestibule.   The nerve in it, like  the pulpy substance of the
brain, which is disposed in lines, is extremely soft; it  is of  a white
colour; it floats in a gelatinous fluid, and the membrane which se-
parates it from the bones, and secretes this fluid, so far from being
of the  consistence of the areolar tissue, which secretes and contains
the humours of the  eye, is so delicate as to resist all  the efforts
of anatomists to dissect it.   The same  remark is applicable to  the
blood-vessels of this nervous expansion; so that it is impossible to
discover in it any thing but a semi-fluid, organized,  nervous mat-
ter, together with a small portion of free albumen or gelatine.
   The vestibule is the point of union of the two lamina; spirales of
the cochlea, and of the semicircular canals.   A fibrous membrane
of an elastic and firm texture closes this vestibule, on the side cor-
responding to the cavity of the tympanum, and prevents all foreign
bodies, of whatever  nature they may be, from penetrating as far as
the acoustic nervous matter.
   The  middle cavity of the ear, called also the cavity of the tym-
panum, is, like the former, situated in an excavation  of the tempo-
ral bone; it contains air, which reaches it through a canal  situated
on its  internal side, communicating with the posterior nares, and
which has received the name of Eustachian tube.   On the  side
opposite to this tube, the osseous cavity of the tympanum presents
an opening, which communicates  with  the  external auditory ca-
nal;  but, during life, this opening is closed by an  elastic mem-
brane, similar to that of the opening corresponding with the vesti-
bule.   Finally, a fourth opening, situated at the posterior and infe-
rior part of the cavity,  leads into cells,  in the mastoidal portion of
the temporal bone: this opening is not  closed, but the cells  into
which  it leads  have no  communication externally;   so  that  the
cavity  of  the tympanum  communicates  with the  external  air
through the  medium of the canal alone, which terminates in the
posterior nares,  and is denominated  Eustachian tube.
                               8 
58
EXAMINATION OF THE
   In the cavity of the tympanum are  found the small bones of
the ear: they are four in number, and designated by the names of
stapes, malleus, incus, and os orbiculare.  They form  together
a kind of chain, by which  the  membrana tympani  is made to
communicate with that of the foramen ovale, which  opens into
the labyrinth.   The stapes is applied to the former, and the incus
to the second; whilst the malleus and the  os orbiculare are inter-
mediate.   Muscles are attached to these small bones, and inserted
by their other extremity into different parts of the temporal bones.
The whole is covered or enveloped by a membrane, which forms
the continuation of that of  the  fauces,  and which, from this cir-
cumstance, has  been classed among the  mucous tissues.
   Such  is the internal ear: the  external consists of a canal which
commences at the membrana tympani, and opens externally on the
lateral part of the head, by a large cartilagino-membranous expan-
sion, denominated the concha of the ear.   It resembles a kind of
funnel, the form of  which varies in different animals.   Its figure,
in our species,  is too well known to require a description in this
place.   The external ear is covered by the skin; but in propor-
tion as this envelope advances into the  external auditory canal, it
becomes thinner, and finally  assumes  nearly the character of the
mucous membranes.
   From what we have  already said it  may be perceived, that the
Eustachian tube and the meatus auditor ius extemus present a great
analogy to one  another, since they both consist of tubes, the small
extremities of which correspond with  the tympanum,  whilst the
large  ones open externally, and terminate in expanded openings.
They differ, however, in this, that the Eustachian tube penetrates
freely as far as the internal ear, whilst,  on the contrary, the course
of the meatus auditorius is interrupted  by the membrane of the
tympanum.  This disposition, however, does not constitute an es-
sential condition for the exercise of the sense; for in many instances
the Eustachian tube  is obliterated, and,  if hearing be prevented by
this cause alone, it can sometimes be restored by procuring the ac-
cess of air to the cavity of the tympanum, by the perforation of the
membrana  tympani.   These two canals are entrusted, therefore,
with analogous  functions, and  can, to a certain  extent, supply the
place of each other.
   It moreover results, from  the  preceding observations,  that the
parts essentially necessary to hearing, consist of those cavities which 
EXTERNAL SURFACES OP  RELATION.            59
 when united together are  designated by the name of labyrinth;
 since it is in these, that the  nervous expansion of the auditory sense
 is situated.

                 Of the Mechanism of Hearing.

   The last  observation in  the preceding paragraph is correct, for
 all the remaining parts of the ear are only accessary.  The air, the
 particles of  which are  agitated by the vibrations of sonorous bodies,
 is collected  by the concha of the ear, and passes into the meatus
 auditorius:  the membrana tympani  receives the impression—the
 vibration it  experiences occasions  another in the air  contained in
 the cavity, and excites the contraction of the muscles of the small
 bones that are fixed,  on one  side to the membrane of the tympanum,
 and on the other to that of the foramen ovale.  The impulse felt
 by this latter is communicated to the vestibule, and from this through
 the whole extent of the labyrinth.  Finally, the auditory nerve,
 which partakes of this vibration, transmits it to the cerebral centre,
 whence results the perception constituting  audition.  Such is the
 explanation of this phenomenon as given by natural philosophers:
 to this they add, that the air contained in the mastoidal cells  con-
 tributes to the perfection of the sense, by increasing the vibrations
 communicated to the foramen ovale.
   However this may be, hearing may be exercised independently
 of all these  accessaries, since certain animals are not supplied with
 the cavity of the tympanum—since it may  likewise be perfect in
 man, notwithstanding  the perforation  of the membrana tympani,
 and the destruction of the small bones of the ear—or finally,  since
 children,  in whom the mastoidal  cells are not yet developed, hear
 as well as adults.  These cells, the extent of which increase with
 age, are perhaps necessary in order to make  up, by augmenting the
 power of  the vibrations, for the stiffness of  the membrane protect-
 ing the labyrinth, and for the diminished sensibility of the acoustic
 nerve.
   In all animals possessing  long ears,  these are directed towards
 the place whence the  noise proceeds, which  adds very much  to
 the delicacy of  the  sense of hearing,  by collecting and concen-
trating in the meatus  auditorius a greater  proportion of air  in a
 state of vibration; but  man is deprived of these  advantages,  and
 can supply  their deficiency only  by  means of artificial  acoustic
horns. 
60
EXAMINATION OF THE
 Of the Manner in which the  Local Phenomena of Hearing
                   degenerate into Disease.

   When too intense, noise may, by causing a violent irritation of
 the auditory apparatus, produce in it inflammations and hemorrha-
 ges; or occasion, without the intermediate action of these affections,
 a disorganization of the pulp of the acoustic nerve, whence  results
 a paralysis producing deafness.  When the sensibility of the organs
 in question  remains in  a  state of exaltation, after extraordinary
 commotions, the individual retains the perception of a continued
 and  insupportable noise, and  forms erroneous judgments  of the
 nature of those bodies that modify the auditory sense.
   The perception occasioned  in the cerebral centre  by the vibra-
 tion  of the acoustic nerve, conveys to us the ideas of noise,  sound,
speech, singing,  and music, which are only modifications  of the
 same phenomenon.   These ideas are more or less distinct, accord-
ing to the nature of the object which has determined the vibrations
of the air; because we invariably refer the sensations to the exter-
nal bodies from which they arise, and never to the modification of
our sensitive organs. When sounds convey to us distinct and clear
ideas, we are able to communicate them with the same clearness to
beings of similar conformation with ourselves, either  through  the
medium of  speech, of singing, or of music.  .We even convey to
our fellow creatures, through the medium of the sense of sight,
employing the characters of writing, musical notes,  or gestures, a
part of the ideas we have derived through the auditory sense;  but
 there are many  which we cannot  convey.   These differences
depend solely  upon the organization of the brain, and not at all
upon the sense of hearing.  Speech is heard  and repeated by all
men, who are not deprived of the auditory sense, because they are
all endowed with a cerebral organization,  fit to procure for them
distinct ideas on that subject Music, when viewed as a mere noise,
is also heard by  every one; but it furnishes ideas sufficiently clear
 to be reproduced and communicated  by those individuals only,
 whose frames are organized  in a manner adapted to this  kind of
 sensation.   A similar remark is applicable to a number of  noises,
 which leave behind them nothing but confused ideas; such,  for ex-
 ample, as the voices of animals, the accents of which, although
we hear them perfectly, convey rarely to our mind a definite mean-
 ing.  Whenever we hear a foreign language spoken, it at first sounds 
EXTERNAL SURFACES OF  RELATION.
bl
to us like an idle noise; but as it represents ideas analogous to those
of our own language, we insensibly accustom ourselves to associate
with it these same ideas: whilst, on the other hand, it is impossible
for us to attach any analogous ideas to the sounds of various ani-
mals.  We acquire, on this subject, only notions, more or less ap-
proximative, and often more hypothetical than real: the same may
be said of many other noises.
  The preceding remarks refer entirely to the intellectual part. As
respects the relation of sounds with the play of our organs, we dis-
cover in them phenomena analogous to the  relations of the other
senses; we, consequently, defer enlarging upon them, until  after
we have offered the history of all the senses.

             Section V.—Of the sense of Smell.

  Structure of the sense of Smell.—It is located in a portion of
the superior  mucous membrane, which lines the  nasal fossa; and
the maxillary and frontal sinuses. This membrane adheres, through-
out its whole extent, to bony tissues,  and is abundantly  supplied
with  blood-vessels,  nervous substance,  and mucous follicles.   A
nerve of considerable size, passing through the ethmoid bone in
numerous white and pulpy filaments, after having proceeded a short
distance in the interior of the cranium, under the  cerebral hemis-
phere, is spread over its surfaces, and establishes a correspondence
between it and the centre of perception.
  The nose,  which forms so remarkable a prominence in the  mid-
dle of the face, serves as its protector, and  modifies, by means of
the muscles with which it is supplied, the column of air destined
to produce the  sensation.
  Nature, by placing in the interior of the nose small bones, dis-
posed in a spiral form, and called  comets,  has multiplied the sur-
face in which the olfactory sense resides.  There are other bones,
such as the superior maxillary and frontal, which,  by containing
anfractuosities,  contribute to the  same  end: finally, the  one de-
nominated  ethmoid  presents  many furrows, and forms the sum-
mit of the olfactory arch.  The degree  of  delicacy of the olfac-
tory  sense is proportioned  to the  extent  of the ethmoid bone,
and more particularly of the cornets situated beneath it, as may be
remarked in herbivorous, and some carnivorous animals, and more
particularly in the species of the dog which is employed  in hunt- 
6*2
EXAMINATION OF THE
 ing.   As the olfactory cavities are developed only in the progress
 of age, the sense of smell is much less delicate in children than in
 adults.

           Of the Mechanism of the Olfactory sense.

   The sense of smell places us in relation with all bodies situated
 at a distance from us, provided there  emanate from them particles
 termed odoriferous.  The air  becomes impregnated with these
 particles, and, when drawn  towards the lungs by the movement
 of inspiration, deposits  them, as it passes through the nasal fossae,
 upon the membrane in which resides the sense of smell.
   In order that  smell  should take place, it is necessary that the
 lining membrane of the fossae should be moistened, though not over-
 charged, with mucus; for when  the nostrils are dried or filled  up
 with mucosities, the sensation  is almost  annulled.   From this,
 therefore, it appears, that the odoriferous particles  are  blended
 with the mucus, and by it applied to the membrane on which the
 sensation  takes place.   This operation  is very far from being as
 prompt as that which  procures to us the  sensation of sight and
 hearing; for a certain space of time must always  elapse  before it
 can take place, and we are often obliged, in order to obtain it, to
 excite at short intervals several oscillating movements in the air
 in the nasal cavities, by executing short and successive movements
 of  inspiration  and  expiration;  it sometimes  happens, also, that
 smell is not manifested  until a few seconds after the air charged
 with molecules has  passed through the nasal cavities—a circum-
 stance that depends upon the same cause.

 Of the manner in which the Olfactory sense may  become dis'
               eased in executing its Functions.

  The irritation excited  in the olfactory surface may be so power-
 ful  as  to cause the  development  of inflammation.   Its  primary
effect is to stimulate gently the membrane, and  to promote the
secretion of mucus.   When long  continued,  it produces a state
 of dryness and heat, which may change into a phlegmasia.  This
sense, when too powerfully excited,  likewise loses, in many in-
 stances, its delicacy, as is observed in individuals who  make an
habitual use  of snuff; as they thereby become  insensible to smells 
EXTERNAL SURFACES OF RELATION.
C3
that  are less  powerful than  those  of the substance to which
they are accustomed.  When a person is occupied during a few
hours in smelling aromatic substances, as happens, for example, to
those who are engaged in  the  study of botany, the olfactory sense
becomes blunted,  and only resumes its  accustomed delicacy by
means of rest.
  The  olfactory sense procures  us  different  kinds of ideas—it
affords us that of the  nutritive properties of bodies—it appears to
apprize  us of their chemical composition; whilst, on the contrary,
the senses of touch and sight afford us a knowledge merely of their
surfaces—it furnishes few  materials to the mind, since we do not
derive from it clear  and  distinct  ideas, and our memory cannot
retrace  them  as easily as those which are furnished to us by the
three senses we have already examined.  Hence' we cannot com-
municate these ideas to other individuals.  We recognise an odour
we have already smelled; but when  the substance from which it
emanates is absent, we endeavour in vain to retrace it in our minds,
or to excite it in that of  others, either by means of words or of
figures.   But  if the olfactory sense exercises but little influence on
the mind, it is in return associated by means of very remarkable
relations with the viscera, particularly with those of respiration
and digestion.  In our own species it corresponds in a very limit-
ed degree with the genital organs, whilst it modifies these very
powerfully in  many of the mammiferous animals.  From  these
relations result a great number of phenomena,  in which are dis-
covered many causes  of disease.  We shall examine them in con-
nexion with those of the other senses,

             Section VI.—Of the sense of Taste.

  Structure of the Organs entrusted with this sense. —The por-
tion  of the mucous membrane  entrusted with the  sense of taste is
situated in the mouth. The tongue is its principal seat; and the
nerves by which it is made to  communicate with the centre of re-
lation, resemble all those  that  are destined for general sensibility
and muscular movements.  The tongue, like the fingers, is supplied,
more especially at  its extremity, with a number of papilla;,  which
are made up here, as in every other part, of nervous  matter and
sanguineous capillaries 
64
EXAMINATION OF THE
   The tongue is a fleshy tissue, the muscles of which are attached,
 posteriorly, to the styloid processes of the temporal bone; below, to
 the os hyoidcs; anteriorly, to the inferior maxillary bone.  In other
 parts it communicates, by means of muscular bands called the pillars
 of the velum pendulum palati,  with the palate  bones; and with
 the pharynx by means of other muscles. It contains proper longi-
 tudinal bands, as well as transverse oblique ones,  depending on the
 preceding muscles.  This truly admirable arrangement affords it the
 power of being moved backwards, upwards, downwards, to each
 side—of being  elongated and  flattened when protruded from the
 mouth—of being shortened and swelled so as to form a large mass,
 which is directed backward  and upward, and applied to the  roof
 of the palate;—in a word, to execute movements in all possible di-
 rections.  The  muscular tissue of the tongue is  placed under the
 dependence of the cerebral centre; and the will may dispose of it,
 so long as it meets with no very powerful obstacle from the  wants
of the viscera.
  The parietes of the cheeks, that are contiguous with the tongue,
 and the lips that are placed exteriorly to the. double dental arch, are
 formed of muscles, covered over by the skin, and intermixed exte-
 riorly with a fatty tissue;  whilst the internal surface of these pa-
 rietes is lined by the same mucous membrane which  envelops the
 tongue.  Finally, the velum pendulum palati is in  like manner a
 muscular tissue, separating the mouth from the pharynx, and con-
 taining, between two muscular bands situated laterally and deno-
 minated pillars, a large  gland.   These bands are attached superi-
 orly to the bones of the palate, and are lost in the lateral parts of
 the tongue, which they draw up, as we have already stated, towards
 the superior region  of the mouth.
  The muscles of the parietes of the mouth  are, like the tongue,
under the dependence of the centre of perception; but it  is not
exactly so as regards those that form the velum  pendulum palati;
 hence they are supplied with branches from certain ganglia of the
 great sympathetic, which also furnish some to the pharynx and to
 the olfactory sense.   These ganglia are very  small, and communi-
 cate with those supplying filaments to the apparatus of vision, and
 with the branches that penetrate into the internal cavity of the ear.
  I do not allude here to the vessels of those various sensitive ap-
 paratuses, as they do not afford a subject for any peculiar physiologi- 
EXTERNAL SURFACES OF RELATION.
65
cal remark. Indeed, it is of little importance to the functions of
these organs, that blood  should flow into them  from' one arterial
trunk or another; and it is sufficient, that some should be contained
]n the neighbouring vessels, in order that these organs may be en-
abled to attract into their capillary tissue the quantity requisite for
their vital erection;—now every  one knows, that the carotid arte-
ries, which are very near the heart, supply a large quantity of blood
to every part of the face.

   Of the Mechanism and Sympathies of the sense of Taste.

   When nutritive  substances have been recognised by the centre
of perception, through the  medium of the  sensations transmitted
to it by the other external senses, it commands the  movements ne-
cessary for seizing them; and the  aliments are applied to the sense
in question.   The sense of taste is distributed differently, in  the
various parts of the mouth.  The lips judge more particularly of the
temperature of the aliment, and being  more sensible to heat than
the interior of the mouth, they only permit, when consulted, the
introduction of those substances that are incapable of injuring, in
this respect, that cavity.  The extremity of the tongue, supplied as
it is, with numerous delicate papillae, is the principal organ of taste:
the palate  concurs with  it  in relishing aliments, and particularly
drinks. Those that are pleasant to the sense,  are pressed powerfully
by the tongue against the roof  of  the palate.  If the aliment be
liquid and  pleasant, it is soon swallowed;  if solid, the centre of
perception moves  it, by the aid of the muscles of  the tongue,  of
the lips, and of the parietes of the mouth, in all the parts of this
cavity;—submits it to the action of the different teeth, the assistance
of which is necessary in order to effect its division,  which depends
on the muscles of the lower jaw.   Solid aliments procure,  at first,
but a confused sensation;  as soon as they are triturated they become
mixed with saliva, and the sense of taste becomes  more delicate;
soon, however, this double operation  occasions some change in the
flavour of the aliment, and the movements of mastication tend  to
approach it to the velum pendulum palati.  If this latter, the most
sensitive part of which is the uvula, judges it fit to be swallowed,
deglutition is performed;  if, on the contrary, the aliment be offensive
to the sensibility of the velum  palati, it is once more submitted to
the operation of mastication, or is even rejected.  The velum palati
                              9 
b6                   EXAMINATION OF THE
is, therefore, connected to the gastric sense by more intimate rela-
tions than the rest of the mouth; hence we frequently retain in that
cavity substances, which,  owing to the disagreeable  and nauseous
sensation  they occasion on approaching the isthmus of the fauces,
we cannot make up our mind to swallow.
  We  discover in the sense of  taste the two orders of sympathies
we have already noticed in that of sight.   Thus, in respect to taste
we observe: 1st, Sympathies exercised on the mucous follicles and
on the salivary glands, whence arises  the afflux  of the mucus and
of the saliva: this phenomenon is purely organic.   2d,  Sympathies
exercisedon the muscles of the tongue,  of the parietes of the mouth,
and the elevators of the lower jaw.   These latter only take place
through the medium of the cerebral centre, and  ought  consequent-
ly to be included among the phenomena of relation.
  The centre of perception, attentively occupied with  the impres-
sions produced  by aliments on the different regions of  the mouth,
commands, in virtue of these impressions, the  execution of all the
movements we have enumerated; but if its attention becomes dis-
tracted  by some other stimulation,  it  suspends the operation.
When the appetite  is  keen,  this  distraction  occurs with greater
difficulty;—in proportion as appetite diminishes, it takes place more
readily.   By the force of habit, we acquire the faculty of chewing
and swallowing without necessarily directing strongly our attention
to the operation; but a moderate degree of  it is in all instances re-
quired.  The same thing occurs in this respect, to the  masticatory
muscles, as to those of locomotion; they cannot be moved with regu-
larity, but by the express will of the  individual.   It  is very true
that instinct, when solicited by the  appetite, which has its seat in
the stomach, tends continually to determine the will;  but this in-
stinct does not acquire an absolute control over the muscles of
mastication, as  well  as over those of  locomotion, unless the will
has lost all its influence over these  organs.   Under these circum-
stances, instinct may dispose of them;  as is observed during sleep,
in the delirium of  acute  phlegmasia;  in which the  brain partici-
pates, in those  cerebral irritations which produce hysterical  and
epileptic  convulsions,  and other diseases of a  similar  nature.   In
the greater number of these instances, the muscular movements are
irregular; but they can also be regular, since we observe somnam-
bulists, and  persons  affected with delirium, walk, repeat the ma-
noeuvres of their profession to which they were accustomed—feign 
EXTERNAL SURFACES OF RELATION.
67
prehension, mastication, deglutition, and converse on the subject
of the acts they imagine they execute.   In all these instances the
will is in action; but acts  under the control of instinct; and this
latter is the expression of the irritation of the viscera, which is
transmitted to the centre of perception, and governs it in an exclu-
sive manner.   As soon  as the  irritation of the viscera has been
appeased, the will regains  its empire, and  no longer acts but  in
consequence of reflection.
   There exist in the sense  of  taste, as in that of sight, other rela-
tions  with  the viscera contained  in the different  cavities of the
body.   The brain is invariably the  medium through which they
occur; but we reserve them, together with those of  the same order
belonging to the other senses, for the detailed  history of the func-
tions of relation.

 Of the manner in which the sense  of Taste becomes diseased in
                 the exercise of its Functions.

   Aliments of too acrid, and  drinks of too irritating a nature, give
 rise to inflammation in the cavity of the mouth, excite so power-
 fully the secretion of the salivary glands as to convert it into disease,
 and even occasion the  inflammation of these organs.   In  conse-
 quence of a too long continued exercise, this  function may, inde-
 pendently of the satiety  of the  stomach, become blunted; but it is
 never permanently paralyzed, unless as a consequence of an affec-
 tion of the encephalic organ.
   The sense of taste, like that of smell, furnishes us with clear and
 distinct perceptions; we have in our language words to express
 some of the most prominent among  these; such, for example, as the
 bitter, the acid, the saline, &c.   Nevertheless, memory cannot re-
 produce them in the absence  of those bodies that have occasioned
 them.  Neither are we able to make those with whom we converse
 understand them either by figures or words.  Hence we must con-
 fess that this sense, when compared to those of sight and hearing,
 furnishes few materials to our intellectual faculties.   In compensa-
 tion, however, the sense of taste, as we shall  have occasion to  re-
 mark when tracing the history of the internal functions,  exercises
 considerable influence on the stomach, and addresses itself clearly
 to instinct.  Taste, indeed,  is a purely chemical sense; it decom-
 poses bodies,  and causes instinct to foresee their influence on the 
68
OF  1 HE ENCErilALDM AND
digestive viscera.  As we have already seen, this property is prin-
cipally enjoyed by the basis of the tongue:  the velum palati,  to a
certain degree, participates in it; since, at the moment the aliments
are presented, in order to pass the isthmus of the fauces, we expe-
rience an eagerness or a reluctance to swallow them, according as
they are more or less proper to gratify the wants of nutrition.
                        CHAPTER VI

 EXAMINATION  OF THE  ENCEPHALUM  AND  OF  ITS SPINAL PRO-
                          LONGATION.

   Description of the Brain.—The brain, towards which  all the
 sensations converge, and whence  all volitions depart, consists, in
 great measure, of albumen.  We discover no gelatine or  fibrine,
 except in its vascular coats and in its meninges; but the portion of
 animal  matter presiding more particularly over the sensitive func-
 tions, exists under the form of albumen.   The mass of this latter
 substance, constituting  the  brain, assumes two  different aspects;
 one  portion of it being of a gray, whilst  the other is of a white
 colour.   This  latter presents a linear disposition;  the former, on
 the contrary, offers no such appearance.   These two substances are
 intermixed, the gray portion appearing to  support and give origin
 to the white.   It would  indeed seem that  this latter originates in
 the midst of the other,  by radicles or  lines, which traverse it for
 some distance,  approach each other, unite in bands, and again se-
 parate by intermixing with the gray substance.  Dr.  Gall says, also,
 that whenever a band of white substance  is divided into lines or
fasciculi, in order to pass through  a mass of the gray substance, it
 is larger on leaving than on  entering  it; because new whitish
 lines, which originate in the gray mass, invariably unite  to  the
former, and increase the size of the band.   It is for this reason,
that he considers the gray substance as the  nutritive matter of the
nerves.   %
  The gray substance is in closer  relation  with the blood-vessels
ihan the white; hence  it occupies almost the whole of  the peri- 
ITS SPINAL PROLONGATION.
69
phery of the cerebrum and cerebellum, and receives a very large
quantity of blood from avascular net-work, which lies upon it over
its whole extent, and which is denominated pia mater.   In some
parts of the periphery of the brain, and in the whole extent of the
spinal marrow, the  white substance is found situated externally,
and adherent to the pia mater; but numerous and large vessels are
discovered to originate in that membrane, and separate the lines of
the white substance, in order to  penetrate into  the  gray matter,
which is situated more deeply.  The two substances are doubtless
both supplied with blood-vessels;  but  the gray receives a greater
number than the white, and we may even suspect that the colour,
which serves to distinguish it, depends on this more  than  on any
other cause.
  After examining the relations existing between these two sub-
stances, as also between them and the  blood-vessels, we ,shall next
turn our attention to the direction of the  white lines or fibres.
As many of these lines, when they have reached the periphery,
penetrate into the openings of the cranium, and are  continuous
with  the nerves  proceeding to the different parts of the body, it
was natural they should themselves be regarded as the intra-cephalic
nervous apparatuses, and their arrangement was studied with care.
The only anatomist who has hitherto done this successfully, is un-
doubtedly Dr. Gall; and I do not think I can do  better than to
conform to the descriptions he has given.
  According to this author,  the medulla  oblongata is the central
point of all the nerves of the human  body.  On its superior part
are found four large white cords, in the centre of which, as well as
in that of  the whole medulla spinalis,  the gray substance is disco-
vered: these four cords are the points of termination of all the
nerves that escape through the openings of the spine, or, in  other
words, of  the nerves, which, from all parts of the body, proceed
together to that common centre.
  Of these four cords, the two inferior, denominated  the eminen-
tisepyramidalia, pass through the mesocephalum, or pons varolii;
they enlarge as they ascend, and become the crura ot peduncles of
the brain.   They soon divide into bands, and pass through two
masses of gray matter; one of which is very improperly denomi-
nated thalamus nervici optici, and the other corpus striatum. We
say improperly, because the optic nerves, in their passage totheante-
rlor tuberculaquadragemi?ia.i>diSsdong the lateral portions of these 
70
OP THE ENCEPHALUM AND
bodies without being lost in their substance. These tubercles, them-
selves, constitute part of the cord in question, and, after dividing
into these enlargements of gray substance, are also continuous with
the  peduncles and pyramidal eminences.    The  peduncles once
more approach each  other, and are considerably swelled by the
addition of a number of other bands, that originate in those enlarge-
ments; they next enlarge, spread out in the shape of a fan,  and con-
stitute a white membrane, which unites closely with the gray sub-
stance of the periphery.  This membrane, which, owing to its ad-
hering now to the gray substance, is externally of the same colour,
presents a white appearance internally,  and  conveys to the  mind
the idea of a kind of balloon, divided into two segments called hemi-
spheres, and the size of which would greatly surpass that of the head,
had  not nature taken care to fold it on itself in the same way as the
intestines:  these folds constitute  the  convolutions of the brain.
It is by means of this artifice, that this membrane is enabled  to be
contained within the  limits of the cranial cavity.  This  arrange-
ment is shown to exist by hydrocephalus, and we may, with a lit-
tle  patience, practise an  unfolding, by which it  will be rendered
equally evident on the dead body.
  After lining the internal surface of each hemisphere of the  cere-
bral balloon, the  white membrane  in question  proceeds  towards
the internal  parts, where these hemispheres are contiguous; and the
lines or fibres by which it is constituted, are  condensed, and  unite
under them  in order to form what is called the corpus callosum.
Proceeding afterwards posteriorly and inferiorly, these fibres form
successively the septum lucidum, the fornix, as well as the ante-
rior and posterior commissures; but they are not continuous with
the crura cerebri, for the purpose of returning to the corpora py-
ramidalia.
  In order to form an idea of the structure of the cerebellum, we
must again direct our attention to the four cords, which are disco-
vered at the superior extremity of the  medulla oblongata.   It may
be remembered, that the two inferior, or  corpora pyramidalia,
went to form the hemisphere of the cerebrum.  We shall now see,
that the two superior, or corpora  restiformia,  will  furnish the
white and linear substance  of the cerebellum.   These two cords
soon spread, and unite to the gray substance, placed at the periphe-
ry of the cerebellum. We cannot doubt, that the union to these two
substances, which constitutes what was formerly denominated the 
ITS SPINAL  PROLONGATION.
71
arbor vitas, consists of a membrane folded on itself; but Dr. Gall has
not as yet succeeded in unfolding it
  From this membrane folded on itself, which constitutes the ce-
rebellum, proceed, according to our author, white fibres, the origin
and relations of which with the expansion of the corpora restifor-
mia, are  not known.   However  this may be, these fibres, in con-
verging towards each other, form the pedunculi of the cerebellum,
and  finally  unite at a raphe, on the inferior  surface  of the meso-
cephalum, usually called pons varolii.
  If we remove this eminence in  successive horizontal layers, we
shall discover behind the white covering, resulting from the union
of the returning fibres of the cerebellum, some gray matter inter-
sected by lines proceeding from the expansion of the corpora pyra-
midalia: consequently the mesocephalum  is formed of transverse
fibres, proceeding  from the cerebellum;  of longitudinal  fibres,
arising from the corpora pyramidalia, and of a gray substance which
serves for their support: and yet these two kinds of fibres, proceed-
ing each to  its destination, pass near to each other, without inter-
mixing, and even without any apparent union between them. The
two hemispheres of the cerebellum are, consequently, constructed
on the same plan as those of the  cerebrum.  The former, as well
as the latter, receive white fibres  from the medulla oblongata, and
furnish others, which unite at their respective centres;—namely, the
corpus callosum for the cerebrum, and the  pons varolii for  the ce-
rebellum.   The diverging fibres  of  these four hemispheres being
continuous with the medulla oblongata from which they originate,
are also continuous with all the nerves of  the body, since there  is
none but what communicates with  the medulla oblongata;  whilst,
on the  contrary,  the converging fibres are  not  united to these
nerves by their central points  of  union; but it is easily conceived,
that they communicate with them  after a circuitous course, since
they are continued with the diverging fibres in the convolutions of
the cerebrum and cerebellum.
   The medulla oblongata,  and not the pons varolii,  constitutes,
therefore, the central point of all the white fibres of the encepha-
lum, which are now regarded as the intra-cerebral nervous appara-
tuses, and also of all the extra-cerebral nerves which communicate
with the different parts of the  body.   If, therefore, there exists a
single centre of sensations and volitions, we  cannot conceive it to
be olsewhere than  at this point, which, as the most essential, is also 
72
OF  1'llE ENCEPHALIM AND
the most hidden, and best protected, of the whole encephalic mass.
At any rate, it is very certain, that in rabbits respiration continues,
although we remove, by layers, all that portion of the encephalum
situated above the  medulla oblongata; and that it ceases, as soon as
that portion of the medulla in which the nerves of the eighth pair
are inserted, is destroyed.  [See the Experiments of Legallois.]
Now,  as it ceases also, when an incision is made below this inser-
tion, (op. cit.) I thought myself justified in drawing the following
conclusions, in a memoir inserted in the Journal Univcrsel dea
Sciences MSdicales.
   Respiration is founded on the perception of the  want  of  air.
This want is conveyed to the centre, by the nerves of the eighth
pair; the centre, by acting  on the nerves proceeding from the me-
dulla spinalis, determines the movement of the inspiratory muscles.
Granting this, if we destroy the point of insertion of the eighth pair,
the want of air is no longer felt, and respiration ceases: by cutting
the medulla, below this  point, the  want of air is  felt; but as the
central point,  to which it has been  made known, no longer com-
municates with the nerves  proceeding to the inspiratory muscles,
respiration must equally  cease.
   After  this reasoning,  I have made  the following.   If there be
but  one centre  of perception  and volition,  it must be situated at
the point where the  perception of the want of respiration is felt,
and  from which  emanates the volition  determining the  action
of the  respiratory muscles.   This point is situated at  the  insertion
of the  nerves of the eighth  pair; consequently,  it is the only centre
of all the perceptions and volitions.
   It is without difficulty  perceived, that the whole of this reason-
ing is founded on another fact; namely, that respiration is the effect
of a sensation.   In the memoir already alluded to, I have taken
pains to cite the facts which  serve  to prove that respiration really
depends on this mechanism.   I have  more particularly called to
my aid the respiration of the amphibious animals,  which remains
suspended  during a much longer  period  than  that  of  others,
and is  executed  only when the want becomes  so  imperious as to
force the individuals of that class to  leave the bottom of the water,
in order to seek the external air.
   I am not aware of the degree of importance that will be attached
to these propositions,  by physiologists; but, as I am not acquainted
with any fact opposed to them, I am still inclined to adhere to them; 
ITS SPINAL PROLONGATION.
73
and it is on this basis that I propose to establish all I shall have to
say respecting the cerebral functions.
   The spinal  marrow cannot be considered otherwise than as a se-
ries of ganglia formed of gray central substance, and of white fibres
placed on its surface.  We distinguish  in it three considerable en-
largements; one cervical, one dorsal, and one lumbar,—in which all
the cerebral nerves terminate.
   The spinal marrow, when it has reached the last dorsal vertebra,
contains no longer any gray substance; and  consists now of large
nervous cords, which are supplied with their neurilema, and escape,
together with this envelope, through  the  foramina of the  lumbar
vertebrae and of the sacrum.   Consequently,  from the dorsal re-
gion, the neurilema exists in the spinal canal, and does not, as in
the superior  regions, only commence at the  circumference of the
foramina. This assemblage of lumbar and sacral nerves is no long-
er called medulla, but receives the name of Cauda Equina.
   The neurilema is found in those nerves only that proceed a  long
distance, in the various organs of the body,  before reaching their
place of destination.  Hence it is hardly apparent  in  the optic
nerves,  so long as they are contained in the encephalic cavity.
These nerves have no other envelope than a very delicate coat de-
rived from the arachnoid, until they pass out of the cranium; after
this, they are contained in a solid sheath, furnished by the pia ma-
ter, and embracing the small cylinders of their neurilema.   Final-
ly, the acoustic nerves, which never leave the osseous cavities,  pre-
sent appearances precisely analogous to the white lines of the brain,
although it is reasonable to suppose  they are covered with a thin
layer of the  same nature as the arachnoid, and  such as we admit
to exist  in the ventricles, and between the lamina; of the septum
fucidum.
   From these approximations we are justified in believing, that the
white  and linear  substance of the brain is  continuous  with  the
nerves, the neurilema of which  is very solid; and that  it  is  also
contained in those small cylinders that are formed  by this enve-
lope.
  The neurilema, or envelope of the nerves, is the continuation of
the middle membrane of the encephalic  apparatus,  denominated
the arachnoid.  This,  consequently,  is the proper moment for
speaking of those coverings of the brain, which  collectively arc
designated by the name of meninges.
                              10 
74
OF THE EJsCEPllALtAl AND
   The one among them which is nearest to the cerebral matter, if
 nothing more than a vascular net-work, derived  in great measure
 from the subdivision of the carotid  and vertebral arteries, which
 supply blood to the encephalic apparatus.  This net-work contain?
 likewise veins, which, however, are of small  size,  because they
 deposit their blood in large cavities denominated sinuses.  A cel-
 lular, or rather laminated  tissue supports these vessels,  and it is
 this assemblage which constitutes ihe pia mater.
   The pia mater is covered  over by the arachnoid, which  is a
 transparent membrane, of the nature of the serous tissues, and ex-
 haling and absorbing a serum, which appears only in form of a va-
 pour.  According to Bichat, the arachnoid is a sac without open-
 ing, which, on the one hand,  is spread over the membrane adhering
 immediately to the  internal  surface  of the bony parietes, and, on
 the  other, covers the convolutions, without penetrating between
 them.   It is also found on all the pedunculi of the cerebellum—
 on the medulla spinalis—in the ventricles—around the nerves until
 they leave the cranium or spinal canal, and  upon all the folds of
 the most external of the meninges, known under the name of dura
 mater.
   This latter membrane possesses a much greater degree of consist-
 ence than the others, and serves as the internal periosteum of the
 cranium  and spine:  its internal  layer is detached  from the exter-
 nal one in order to form various folds, known under the names of
falx cerebri and tentorium cerebelli.   These  folds serve to sup-
 port these two organs, and contain the sinuses of which we have
 already spoken, and which  consist in a sort  of canals  performing
 the office of veins,—receiving the blood from the smaller veins of
 the  pia mater, and  depositing it into the jugulars, by which  it is
 conveyed to the heart
   Such is a general  sketch of the structure of the cerebral appa-
 ratus.  The arteries which proceed to the brain and spinal marrow
 are  surrounded by  nerves, called ganglionic, and of which we
 shall speak elsewhere.  The  existence of lymphatics in the  sub-
 stance of the brain, has long been denied; but, at the present time,
 the researches of professor Lobstein, of the faculty of Strasburgh,
 have led some anatomists to admit them.
   Dr. Gall recognises two sorts of nerves.  1st, The extra-cerebral,
 which are familiar to  all  anatomists:  he regards  them as arising
 from the different parts of the body, and proceeding to the medulla 
ITS SPINAL PROLONGATION.
75
oblongata, either by penetrating into the cranium through its fora-
mina, or reaching  the same part through the occipital hole, after
passing into the spinal canal by its foramina.   The next set of nerves
consists of the intra-cerebral; for according to this author we must
view as a nervous apparatus, all  those white lines which arise from
the medulla oblongata,  in  order to  form  the hemirpheres of the
cerebrum and cerebellum.   He also considers as a nervous appara-
tus,  but situated in  the centre  of the preceding ones, all  the other
white fibres, which  unite at the corpus callosum, at the septum
lucidum, at the fornix, and  at the commissures..  All these internal
nervous  assemblages,  are doubtless  nourished by  the  gray sub-
stance in which they originate.  Derived from this substance, which
is their matrix and  support, such of these apparatuses as  form to-
gether with it  the  convolutions of the cerebrum and cerebellum,
proceed to, and unite at, the superior part of the medulla oblongata,
whence we have seen  them  arise by the four pedunculi already
mentioned.   In respect to the central apparatuses, he  does not
view them as converging towards the medulla, but as independent;
acknowledging at the same time, however, that they communicate
with the former in the  membrane forming the convolutions of  the
brain; but this  communication  necessarily supposes  that the me-
dulla oblongata  is also their common centre.
  Every one is aware of the use of  the extra-cerebral nerves:  ac-
cording  to Dr.  Gall,  the others are particularly destined  to  the
intellect, to the propensities, and to instinct.  He even goes so far as to
designate,  under the generic name of organs, the  regions  of  the
encephalic cavity,  occupied by each of these apparatuses.  It is in
this way that he recognises the organ of courage—of pride—of theo-
sophy &c. which signifies nervous apparatus destined to courage,&c.
The whole cerebellum appears to him destined to the instinct of pro-
pagation.  Here commences  the uncertain, the undemonstrated,
the  hypothetical: but since, in the series of animals, the volume of
the  cerebral hemispheres diminishes with the intellect, although the
extra-cerebral nerves  acquire at the same time a degree of develop-
ment proportioned to the force of the muscles, and the delicacy of
the  senses, it appears to us evident, that the nervous substance  con-
stituting the brain, is actually devoted to the exercise of  the intel-
lectual faculties, of the  affections, and of the propensities.  It now
remains to determine whether these white lines are the  principal
agents of these phenomena, or whether  they are not rather the sim- 
76
SENSATIONS—INSTINCT,
pie conductors of the sensations and volition, which would then have
their seat in the gray substance.  This question appears to me ol>-
scure; but I do not perceive, in the theory of the German physician,
any reason for refusing to admit a central point for all the nervous
operations; and from the observations I have already made, I am in-
duced to place it in the superior part of the medulla oblongata.
                       CHAPTER VII.

EXAMINATION OR STUDY OF THE SENSATIONS, OF INSTINCT, AND OP
               THE OPERATIONS OF THE INTELLECT.

   In a state of health,  and when there does not exist any sense
created by a morbid condition  of the  system, all the sensations
originate from an impression made on a surface of relation.   I have
said that these surfaces were of two kinds: the  external, consisting
of the five senses  generally admitted;  the others internal, which
cannot consist in any thing but the mucous membranes, and some-
times their appendages.  We have seen above, that the wants ori-
ginated from  the  latter surfaces, in order to reach  the cerebral
centre.   It is of the highest importance to bear this  in  mind, in
order to form an  idea of instinct and of the intellectual faculties;
since these two orders of operations are invariably modified by the
condition of the viscera.
   Thus, whenever a stimulating action is exercised on an external
sensitive surface, it is reflected by the cerebral centre to the internal
senses.  This reflection occasions another sensation in  the cerebral
centre; and it is in consequence of this latter that this centre is im-
pelled to action.
   But the operations of the centre, though all determined by the
same cerebral point, present themselves under  two aspects; 1. the
acts relative to the urgent wants; these belong to the domain of in-
stinct: 2. acts relative to remote wants; and it is by these latter that
we arrive at a knowledge of the intellect.

         Sect. I.—Development of these  Propositions.

   The object of all the  acts is to increase the duration of pleasure*
or to shorten that of pain.   This phenomenon, when applied to the 
OPERATIONS OF THE  INTELLECT.
77
gratification of an urgent want, gives rise to the acts of instinct;—
when applied to the gratification of a remote want, they give rise
to those of the intellect.  Both imply, that the portion  of the brain
destined to feel the wants and command the acts, is sufficiently de-
veloped, and is not in a pathological state. Let us first examine the
acts, and all the phenomena of instinct.

     Sect. II.—Of the Phenomena of Instinct in general.

   By  some  physiologists it  is  maintained, that the brain alone
presides over the instinctive operations; because they invariably re-
mark a development of certain regions of the brain, corresponding
to certain acts in animals.  I am far from wishing to deny, that the
brain feels the wants, and commands the acts of instinct.   I am
willing to agree with Dr.  Gall, (to whom alone we owe our actual
knowledge of the  structure of the brain, and more precise ideas of
the acts over which it  presides,) that there exists intra-cerebral
nervous  apparatuses appropriated for a certain order of ideas; but
I cannot coincide with him in opinion, that the brain acts indepen-
dently of the other viscera.  Animals possess invariably the cere-
bral organs, (to conform myself to the language  of  this author)
which preside over the prehension of aliments,—the acts relative to
generation, such as the seeking after a female or a male, copulation,
construction  of the nest, incubation, the action necessary for seek-
ing nourishment for their young, depositing their eggs in a certain
place, fecundating those of their females, protecting and defending
their young, disputing for the  enjoyment of a female, &c. &c.—
Wherefore then do not these animals constantly perform these acts?
Because the condition of the viscera, which solicits  these from the
brain, is not  constantly the same. Whenever the  stomach is full, 01
diseased, the acts requisite for seeking and seizing  aliments cease.
If we remove the testicles, the acts relative to generation, and we
already know how numerous they are, cease to be performed. It is
alleged, that  in this case the cerebellum becomes atrophied:  even
this I am willing to admit; but if it be true, that it presides over
generation, it has become atrophied only because the stimulus of
the sexual organs has ceased to maintain it in a state of action.  It
is asserted, that the loss of the sense of  sight occasions gradually
the obliteration  of the ideas which were furnished  by that sense.
If this fact be certain, it serves to confirm my proposition, by prov- 
7S
SBNSATIONS--INSTINCT,
ing, that the brain acts only in concert with the other viscera.  But
let us again direct our attention to the  acts of generation.
  If,  when a hen becomes impelled to incubation,  we dip several
times its belly in cold  water,  the excitement disappears, and the
kind of clucking which accompanies this  desire ceases,  together
with all the other acts which tended towards the same end.   How
shall we explain this phenomenon, unless we admit, that the desire
of incubation is suggested to the hen by a sensation which the brain
perceives in the abdominal viscera?  Similar observations have not
been made on insects; but who will assure us, that experiments for
demonstrating in them a similar fact,  will not  be devised?  Let
individuals who cultivate the science of zoology, or the veterinary
art, take the trouble of making local bleedings to the vulva of
females of quadruped mammiferous animals, at the time of rutting^
let them apply a great number of leeches, and they will see whether
the ardour  these animals experience for copulation does not in some
measure diminish.
  It is said that migratory birds are guided only by their cerebnl
organization; yet it is certain that they do not arrive on a fixed day,
and that if the development of spring be retarded by the prevalence
of cold winds, swallows appear later than usual, or else  retire after
having already appeared:  but even were these differences not to
occur, as the migrations of these birds cannot be the  effect of rea-
soning, it follows, that they can only depend on  the  manner in
which the  viscera are modified; and I cannot help thinking, that
the sensations  which determine the action of the  cerebral centre
are perceived by it in the other organs. Cold and heat must operate
on them in the same way as on quadrupeds that live under our eyes;
and in all these latter we easily perceive that the turgescence of the
genital organs,—an effect of heat, is the cause of the acts relating to
generation; since castration puts a stop to their manifestation.  I
have already said, that the  acts which relate to the prehension of
aliments are subordinate to the wants of  the stomach.  Now, why
should we deny, that the changes of temperature which compel
migratory birds to depart, act on the skin, and thence on the diges-
tive and genital organs,  and determine  in these  parts sensations
which are reflected to the brain?
  There are still other instinctive acts of which I have not spoken;
they are such as  have  for  object to avoid any imminent danger.
These acts are  founded on the love of self preservation, and this 
OPERATIONS OF THE  INTELLECT.
79
love is itself founded on pleasure and  pain.   Every thing that
causes pleasure determines  the animal  to  approach the external
agent which procures it;  whilst, on the contrary, that which causes
pain developes in him those  acts, which  have for object,  either to
repel the agent or escape from it.   If he repel it, it is anger; if he
fly from it,  it is fear.  Fear  and anger are the effects of two diffe-
rent kinds of pain;  but still  they are pains, such  too as are per-
ceived very plainly by the cerebral  centre  (if we judge of them
from our own species), in the organs situated in distant parts of the
body; as for example,  in the chest, in the heart which is agitated
by palpitations, in the cutaneous envelope, and more particularly in
the abdominal viscera.  Now,  we have just seen that the other in-
stinctive  acts were determined by irritations perceived in these
same organs.   All these  instinctive  sensations,  and  all the acts
emanating from them, suppose then a simultaneous  action of the
brain or viscera.
   The physiologists who attribute all to the brain, answer these
objections by saying, that all visceral sensations, accompanying in-
stinctive acts, are nothing more than an accidental irradiation of
(he cerebral excitement, which traverses the nervous system with-
out any distinct object; and that, consequently, they cannot be the
immediate cause of these operations.   To this I have already an-
swered in anticipation, by proving, that the acts relating to nutrition
and generation are  subordinate to the state of the internal organs
interested in  these wants.   It only  remains, therefore,  to apply
this answer  to  the acts relating to  the want of self preservation.
Than this nothing is more easy; since the sensations which  keep
up anger or fear in the brain,  are  perceived in the same viscera
which preside over these  two wants.  It will be objected, that sen-
sations are  not the causes, but the fortuitous accompaniments of
anger and fear.  To this I will answer by new facts, as common
and simple as the preceding.   If it be desired that a person should
become easily irascible, it is only necessary to produce  in  him a
gastritis, by means of stimuli  repugnant to the sensibility of his
stomach.  Do you wish to restore him to his accustomed mildness,
remove that inflammation.  If you wish  to impart courage to the
greatest coward, it is only necessary to  stimulate his stomach by
means of a substance agreeable to  the internal sense residing  in
that viscus,  and particularly  by means of fermented liquors.   We
discover examples of these modifications even among animals.  Hy- 
SO                  SENSATIONS--INSTINCT,
drophobia is  kept up in the dog  by means  of an inflammation of
the stomach; and it is to the different degrees of this irritation, that
we must attribute his fears, his melancholy, and his fits of rage,
during which we find him  braving men and animals, that in a state
of health would have put him to flight.   Spirituous liquors act on
several quadrupeds in the same manner as on man; they exhilarate
them, inspire them with courage, and  pervert entirely their natu-
ral disposition.   Even were the  physiologists, to whom I am  op-
posed, to maintain, that all the influences of the viscera upon  the
brain are accidental, it would, nevertheless,  be true,  that they
exist, and that, consequently, the cerebral centre does not act in
an independent manner.  But, were these physiologists to maintain
such a proposition, they would do  so  without foundation; since
nothing can overthrow the proofs I have given, with a view of de-
monstrating that the  brain  invariably acts in concert with the inter-
nal organs  for  which the bodies  which stimulate  the external
senses are destined.
   In advancing these propositions, I do not pretend to deny that
there exist, during the exercise of these instinctive faculties, sensa-
tions purely accidental; they  certainly  take  place, but do not  de-
stroy the influence exerted by the viscera.   For example, during
the venereal  orgasm,  sensations are  felt  in  the  eyes,  mouth,
muscles, joints,  &c.   Hunger gives rise to others nearly analogous:
but these sensations are not necessary; they  might not occur, and
in a great number of cases, in which the want is moderate, they
cannot be  detected; whilst,   on the contrary,  those that reside in
the genital organs and  in the stomach invariably take place.
   From  these considerations,  then, results a fact to which we have
already several times called attention; namely, that when the cere-
bral centre receives sensations produced on the external surfaces of
relation,  by such external  agents as affect powerfully the viscera,
either for the gratification of the wants of one of these,  or else for
the preservation of life, this centre invariably experiences secondary
sensations proceeding to it from the viscera.   Hence, in all these
cases, it is keenly solicited to execute those acts required by these
wants; and it is these same acts which we refer to instinct.
   Nevertheless it does not execute them in all cases;  from which
arises a difference, well worthy of attention, among the acts which
depend on instinct.  Thus, there are some which the centre  is com-
pelled to execute instantaneously; others which it can defer during 
OPERATIONS OF THE INTELLECT.
81
a longer or shorter space of time; others, finally, from which it can
abstain entirely.  In proceeding to the  investigation of these three
orders of acts, we shall finally succeed in discerning the passions,
and the intellectual faculties.

   Sect.  III.—Enumeration of the Phenomena of Instinct.

   Those acts,  the execution of which  cannot at any period of life
be deferred, are such as relate to the most urgent wants, or those
the delay of which would instantly endanger the integrity of action
of the principal  viscera.   Of all our wants, that of respiration is
undoubtedly the most urgent;  hence it  is in the action of the respi-
ratory muscles, that we discover the acts, the execution of which it
is less in our  power to defer.   It is always the stimulation of the
mucous membrane of the trachea and bronchia that determines in-
spiration and expiration.  Now, if a foreign body be placed on this
membrane, we are forced to inspire and expire precipitately;—this
constitutes cough. If the stimulus be applied to the mucous mem-
brane of the nose,  whence  it  acts  sympathetically on  that of the
lungs, the same phenomenon,  somewhat modified, is offered;—this
constitutes sneezing.   I shall explain more fully the mechanism of
these two acts, when I come to speak of the respiratory apparatus.
Next to the  stimulation caused by foreign bodies,  we notiee that
which is produced by the want  of fresh  air.   This want  is less
urgent than  the other,  and  we can suspend the acts  it necessitates,
as is exemplified at every moment in crying, speaking, or singing.
  The want of nutrition comes next to that of respiration: like the
last, it depends upon  the stimulation of a membrane of relation,—
that of the digestive canal; but the acts which are dependent on it
are of several  kinds.   Those  which are solicited in this mucous
membrane, as  in that of the lungs, by the presence of foreign bodies,
are always the most urgent, and cannot be avoided. Thus, it is not
in our power to prevent vomiting, and the attitudes it requires; and
we can only retard for a time  the voluntary movements, which are
to concur in the expulsion  of  foecal matter.  But as respects  the
want of eating, or of drinking, we have  the faculty of deferring
the acts they  necessitate, and  even to abstain from them entirely.
Nevertheless, in those cases, the viscus  does not cease to solicit the
brain; and in too many instances the stimulation which  the former
                              11 
82
SENSATIONS--INSTINCT,
experiences,  causes it to pass to a pathological  state,  as we  shall
have occasion to show in another place.
  Next to these instinctive acts, in  point  of urgency, are those
that relate to the preservation of the  life of the individual.  Every
thing that threatens us with speedy destruction, tends to give rise
to precipitate acts, which are  referred to anger, fear, and to other
passions, of which we shall soon speak. We can resist the sugges-
tions of instinct, which impel  us to  the execution of these acts, but
alas! we too often give way to its impulses.
  There are still other acts, which may be classed in the same series,
or at  least there are desires equally subordinate to  instinct, and
which lead us to act in a particular manner, or to seek repose; such
are the inclination we experience to accelerate our steps, when we
feel the  external cold,—to remain in a state of inactivity under the
influence of an excessive heat,—to place ourselves in such a position
as will enable us to yield to the  want of sleep,—to lie down,—to
give way to stretchings,  yawnings,  &c.  We could enlarge much
more this interesting  series of instinctive suggestions; but  what I
have said must suffice to  make them well understood.
  The acts solicited by the want of reproduction are  likewise sin-
gularly multiplied,  comprehending as they do the movements ne-
cessary for the approach and union  of the sexes.  These acts may
undoubtedly be  deferred or even abstained from;  but are females
capable of preventing the action of the diaphragm, of the inspiratory
muscles, and even of the limbs,  which take place in aid of the con-
traction of the uterus? And do we not perceive here, as in the other
wants, that the stimulation of  an important viscus disposes  of the
cerebral  centre independently of the will? We have seen in the
history of vision, instinctive acts, over which the will exercises no
influence; such, for example, as  certain movements of the eyelids;
and we  have found others analogous  in the  sense of smell, and in
deglutition.   It is only necessary for me to recall all  these facts to
the attention of the reader.
  We must further refer to instinct the acts solicited for the ali-
mentation, preservation, and  protection  of the infant: they are
truly of the same kind; and although they are sometimes eluded by
the power of the will, the want which requires them, solicits it in
many cases, though more particularly among females, with a degree
of energy of which reason is incapable of annulling the effects. 
OPERATIONS OF  THE INTELLECT.
83
   If this faculty affords us the power of retarding or preventing,
whilst in a state of health, a great number of acts which  instinct
requires of us, the same thing does not take place in disease.  If a
viscus be inflamed somewhat intensely, it stimulates the brain with
inconceivable energy,—it assumes absolute control over the centre
of perception and of volition.   It is  by virtue of this law  that we
cannot suppress, in an acute gastro-enteritis,  the voluntary move-
ments indispensably necessary for demanding and  seizing  drinks,
for refusing solid food in the same disease, for procuring heat during
the febrile chill, and cool air in the period immediately succeeding,
—for placing  ourselves in a manner the most advantageous for in-
spiration during an attack of dyspnoea, for changing our position in
the restlessness depending  upon gastric irritation, or arising from
some obstacle to the circulation and to respiration,—for speaking,
vociferating, singing, rising, walking, running, attacking with vio-
lence surrounding persons,  or even committing suicide in phrenitic
deliriums.
   We must likewise class under the same head, convulsions occur-
ring in  individuals affected with epilepsy,  hysteria,  apoplexy,
tetanus, &c.
   All these acts are in like manner  subordinate to instinct; they
consist merely in a vicious extension  of the instinctive phenomena
we experience in a state of health, and most of which are tolerably
calm.  If they constituted the whole of the depravations of this fa-
culty, of which our species offers examples, we should at least not
have  occasion to blush; but, alas, under certain circumstances in
which we have no longer for excuse the morbid state of the brain,
this faculty takes on a hideous degree of development;—I allude to
great public calamities.   From those who have detailed the  terrible
event by which the crew of the frigate La Mtduse were exposed
to the horrors of hunger, we learn that the individuals  abandoned
on the open sea upon a raft, were in  a continual state of phrenzy,
and gave way to acts of  the most  disgusting ferocity.  What had
become of reason under this deplorable circumstance? Was it not
overcome, subdued  by the irritated stomach?  It is true, that on this
occasion some men  were seen so obstinately to resist this want,  as
to allow themselves to die.   But how much  must it not have cost
them to do this?  Many have confessed  it in detailing their tor-
ments.  It must be allowed, however, that  these examples are
very few, and depend upon an extraordinary  increase of the influ- 
34
SENSATIONS— INSTINCT,
ence exerted by the encephalic nerves on the centre of perception;
but tli is increase, however great, does not prevent the solicitations
of instinct  I refrain from sketching the examples of cold indiffer-
ence towards other men, and of ferocious egotism observed in many
unfortunate situations; as for example, in the retreat from Moscow.
It is precisely under these circumstances, that we notice the dimi-
nution of the influence of the intellectual faculties,  and that we are
enabled to appreciate the whole of that of the instinct of nutrition,
and of self preservation.  It is at least very honourable for our
species, that men in whom by education the intellectual faculties
were developed,  should have resisted much more  than others,
under those calamitous and cruel circumstances, the suggestions of
instinct;—that they should even have  triumphed over them, and
offered  examples of a disinterestedness,  of a generosity and self
denial,  of which  individuals  over whom the senses  predominate
cannot even form an idea.
   These  instances  of heroism are not met with  among savage
nations, where instinct, being uncontrolled by the cultivation of
the mind, becomes developed in the most energetic manner.
   It is now many years,  since, extending  in my lectures the idea
suggested by Cabanis, I referred instinct to the  influence of the
viscera upon the  brain.   Since that period this idea  has been ad-
vocated by a modern  writer, who has placed instinct exclusively in
the nerves of the grand sympathetic,—which, in imitation of Bichat,
he regards as  alone presiding over the internal  functions.   It is
not thus, however, that  I understand it.  There are in the viscera
cerebral nerves; and it is by means of these that the centre of per-
ception is made acquainted with  the wants.  It would be easy to
show, that the viscera most supplied with cerebral nerves, are also
those the wants of which are most energetically felt by the centre
of perception.  • Such  are the genital organs,  the stomach, and the
internal membrane of the  respiratory sense.
   It is remarkable,  that the suggestions of instinct are opposed by
the cerebral nervous apparatuses, which are charged with the exe-
cution  of the intellectual faculties.   Thus, the greater the develop-
ment of these apparatuses, the combination of which constitutes the
hemispheres of the brain,the less powerful is the influence of instinct,
and vice versa;—so that it predominates alone among the animals
of the lowest classes, in  which the hemispheres are very small, or
even entirely wanting.  The cerebral centre receives  the influence 
OPERATIONS OF THE  INTELLECT.
S5
of the external nerves, and of those of the hemispheres, and yields
to the most  powerful.   If, therefore, it be wished to diminish the
voice of instinct, it will only be necessary to exercise powerfully,
from earliest infancy, the nerves destined to the intellectual facul-
ties,—for then they will predominate; those of the internal senses
will act in a less energetic manner on the  centre of perception, and
the volitions will be more under the control of the mind than of in-
stinct,—unless, indeed, inflammation should have increased the in-
fluence of the internal  senses, as happens in the delirium of acute,
and even of chronic diseases.
  This appears to me to  be the place, however, to speak of the re-
lations with external bodies, which determine the varieties existing
in the phenomena of instinct.  These relations, doubtless, are inex-
plicable,  depending, as they do, on first  causes; but they  may be
observed, and this is a sufficient reason for detailing them.
  As soon as an animal is born,  the organs of which it is composed
are formed in such  a manner as  to enable them to receive certain
impressions, whilst they remain insensible to several others;  in other
words, as soon as their external surfaces of relation are placed in
contact with certain bodies of nature, they experience from them a
stimulation, which  is repeated in their brain, as well as in their in-
ternal nervous apparatuses, and which determines certain acts; whilst
the same surfaces of relation are insensible to  the action of  other
bodies, capable of producing impressions on other  animals of a dif-
ferent conformation.   Each organized being possesses, therefore,
peculiar  relations,  founded  upon vital affinities proper to it, and
occurring only between it and a certain number of external bodies.
As soon  as these latter are placed before it, it recognises them, by
virtue of the stimulation produced in its interior,  and its centre of
perception immediately commands the acts which are requisite for
bringing it near to those  bodies, in order to make them subservient
to its wants or to those of its young; or in order to escape from them
if they threaten its  existence.
  In the lower orders of animals, none of these phenomena are the
result of reflection; for, deprived as they are of the intra-cerebral
nervous apparatuses, which, in other beings, procure the faculty of
observing the impressions received, and modifying it, they can only
obey; and the consideration of danger, not existing in them, cannot
offer any obstacle.  This may be exemplified by a fly plunging in
honey, although it  must remain in it, and perish.    No sooner has 
8b
SENSATIONS--INSTINCT,
a man deposited his excrements in a field, than a number of insects,
scattered in the neighbourhood, precipitate themselves upon them,
for the purpose of depositing their eggs.   Have they reflected that
this matter was the most proper for the development of their young?
Certainly not.   They have received an internal impulse, occasioned
by the exhalation from the substance in a state of putrefaction, and
they obey it instinctively. If similar exhalations arose from another
body, unfit for the accomplishment of the same object, they would
still obey.   Hence,  they are known to seek, on the chenopodium
foetida, and  other  bodies accidentally impregnated with  putrefac-
tive vapors, a place  which is incapable of serving for the incuba-
tion of their eggs.
   Examine the inconceivable multitude of caterpillars which abound
in the country; they seek for, and will be able to recognise, amid
thousands of plants, those  that may be  proper for their food; and
each plant has its particular caterpillar and  butterfly.   Take the
nympha of this insect,—make it hatch, and  keep it  away from its
plant; the young caterpillars will die.   If, however, you carry it
into the  middle of a field, it will travel under  your eye  during
several hours, or even days, until it finds a plant like the  one with
which its parent has fed, and on which itself was hatched,—although
this plant has never before been placed in contact with its external
surfaces of relation.
   The bee will go out and  seek those flowers which  are proper for
it; it will construct the hives, and fill them with honey; whilst its
queen will deposit her eggs in each cell, without being disturbed
in this occupation by the presence and attentive observation of man;
because they are deprived of those cerebral organs which could
render them susceptible of being thus alarmed.   The same remark
is  applicable to the greater  number of insects; whereas, the spider,
which is provided  with these organs, will remain in its hole, if an
individual has  already touched its web, and will  leave the fly,
which has become entangled in it, struggling.
   The bird, provided as it is with better developed  intra-cerebral
apparatuses, notwithstanding its instinctive  impulse to  seize  its
iood, or to carry some to its young, will abstain from it whenever
it  is noticed by man; as if it were conscious, that by obeying the
first impulses, its life, or that of its young, incurred some danger.
Many other animals, more  closely allied to man, will refuse, in his
presence, to perform those acts that are necessary for their  propa- 
OPERATIONS OP THE  INTELLECT.
87
gat ion.   In all these instances, the relations have become greatly
multiplied.   The instinctive  impulses which direct an animal to
gratify the wants of an organ, are arrested in their effects by more
powerful impulses, which compel it to watch over its own preser-
vation, and that of its young.
   It is particularly in the class of zoophytes, that instinct presents
the utmost simplicity; since in these it  consists only in the acts
necessary for nutrition.   They do not possess any of those isolated
nervous apparatuses capable of procuring to them the  instinct of
generation, or even, among some of them, the instinct of self pre-
servation.   Every portion of this animal matter seems equally en-
dowed with sensibility,—capable of recognizing  the  aliment by
means of the touch,—seizing  it and thrusting it into the digestive
canal.
   Among  the fish we discover many sorts of instinctive impulses;
but their object is not the same as in insects, because their sensitive
apparatuses are in relation with other external bodies. The instinct
by which they are directed to feed themselves is blind, and suscep-
tible of making neither choice nor exception among those bodies
capable of supplying them with nutriment.   Those bodies have no
sooner been recognised by the external  surfaces of relation,  than
the centre  of perception  determines the  acts of prehension and de-
glutition.   The carnivorous fish  do not spare  individuals of their
own species, and devour both their females and  their young. Other
instinctive impulses give them the faculty of recognising the kind
of water and the nature of the soil proper for  their preservation,
and likely to supply them with their  food,—whereas another di-
rects some among them to procure air on the surface of the water.
   The females are able to select a suitable place for depositing their
eggs, and the males are   led to fecundate them with their sperm:
finally, the instinct of self preservation leads them to shun danger;
only, however,  when it  is immediate, and never to anticipate or
retain the recollection of it.
   If we now retrograde toward the mollusquae, we discover some, as
for example the oyster, in which instinct is very limited;—having
for its objects, nutrition, self preservation, and  propagation, which
are executed by means of relations of very limited extent.  Thus their
food is always within their reach, and does not necessitate locomo-
tion for seizing  it; the care of their preservation is reduced to the
closing of their shells; and as these animals are hermaphrodite, and 
 S«                  SENSATIONS--INSTINCT,
 may engender without the assistance of their like, it follows, that
 the instinct of generation is still more limited among them, and is
 in fact merely an organic function.  Other mollusquae, as the snails,
 are compelled to go  far in search of their  food: although herma-
 phrodite, these animals require  each  the co-operation of one like
 themselves, in order to fecundate, and  to be in their turn fecundated.
 From this arises the necessity of more developed nervous appara-
 tuses, which in fact they possess; and notwithstanding the slowness
 of their movements, they have a sufficient quantity of brain to see
 danger and endeavour to avoid it.
   The ophidians and batracians are much less imperfect.  Nature
 has provided them with a well formed head, and with intra-cephalic
 apparatuses,  where impressions are sufficiently repeated and con-
 templated by the centre of perception, to enable them to  deliberate
 and to compare one impression with another, and decide in favour of
 the most powerful.  The snakes  watch their prey, look at it fixedly
 with open mouth, and wait patiently until it precipitates  itself into
 it. Assuredly these acts are not the results  of reflection; but th»
 effects of a determination of the centre of volition, resulting from
 the impression of the viscera, where  these animals feel the want of
 nutrition.  But the development of the intra-cephalic apparatuses
 allows them to perceive the approach of their enemy, to appreciate
 the danger  by which  they are threatened,  and to postpone the
 gratification of the want of nutrition, in order to obey that of self
 preservation.
   If we  examine instinct in the prey threatened by the voracity
 of the snake, we discover something very extraordinary. What is
 the power which compels the tom-tit  perched upon a neighbouring
bush to sacrifice itself for the gratification of the wants of an animal
creeping  upon the ground, at a distance from it? The reptile obsti-
nately pursues it with its looks;—so long as the bird does not per-
ceive the snake,  it runs no risk; but  if the  former rests  for a few
moments  its eyes on those  of its pursuer,  all is lost, for it will
become its prey.  The bird is terrified; it cannot abstain from look-
ing fixedly at the snake;—it flies from branch to branch,  as if with
a view of escaping; and yet it gradually approaches its enemy. This
latter continues gazing at it, presenting it at the same time an open
mouth; and the victim finally flies of  itself into it.  These are not
mere fables, but facts,  which but few shepherds have not  had occa-
 sion to notice. The papers have lately  detailed the manner in which 
OPERATIONS OF THE INTELLECT.
89
a boa constrictor, conveyed to Europe in an English or American
ship,  was fed.  The journalist relates, that those who took care of
this  monstrous snake, when they conceived that it was hungry,
opened its iron cage and presented to  it a goat, (a number of which
had been shipped for its use.)  As soon as the animal perceived its
prey, it unfolded itself, and looked at it fixedly, with open mouth.
The goat, after hesitating some time,  as if undecided between the
instinct of self-preservation and that attracting it towards the mon-
ster, precipitated itself head foremost in the living gulf which was to
serve as its tomb. But the snake, having judged of the impossibility
of swallowing it with as much facility as an  animal of smaller di-
mension, seized it by one foot,—enveloped it in its folds,—broke
its bones,—embues it with its saliva; and next seizing it again by
the muzzle, succeeded in the swallowing it whole.
  What  a multitude of diversified acts, equally commanded by im-
perious  instinct! But why should one surprise  us more than the
others?  They are all equally founded upon  the necessity of the
preservation  of organized beings; but the life of some requires the
death of others.  I do not  see why an animal, destined to become
the prey of another, should not be compelled to yield itself up to
it, when this latter is deprived of the means requisite for seizing
it otherwise.   It is  generally admitted, that a number of animals
are only born to be devoured: such are, among a thousand others,
the larvae of insects,  and the spawn of fish,  which,  without  this,
would become too numerous.   The end of destruction is as much
in nature as that of formation; and those  acts of instinct, which
tend  to deliver up a prey to its enemy, are as natural as  those the
object of which is to avoid danger or gratify an  appetite.   Now,
it appears evident, that, in order to attain all these ends, the author
of all things  has invariably made use of the same means—namely-
instinctive impulses.
  It  follows, from a consideration of these facts, that it is utterly
impossible to  attribute, exclusively, to  the great  sympathetic
nerve, the acts of instinct   No one can refuse to recognise in them
a concourse of visceral stimulations with those  arriving from the
intra-cephalic nervous apparatuses;—all of which act conjointly on
the centre of perception and volition.   Nevertheless, these acts are
not the result of reflection: and when, in  animals differently orga-
nized, fear, instead of attracting the prey towards its enemy, indu-
ces it to escape:  or when the same sensation obliges  the carnivo-
                              12 
90
SENSATIONS—INSTINCT,
 rous animal to abandon its food, reflection has no greater agency in
 these acts.  They result from the circumstance, that the  instinct
 of self-preservation, being more  developed, evidently overpowers
 all  the others;—these differences in the instinctive acts being al-
 ways in direct relation to the conformation of the nervous system.
 In a word, it is always the relations established between the bodies
 in nature, and the animals, which act in these circumstances; but
 which can only do so through the medium of the nervous system.
 If we wish to have a demonstrative and unanswerable proof of this,
 let us reflect, that all these acts do not occur in those animals, in
 which the nervous matter is not isolated; and let us remember, also,
 what has been said above, relative to the manner in which instinc-
 tive acts are modified by the subtraction of certain organs,  and by
 the changes which  supervene in the sensitive surfaces in which the
 nervous substance exists in a state of expansion.   I have spoken of
 the impulse by which the hen is led to hatch, and I have said that
 it was removed, by cooling the abdomen: well, the impulses lead-
 ing this bird, as well as every other, to build  a nest,  depend  upon
 the same organic cause.   It is true, that these birds  derive,  from
 the conformation of their encephalic nervous apparatuses, the fa»
 culty of recognising the materials proper  for the  construction of
 their nests,  as well as that of building them in the most  suitable
 manner for raising and protecting their young; but these faculties
 are  developed in them only through the  influence of  the  genital
 organs; and if this happen to cease, the encephalic nerves,  from
 which they derive  this propensity to industry, remain as inactive
 as if they did not exist.
   If we now pass to a higher class of animals,  many species  of
 which live familiarly around us, we shall have occasion to notice.
 in the instinctive impulses,  modifications somewhat different; and
 the functions of the intra-cephalic nerves will become more evident;
 so much so, indeed, that we might  be inclined  to believe, that these
 animals are endowed with a certain share of intellectual faculties.
  Each of these species is endowed  with predominant  instinctive
 faculties, and many are susceptible of being so modified,  in this
respect, as to become useful to the human species.   This last pre-
rogative results exclusively from the predominance of the cerebral
hemispheres; for it is impossible to obtain these  modifications in
those animals that are  badly provided  for in this  respect   The
buffalo, among  the herbivorous, and the lion, tiger, hyena, &c. 
               OPERATIONS OP  THE INTELLECT.             91

among the carnivorous animals,  are not susceptible  of being edu-
cated.   As soon as,  by their wants, the centre of relation is soli-
cited, they can only obey, whether it be to gratify their hunger or
their amorous desires; to  fly from danger;  to defend their young;
or to retire to some  obscure place  for  the purpose of devouring
their prey and avoiding the observations of man.  It appears, there-
fore, that the intra-cephalic apparatuses they possess, and which, be-
sides, are small, are exclusively subservient to the orders of instinct,
and that the tricks they resort to, in order to surprise their prey,
are more in the domain of instinct than of the intellect.
   This, however,  is not the case in animals of that class which are
domesticated; for  it  almost invariably happens, that  the  instinc-
tive impulses  which in  them predominate,  are likewise those over
which the intellect, whatever  it  may be, with which they are en-
dowed, exerts the  greatest degree of influence.  The horse, for ex-
ample, which is so remarkable for its fondness  for  great muscular
efforts,  and for the  race,  is always ready to allow  this instinctive
impulse to be modified in him by the voice and signs of  his mas-
ter.   The noble animal seems to understand, that it is in this way
he may make himself useful;  and submits himself to all that is re-
quired  of him in this respect.   It is not to avoid chastisement that
he accelerates his  speed, or increases his powerful muscular efforts;
but. to please  those to whom he  has devoted  his services.   He  is
susceptible of emulation in his favourite exercises, and of a kind of
point of honour, to which he  often sacrifices even life itself.  But
the intellect of the horse is not limited to this.  He enjoys, even to
a  considerable degree, the faculty of memory; and when he suc-
ceeds in comprehending what is desired of him, he executes it by
himself, and in such a manner as to surprise persons unaccustomed
to observe him. It is only necessary, in order to be convinced of this,
to witness occasionally the exercises of the celebrated Franconi. The
horse, at the same time, is docile and timid; but he becomes some-
times courageous,  and even intrepid, when sustained by the pre-
sence of man, and particularly when marching with his like. It is
from this circumstance, that man has  been able  to reap so much
benefit  from  his services; but, although he can distinguish his mas-
ter, he  becomes very much attached  to those who  feed him, and
very soon accustomed to  the new hand that guides  him.
   At any rate, the intellectual faculties and the educability of these
animals vary considcrablv, according to the greater  or less develop- 
92
SENSATIONS--INSTINCT,
ment of their cerebral hemispheres,  as may be discovered,  agree-
ably to the remark of  Dr. Gall, by  the external conformation of
their sculls; whilst their instinct, depending,  as it does, upon the
state of the viscera, is far from  presenting  such considerable dif-
ferences.
   The dog, the sea-horse, and the elephant, are perhaps, of all
animals,  the  most intelligent   They manifest gratitude towards
the one who takes  care of them; and obey  with pleasure his least
signal.  They  preserve a recollection of the service or harm done
them; but the dog surpasses all other animals by his almost heroic
devotedness to our species.  His  attachment is not limited to the
mere gratitude  for the food which is given him.  He is suscepti-
ble of feeling a real friendship, by which he is made to experience
pleasure in serving his master, even when harshly treated; whilst,
at the same time, he manifests a  less degree  of attachment to the
servant from whom he  receives his daily food.  He observes all
the members of a family, and distinguishes the degree of import-
ance and consideration of each, and never fails to have more de-
ference for the master than for all the rest.   The caresses  he  re-
ceives from the former  are more grateful to him than  those of any
other. He experiences  pleasure in accompanying him,—in render-
ing him service,—in devoting himself to him,—in sacrificing even
his life to be agreeable  to him.  If he receive a merited chastise*
ment from his master, he forgets it instantly, and caresses the hand
that beats him,—he reads in his looks, and anticipates his desires,—
he defends him against his enemies, and recognises them  by the
manner in which they are received,—he guesses their intention of
injuring the object of his attachment, and even foresees the harm
they  are about doing him.  He very often  possesses the most cer-
tain characteristic  of true  attachment; that of expressing good will
to the friends of his master.  His delicate attention extends even to
inanimate objects,—he  guards carefully the things his master has
entrusted  to his care, and loses his life rather than suffer them to
be robbed.  He pays a deference to  old age,  protects infancy, and
disdains  to take revenge of a powerless enemy.  In a word, this
animal possesses qualities, which, in the human species, would be
held up as virtues.
   These qualities, however, are not  the same in all species of dogs;
but it is observed that their number is proportioned to the volume
of the cerebral  hemispheres; and that the development of one sense 
OPERATIONS OF THE INTELLECT.
93
modifies them by causing certain parts of instinct to predominate.
Thus the greyhound,  whose head is very small, manifests very lit-
tle attachment  for the  individual who takes care of him; whilst
the excellence of his sight impels him, in opposition of the orders
of his master, to pursue his prey.  It is for this reason, that the
pointer  is so overruled by the predominance of the sense of smell,
that it is necessary to have recourse to the severest chastisements
to compel him to employ  this sense to the profit of  the huntsman.
The instinct of the shepherd's dog, by which he guards and guides
the flock without any reference  to his own appetite, is really sur-
prising; but it  is more particularly in the water spaniel that these
qualities, which might be called moral, are exhibited  in the most
admirable degree.   This  dog  unites  memory to intelligence  and
to the sense of smell; and it is  in individuals of this species, that
instinct  seems most susceptible  of being  modified  by education;
witness  the famous Munito, which was seen by all  the inhabitants
of Paris to perform card  tricks, play a game of domino, assort co-
lours, &c.
   It is owing to their strength and disposition to fight, that the mas-
tiff and  the house dog are enabled to render us such important ser-
vices; it is also in this respect that education may succeed in modi-
fying instinct.   Danger does not alarm the terrible animal;—ca-
resses—the temptation of aliments often greatly required, do not
succeed in corrupting his honesty; he knows, of the whole human
species, that being only, to whom he has consecrated his existence.
No sooner has his master spoken or made  a sign, than the enemy
he has designated is prostrated, or the animal perishes gloriously.
But he does  more; he watches, alone and in  the  dark, over the
life and property of his master; and, without being encouraged by
the voice or presence of the latter, he protects  him against every
kind of aggression, and sacrifices his life at a distance from him
with the view of insuring his repose.
   The  instinct of generation is very imperious in the  dog; and  it
is perhaps in this respect, that  he becomes less docile to the com
mands of his master;—because, in this animal, the force of the pas-
sions is  greater than  that of the intellectual faculties.  These pas-
sions, which result always from visceral impressions, torment him
during his sleep, and render him susceptible of dreams.  He recol-
lects then what he has done while he was awake;—he experiences
tender  feelings or anger,  as is shown  by the various inflections  oV 
94
SENSATIONS--INSTINCT,
his voice, and the movements of his tail and ears.   Nevertheless I
have not remarked that the  genital organs were  excited during
sleep; whereas they are easily called into action by the presence of
the female.
   Whatever may be the portion of intellectual faculties, with which
the most perfect animals seem endowed, when under the influence
of external  exciting agents, nothing announces that they reflect on
themselves; it is always by one instinctive impulse that another is
modified. They are never seen to form and adopt a plan of conduct
different from the one they have hitherto pursued, and which point
out positive deductions drawn from what has before happened to
them.  It is true that some wild animals are sometimes seen to aban-
don a haunt, in which they are too  often disquieted,  for the pur-
pose of seeking out another, where their enemy will cease to pur-
sue them; but  this is always art effect of instinct.  The idea of dis-
quietude becomes associated in their limited  intellect with that of
the place where they  have experienced these troubles; they conse-
quently abandon it; but as soon as they again become tranquil, they
do not think of improving their situation; they  enjoy it without
anticipating a happier futurity. These results I cannot refer to any
other cause than  the voice of instinct.   Have these animals ever
been known to sacrifice the present for the future,—to renounce one
kind of happiness in search of another, and, like man, often pursue
a chimera during the whole course of their lives?  Have they been
known  to betray  symptoms of avarice,—of  that passion which is
nourished, during the whole course  of life, only by the prospect of
a futurity happier than the present  time?   They  enjoy this latter,
not from calculation, since they have not the least  idea of the possi-
bility of a better condition.  When once their desire of food, repose,
sleep, protection from agents threatening their existence, is  grati-
fied, they are not kept awake by the anticipation  of another  state,
by a reflection on themselves,  or by the  necessity of contemplating
nature; they sleep, and are only aroused by the wants of the viscera.
They have no spoken nor written language.
   Some may perhaps argue, in favour of the existence of  reflective
faculties in  animals, the  propensity of many of  them to live in a
state of society,—their  attachment for each other, and for man,—
the possibility of  taming their disposition, and forcing them to live
with their prey, without danger  to the latter,—the tricks they re-
sort to to seize it; as for example those of wolves, foxes, and  dogs, 
INTELLECTUAL FACULTIES.
95
which call each other, and unite together in order to triumph over
an animal more powerful than themselves,—which  allot  to  each
other the part to be performed in the attack or defence,—some pur-
suing  the prey, whilst others place themselves in the path it must
follow, with a view of throwing themselves upon it at the favoura-
ble moment.   They may likewise offer in proof of  their opinion,
the simulated  flight of the wolf with a view of  decoying a young
horse from its companions,  and attacking  it behind as soon as it
turns to rejoin them;—the skill which some display in deceiving the
enemy that pursues them;  as for example the stag,  which throws
the dogs at fault by  making a leap  from  the track,  and hiding
itself in a thicket, whilst the astonished hounds seek its footsteps in
the neighbouring parts; or the singular trick of  the old stag, who,
when  exhausted with fatigue, will start out a young one, take its
place, and allow the dogs to pursue the young imprudent one.  All
these examples, and a thousand others of the same kind, are fami-
liarly known to huntsmen, and those who  spend their life in ob-
serving animals.
   All this, doubtless, points out a certain degree of intellect; and it
is not without cause, that the brains of birds and  mammiferous ani-
mals are provided with hemispheres.  But this intellect is in no re-
spect comparable to that of man; and I defy those who imagine they
acquire importance by contradicting others, to  cite a single  fact
which points out in those animals the  character  we have  assigned
to man,—the want of self observation,—of contemplating nature,
and of accounting to himself for what occurs around him.

           Sect. IV.—Of the Intellectual Faculties.

   This subject is of so serious and delicate a nature, that I approach
it with a considerable degree of hesitation.  Nevertheless, nothing
can prevent me from repeating what has been said by the best phy-
siologists,—that man derives his intellectual faculties from the rela-
tive volume of his cerebral  hemispheres.   This fact is so evident,
that it is only sufficient to mention it.  Let us, therefore, go farther,
and expose our views relative to the characteristics of human in-
tellect.
  The power of reflection, as we have already said, constitutes the
characteristic of this intellect; now, as a celebrated  philosopher has
said, to reflect is to feel^   Man not only feels the. stimulation pro- 
96                INTELLECTUAL FACULTIES.
duced in him by external agents, and by the movements of his own
organs,  which constitutes sensation, or in other words perception,
but moreover feels that he has felt these  stimulations: he observe^
himself feeling, and says,  I feel that I feel.   Consequently he has
the perception of his actual perception.  This constitutes mental
reflection.   He may repeat this as frequently as he thinks fit;—he
may observe all his sensations, and the different manners in which
he  felt, whilst he observed  himself  occupied with  his feelings.
From this study he derives an idea of his own existence, independ-
ent of every other object in  nature;—he distinguishes himself in
the midst of ereation, and, paying regard  only to his own existence,
compared with all that is  not himself, he pronounces the word /,
(moi,) and says Iam; and if he  views  himself in action he says,
I act, I do, 8,-c.
  Perception of himself procures to  man, modified by other bo-
dies,  what is denominated Ideas.  This is, therefore, another re-
sult of reflection,—or, in other words, of the faculty he possesses of
feeling himself feel:  but man feels, moreover, that he has already
felt;—this constitutes Memory.   He cannot exercise a single judg-
ment without calling this faculty into action, since it is always ne-
cessary, in order to judge, that he should  experience two succes-
sive perceptions; that is to say, that he should feel  them alternately,
which he could not do, unless he  possessed the faculty of renewing
that which he felt  an instant before; or in  other words, unless he
possessed memory. Hence, the loss of this  faculty necessarily occa-
sions that of judgment, and reduces man  to  a state of imbecility.*--
  In comparing two perceptions with each other, man only feels
them successively; and this operation  gives him a third perception,
which is Judgment.   Consequently,  to  judge, is also to feel; and
as,  in this case, it is always himself who feels himself experiencing
sensations—in other words, who reflects his self (moi) on himself,
or, if you will, on this same self (moiJ, we may say that judgment
is nothing more than reflection.   Hence,  sensation, reflection^
and judgment, are absolutely synonymous, and present to the phy-
siologist nothing more than the same phenomenon.
  The will, or that faculty by virtue of  which man  manifests his
liberty, by choosing, among different perceptions, the one he must
obey,—that faculty which gives him  the power  of resisting, to  a
certain extent, the suggestions of instinct, is founded on reflection.
Consequently, when we consider it in a physiological point of view, 
                   INTELLECTUAL  FACULTIES.                »'
(to which it is our intention to restrict our remarks,) we can only
discover in it the faculty of feeling ourselves, and of perceiving that
we feel ourselves.
  Such is the  manner in which I conceive the intellectual faculties;
and, as my senses  do not enable me to perceive similar operations
in animals, and as  I cannot discover them by means of induction,
I am justified  in affirming, that, at least in my opinion, animals are
not endowed with the power of reflection; that, consequently, their
intellectual faculties cannot be placed  on a parallel with ours; and,
hence, that their ideas are also of a different order.
  By an attentive examination of the subject, it will be found, that
reflection  implies,  necessarily, the faculty of contemplating nature;
since man cannot reflect otherwise than in feeling himself feel what
passes around him.  Animals not being endowed with this faculty,
it follows, that they are deprived of the power of reflection; conse-
quently, this attribute becomes the  exclusive characteristic  of man.
  Some persons might, perhaps, attempt to invalidate the correct-
ness of the opinion I have advanced above,—that judgment  invaria-
bly implies the existence of memory, by  objecting, that individu-
als, in whom this faculty predominates, are not such as are greatly
distinguished by the rectitude of their judgment.  To this I answer,
that  if the faculty of feeling be powerfully employed in recalling to
the mind  old  perceptions,  it is less so in  feeling them in the rela-
tions they may bear  with  ourselves.   There are  very multiplied
shades in  the reflecting faculty.  All men are endowed with it;—
but those who possess it in a less degree, experience a greater plea-
sure in feeling the impressions of  external agents; and, as we are
in absolute need of emotions, the latter individuals procure them
by renewing in their minds old impressions, on the occasion of new
ones; or rather, they are governed,  owing to the peculiarity of their
cerebral organization, which facilitates the recurrence of old impres-
sions, by the pleasure they experience from their sensations.  Others,
on the contrary, and  always in consequence of the peculiarity of
their organization, occupy themselves with studying the effects
these sensations produce upon them; in  other words, they derive
more pleasure from the exercise of the faculty of reflection,  or from
the secondary sensations; whilst the others derive more  from  the.
primary one.   Nevertheless,  these latter are not limited  to this
pleasure;—they continue to reflect on the sensations they experience,
though less profoundly than the  former;  that is to say, their con-
                              13 
95
INTELLECTUAL FACULTIES.
sciousness (moi) is more seldom reflected on itself. But, however
this may be, the mechanism of these phenomena is the  same in both
instances;—implying always the return of passed sensations, and the
comparison of these with present ones. The only difference, there-
fore, consists  in this, that the former of these individuals are less
retentive of sensations than the latter.   Some are so fortunately
organized, as to possess, in a high degree,  the faculty of recalling
passed sensations, as well as that of retaining those of all kinds, with
a view of submitting them to reflection.   But, as the pleasure of
reflection, or rather of the sensations  these individuals procure to
themselves, is greater than that  resulting from the sensations  pro-
duced by external agents,—reflection giving them a degree of su-
periority over the rest of men, and flattering their vanity, they
willingly acquire the habit of this  kind of intellectual  operation,
and always come at last to  neglect their memory.
  Nevertheless, the aptitude for reflection,  and the pertinacious ex-
ercise  of this faculty, are not sufficient to  constitute  sound judg-
ment, which implies their  existence,  but is not a necessary conse-
quence of them.  Thus we often  see  profound  thinkers, whose
judgment is  eminently  false.  The soundness of this faculty sup-
poses a just medium in  the degree of the impressions received; for,
if too weak, they do not give rise to any intellectual result; and if
too powerful, they lead  us to form judgments not conformable to
the natural relations of things.   It is thus  that some  maniacs, and
the greater number of individuals labouring under chronic inflam-
mation of the digestive organs, judge  very erroneously of a number
of objects, although they are impelled by an irresistible propensity
to retain the impressions,  and  contemplate them  to  excess.  The
same occurs in individuals whose brains are developed in excess;
for, by reflecting too profoundly on their own  sensations,  they ac-
quire  confused ideas of them, and  finally become  undecided;—
they cannot  form a determinate opinion on any subject;  they be-
 come inconsistent in their conduct, which even appears the result
 of a want of due reflection.
   The intellectual faculties are doubtless one of the effects of the
 functions of the brain;—yet notwithstanding, this result is not con-
 tinuous.   It offers considerable intervals,  during  which the  cere-
 bral action is not annihilated, but only withdrawn  from the empire
 of the self (moi).  This I propose to prove by facts,  showing  at
 the same time, that physiologists have greatly erred in their defi- 
                  INTELLECTUAL  FACULTIES.                9!»

nition of sensibility, when they simply say, that it is the effect of
the Action of the nerves and brain,—in the same way that locomo-
tion is the effect of the action of the muscles,—digestion that of the
functions of the stomach,—respiration  that of the action of  the
lungs, &c.
   To the brain is assigned the duty of reflecting, by means of  the
nerves, to the various parts of the body, the stimulations transmitted
to it by the same nerves: this operation  is purely organic.  It is
in this way, that the brain establishes sympathies between the  dif-
ferent organs,  and makesthemsubservienttothe preservation of life:
this constitutes its constant  function.   It begins to perform this as
soon as it exists in the foetus; and during the nine months of utero-
gestation it has  no other.   As soon as the child is born, it mani-
fests for  a moment,  that it is susceptible of experiencing pleasure
and pain; this is an  extension of the function performed by  the
brain  before birth.   But as  soon as its wants are gratified,  it falls
asleep; or, in other words, falls again into the same state in which it
was whilst contained in the uterus.   There  is no longer for  him
either pleasure or  pain; hence there is  no  sensibility:  we know
that he is susceptible of it,  but nothing  indicates its actual exist-
ence.   His brain continues to grow; and when it has attained a
certain degree of development, the observer may notice the  first
rudiment of consciousness  (moi):  this  constitutes  a further  ex-
tension of the cerebral  function.   But the child once  more  falls
asleep, and this second  extension, like the first, is dissipated;  but
as we recollect that it  did  enjoy it,  we  say that it possesses it.
Finally,  the  child attains the age of manhood; at this period sen-
sibility and  reflection  are manifested in  their full vigour; but, as
soon as they have  been exercised for a certain period, they  are
made to disappear  by  an imperious law.   Man falls once more
asleep, and, although, during this time, these faculties are no long-
er exercised in him, the brain does not cease to receive stimulations
through  the nerves, and  to transmit  others by the same means to
the different parts of the body.  This is shown  by the  fact,  that
if some  internal or  external sense be placed in contact with a  sti-
mulating agent not only the limbs are moved, but the .heart  and
other viscera receive an impulse, by means of which their move-
ments are precipitated.  They become injected with blood,—their
>ecretions take place more actively;—in  a word, a number of sym-
pathies depending on the brain are  called into play 
100
INTELLECTUAL FACULTIES.
   Let us be  understood: if it  be maintained that sensibility and
mental reflection constitute functions of the brain, it will be neces-
sary to admit, that these are  not the  only functions of that organ,
and also  to confess that they  arc intermittent.  Consequently they
cannot properly be defined to be the  effect of the action of the
nerves and brain, or, more  vaguely still, the action of the nerves
and brain.  They must necessarily be viewed as one of the results,
or as one of the effects of this  action; and we  must admit, that
organic reflection, or the transmission of stimulations from the parts
that received them, to other parts, constitutes the principal function
of the brain and nerves.   In order to  elucidate the question still
more, it is necessary to add, that man has at times the consciousness
of this transmission, and that he modifies K; as is manifested by the
phenomena  we  denominate sensibility,—intellectual  operations
which are a result of  it; and  that at other times he is not conscious
of it.   During the early periods of his life, whilst in the uterus,
he does not possess  this  consciousness; he acquires it afterwards,
but loses and reacquires it periodically, by means of sleep; finally,
he is deprived of it during attacks of apoplexy, epilepsy,—during
syncope, asphyxia, &c.; but  during these several states the grand
function  of the brain  and nerves—the transmission of stimulations,
continues uninterruptedly: it is  only diminished and irregular, but
cannot cease except by death.
  This manner of viewing these  functions is very important in
pathology, as it destroys those arbitrary divisions by which the dif-
ferent shades of the same function are usually separated. It shows,
that a point of irritation, as for example an inflammation, acts al-
ways in  the same way when it calls into play the  sympathies^
whether  the individual be conscious or not of its existence.  For
example, in the commencement of an attack of acute gastro-enteri-
tis, sensibility  and mental reflection  are as  yet unimpaired; the
patient is conscious of his condition, and  refers, himself, the unea-
siness he experiences, and even his fever, to the pain of  his stomach;
because he very plainly observes, that these phenomena are aggra-
vated or  diminished according as this viscus is stimulated or calmed
by the substances introduced into it.   When the disease is much
aggravated, however,—when the patient no longer speaks or hears,
and is in fact in extremity,  sensibility  has disappeared,  together
with every sign of the existence of consciousness (moi).  Yet not-
withstanding, the  unfortunate being continues to be agitated by the 
INTELLECTUAL FACULTIES.
101
:,amc movements as before;—they are even more intense, amount-
ing as they do sometimes to  convulsions.  What should we think
of the physician, who, after admitting with the patient, at the com-
mencement of the attack, that the fever and muscular agitation
depended on the irritation of the stomach, would affirm that in the
latter stage these symptoms were no longer the effect of this cause;
because the patient no longer complains of pain, nor regulates any
of his movements? For my part I am inclined to believe, that this
physician would be in the wrong; but it appears to me, that all dif-
ficulty may be obviated by saying, "the stimulation of an inflamed
stomach, being transmitted to the brain, and to the whole nervous
apparatus, gives rise, from the commencement of the attack in this
patient, to the acceleration of the pulse, and to the convulsions he
experiences; but the  changes in the condition of the encephalon
which have supervened, having caused all the phenomena  of con-
sciousness (moi) to cease, the patient is  no longer sensible, as  at
the commencement of his disease, of this transmission."
   It is for this reason, that I have regarded, above, contractility as the
only vital property of the tissues, and  sensibility as one of the re-
sults of the play of this property;—a result which is not  continuous
nor necessary to the existence of animals, as is proved in the foetus,
in zoophytes, &c.;—which is subordinate to an inexplicable condi-
tion of the brain;—a result, finally, which appears to me so astonish-
ing, so difficult to conceive, that, with all philosophers, I  regard it as
immaterial.  And indeed if thought be considered as such, sensi-
bility, on which it is founded, cannot be viewed otherwise.  It  is
true we notice, that thought is  manifested in consequence of the
movement of matter; but I cannot  seize the quo modo.  It  is
impossible to say what is the necessary result of the movement  of
the matter which  constitutes the brain; since we observe that this
organ is  agitated,—moves  the organized machine,—connects to-
gether all  the  movements, and maintains  life, even during a long
time, without  the manifestation of thought, and  consequently  of
sensibility.   What then is  the condition of the brain which  pro-
duces these phenomena?  I  know not, and consequently  will re-
peat, that sensibility consists in an immaterial, and, at least for me,
in an incomprehensible result of  the exercise of our functions.
   But  I have said that sensibility is a forced state; and my reason
for so saying is, that it cannot continue long.  The proof that it is
painful to nature is, that she interrupts it, and that if by the power 
102
l N TE I.LEC TV AL F Al'ULTI ES
of volition we prolong it beyond the limits she has imposed, we in-
come diseased; whereas the exercise of contractility is never inter-
rupted.  It will perhaps be objected, that every immoderate exer-
cise of this same contractility is also a disease.   Admitting this to
be the case, and I have never  thought of denying it,  it is never-
theless true,  that  sensibility is a forced state which is  painful to
nature: these two facts  do not, in the least, contradict each other.
I say moreover that they agree perfectly; since the state of sensibility
cannot occur without an exaltation of  contractility in  the,nervous
apparatus, and, consequently, also in  the vascular  system of the
principal viscera.
   After having discussed the subject of the intellectual faculties,
considered in their relations with those organs the action of which
makes them appear evident,  I  must next examine  them  in  refe-
rence to those external objects, on the occasion of  which we find
them  to manifest themselves;  in other words, I intend to examine
these  faculties when called into play by the impressions produced
on our surfaces of relation, by the different  bodies in nature.   By
this study we shall be led to that of the affective movements,  and
of the passions.
   Philosophers have often repeated the axiom,  Nihil est in inttl-
lectu quod non priiis fuerit in sensu,  and to this opinion I am
ready to subscribe; but I  place among the senses the mucous mem-
branes of the respiratory,  digestive, urinary, and  genital  organs,
and my reason for doing so is  that they are sensitive surfaces.   It
is  upon the result of impressions made on these internal senses,—
impressions which are more or  less  powerfully repeated in the
neighbouring nerves and in the other tissues,  and which are analogous
to those produced  on the external  senses, that the centre of relation
operates.   We have demonstrated, that the brain, when it orders
movements in consequence of impressions  transmitted to it,  does
not act alone.  This is, therefore,  the place for examining in de-
tail, though not too minutely, the acts depending on that organ, in
which it is more powerfully under the control of the other viscera,
as well as those in which it is less subservient to their influence.   In
doing this we shall be  able  to see, that this  difference is purely
subordinate to the nature of  the bodies producing the impressions
and which are placed in contact with  the different  surfaces of re-
lation. 
INTELLECTUAL FACULTIES.
103
  When the impression is produced on the external senses,  by a
substance which interests very nearly the viscera,—such, for exam-
ple, as an aliment,—an air, more or less proper for respiration,—a
destructive agent, as a menacing enemy, an enraged and powerful
animal,—a precipice,—a voluptuous object, as the body of a female
placed in contact with that of a man, and  vice versa;  when  these
impressions, I repeat, are produced on the external senses, as those
of sight,  of hearing, of smell, or of touch, the viscera are instantly-
agitated.    A secondary  impression,  starting from  the viscera,
reaches the  centre of relation;  and it is in consequence of its ad-
vice, that, if not  influenced by  another impression which we shall
soon examine, it is determined  to action.
  During the first  periods of infancy,  and  before memory  be-
comes stored with recollections, the centre of perception obeys the
suggestions  of the viscera.   In this state man approaches still to
the nature of animals; but after a while his intellectual organ  be-
comes  perfect,—he acquires abstract ideas, and he soon attains that
point^at which he no longer judges  of impressions solely in refe"
rence to  his actual wants, but rather agreeably to the prospect of a
future pain or pleasure,—which prospect induces him often not to
obey the calls of a  viscus soliciting  him to action.   It is thus that
a pious man resists the want of  nourishment, from the fear of a
punishment with which  he  is threatened by the dogmas of his
creed,  or from the  pleasure he experiences  in  thinking that the
privation he thus imposes upon himself will  be agreeable to God,.
and will obtain for him the enjoyments of a purely intellectual life.
The idea of these, pleasures procure him some even at the  moment,
and this  is sufficient to make him silence the suggestions of the
viscera.   Another individual will be guided  by other pleasures
apparently very different from these, but which yet are of a simi-
lar nature.   A mother is solicited by the want of nourishment; but
the love  she bears to  her child causes  her to anticipate more plea-
sure in gratifying the wants of this beloved being than in providing
for her own.  The aliment she could have made use of herself, is
therefore given to the child;—and this sacrifice procures to her a de-
gree of enjoyment, well calculated to  compensate her for the pri-
vation she thus imposes upon herself.
  But this is not all:—man is endowed with the faculty of creating
for himself  pleasures from  motives far  less elevated, and which
sometimes are not even plausible in their nature. A Hindu fanatic 
104
INTELLECTUAL FACULTIES.
is tormented by the want of aliment,  but resists it in consequence
of the pleasure he experiences in appearing an extraordinary man,
and  in attracting the respect and admiration  of the multitude.
With the same object in view, he imposes  on himself the law of
mutilating his  body, and of preserving,  during several years, a
painful attitude.  In fact, these sacrifices are regarded as something
supernatural, because every one feels  how  painful they must be.
From this consideration there result  praises and  a degree of re-
spect, which become, for the one who has had the courage to subject
himself to these painful trials, a source of pleasure, of which, as in-
tellectual, all men are not susceptible.
   Courage, which consists in despising death, is founded on simi-
lar enjoyments,  when not  inspired,  as it generally  is, by anger,
or the instinct of self preservation, &c.  The one exposes himself to
danger, under the influence of a sentiment of anger;  or, in other
words, in consequence  of the  pain  excited within him  by  the
threats of an enemy;—another,  in order to escape  from danger
which appears unavoidable;—a third, in consequence of the pleasure
he anticipates from vengeance;—a fourth, in order to  procure for
himself the pleasure of being esteemed and admired;—a fifth, from
the fear of experiencing the moral  pain accompanying contempt;—
a sixth, in the hope of obtaining, by means of martyrdom, an en-~
joyment purely intellectual, which will ensure him the admiration
of men, or the good  will of the Deity, for whom he had the cour-
age to sacrifice himself.
   The domain of the intellectual faculties is immense.   Very often
we see man sacrifice the pleasure of gratifying the actual wants of
the viscera, to motives much less powerful than those of which I have
just spoken;  but  which  are always founded on the prospect of a
future pleasure or pain.   For what  reason do so many literati, so
many  artists, warriors,  diplomatists, deprive themselves of their
sleep, and renounce all sensual pleasures,—the sources of which are
constantly before them, if it be not to enjoy one day  the esteem
and admiration of their fellow citizens, or more simply, in  order to
procure themselves, at a period  more or less remote, the means of
gratifying  the very wants  they now  affect to despise?  Some will
reply that it is to establish their  children, elevate their families, or
please their sovereign, &c.: admitting this, it does not the  less fol-
low, that in  all  these cases they have succeeded in creating for
themselves an intellectual enjoyment, which appears to them a suf- 
INTELLECTUAL FACULTIES.
105
ficient compensation for the privations they have  imposed upon
themselves.
  It may,  perhaps, be further objected, that the desire or hope of
discovering a new truth, is  sufficient to induce  them to  submit to
the most cruel sacrifices, independently of all prospects of esteem,
respect, or remuneration.   I  am  ready to grant this; but then  it
must also be admitted, that the pleasure they experience, either in
thinking they afe about  making  a discovery, or in making it,  is
the pivot of, and compensation for, the pains they take  and the pri-
vations they undergo.
  The fear of pain, and the prospect of pleasure, which  are them-
selves a pain or a pleasure, are consequently always the motives for
the actions of man, and  sufficiently explain the efforts  he  makes
for resisting the suggestions of the viscera,—that is to say, the voice
of instinct, which never ceases, notwithstanding these  oppositions,
to solicit the centre of perception, and which often overcomes the
obstacles it meets with on the part of the will.
  These phenomena are doubtless  intellectual, since  they imply
the exercise of sensibility, which itself is purely intellectual; but
they are not more so than the pain or pleasure experienced in con-
sequence of obeying the impulses of instinct, and in gratifying, with-
out control, the wants of the viscera.  All I see in these acts,  in
appearance unnatural, is the action of the centre of perception op-
posed to the influence of  the viscera.  Now,  as the nervous appa-
ratuses of  the hemispheres, from which we derive our intellectual
faculties, and which act, in this case, upon the centre of perception,
are in the brain, I can discover nothing more, physiologically speak-
ing,  in this resistance to our wants, than the action of one por-
tion of the animal matter against the other.
   When the centre of perception undertakes this resistance, the
nervous  matter which composes it, as well as  that of the  hemis-
pheres which enable it to resist, is always in a state of  vital erec-
tion,—in  other words, its  contractility is augmented—fluids are
attracted to  it, and the phenomena of vital chemistry are carried
to excess.   These are facts which should never be lost sight of by
the medical physiologist, in his attempts to explain the  causes and
phenomena of diseases.
  Let us  now endeavour to discover the origin of those abstract.
ideas through the agency of which the centre of perception resists
the influence of the viscera.  In order to do this. I shall investigate
                               14 
106
INTELLECTUAL FACULTIES
the impressions of those bodies which do not appear destined to
gratify our wants, in the same way as I examined the impressions of
those that are in close connexion with these wants.  The former,
as well as the latter, constitute the source of the abstract ideas on
which are founded, pride,  self-love, courage, compassion, &c.  The
sight of the sky, of the earth, of a field, of an edifice, of an instru-
ment the use of which is unknown to  us, of a book, of a table, of
a mathematical proposition, of an hieroglyphic, of The characters of
an unknown language; the sound of thunder, of a torrent;  the notes
of a bird—all make upon  us impressions which very often do not
appear to act on the viscera,  and consequently do not serve to in-
terest  our instinctive  operations.   Hence we might, perhaps, be
tempted to regard them as limited  to  the sense by which they are
received, and to the brain  to which this latter transmits them.   A
little reflection will suffice, however, to show, that they are much
more extensive than they appear at first sight.  Thus we  may con-
ceive in man the existence of a state,  during  which these impres-
sions will  act powerfully on the viscera; whence the aspect of the
sky will excite emotions in an individual long deprived of it,—
after a long  voyage the mariner will  be  rejoiced at the sight of
land,—an unknown instrument may arouse our curiosity, and pro-
duce in us agitation, if we suspect that it can serve to the gratifica-
tion of a want, or cause our destruction,—a stone which is about
falling may make  us startle with fear, and one from which, when
shivering  with cold, we expect to draw fire,  may cause us to leap
with joy,—a book will occasion  the same effect in  a man devoted
to study and dying with ennui,—the sound of thunder excites fear
in a timid  person,—a table on which one of our most urgent wants
is ordinarily gratified, will excite in us a return of the sensation of
hunger,—the sound of a torrent grieves the fatigued traveller, who
by this obstacle finds himself prevented, for a long time, from attain-
ing the object he desired,  &c. It is almost impossible to conceive
the existence of an  object  in nature, which may not be  found in-
timately connected  with some one of our most urgent wants.  The
sight of a man who gratifies the want of making water, is very
indifferent to the one whose bladder is empty; but under different
circumstances, this want, to which no  attention was paid,  is keenly
felt.  From this it is plainly seen, that I could multiply  greatly
these examples, and prove that the sight of an hieroglyphic, of an
arithmetical rule, and  even the characters of an unknown tongue. 
INTELLECTUAL FACULTIES.
107
 may be the cause of acute sensations, referable to the viscera.
 Now, is not the impression in all  such cases judged  differently
 from what it would be in those  in  which we experienced no-
 thing in the interior of our organs?   The viscera are consequent-
 ly consulted on those impressions that do not seem linked to our
 first wants, as well as  on those which have with them the most
 evident connexion;—or rather all impressions are connected with
 these wants.
   It may,  perhaps, be said, that  it is  only the conclusions drawn
 from these impressions,  that agitate the viscera.  Well; these con-
 clusions are  abstract ideas;  hence  abstract ideas are,  like many
 others, in a state of relation with the viscera.  But, in the emotions
 in question, reflection  does not always intervene; for example,
 the visceral movement, as that experienced on seeing the approach
 of a stone about to strike us, is often executed with so much rapidity,
 that it cannot be the result of reflection; it must be referred exclu-
 sively to instinct
   It may also be said of the impressions produced by these bodies,
 what was before remarked of those occasioned by aliments, by the
 difference of sex, &c. " These impressions are judged by the brain,
 independently of the viscera; and  if,  when very powerful, they
 are transmitted to the thorax, abdomen, or skin, this constitutes only
 a secondary phenomenon, producing no other effect than  that of
 rendering the action on the brain more considerable."
   To this I answer—Doubtless the brain, when it makes us judge
 that a sheet of paper is white, or dotted with black letters—that it
 is square and smooth—that an oak  tree is larger than a  reed—that
 one body is farther off than another—that a sound is acute or grave—
 that a metal is hard, and wax soft—that water is  liquid  and move-
 able, whilst ice is dense  and firm—that a man reasons  correctly,
 whilst another raves—that a whole is more considerable than a part
 —that an effect implies the existence of a cause—that two and two
 make four, &c.—when  the brain makes us judge of these  facts, I
 repeat,  it is not guided by the influence of the viscera, since these
 are purely intellectual operations.   But, at the same time that the
 brain is acquitting itself of these operations, the-nerves of the other
viscera are  agitated, though they do not appear to be so; or in other
words, the  organic movements of the cerebral substance are at the
same time propagated to  the whole  nervous apparatus of relation,
and even to that of  the  internal functions,  in the same manner as 
108
INTELLECTUAL FACULTIES.
when the brain reacts upon the impressions resulting from an ali-
ment, from the sight of a wished-for female or male, from the voice
of an enemy, &c.;  and if  the propagation of these movements do
not cause sensations referable to the viscera, it is because there is
nothing in the idea capable of interesting them. As soon, however,
as a connexion  of this sort exists, the modification of the viscera
becomes appreciable, either by a sensation or by a movement. As
we are on the subject of impressions in general,  I shall select, for
the purpose of illustrating the foregoing remarks, an example already
cited.  A man sees another make water; if his bladder be empty,
he feels nothing in that organ; if, on the  contrary, it  be full, he
experiences a sensation which invites him to follow the example of
the other.   In this latter case, the propagation of the cerebral irri-
tation to the bladder is proved by the evidence of the senses; in the
first it is not so,  but it may be demonstrated by means of induction.
Thus, if the impression made on the brain were transmitted to the
bladder when full,  and not when empty, its mode of action would
not always be the same. Now, we cannot admit two different modes
of the same impression;  consequently, if in one case it be transmit-
ted to the bladder, it must  be also in the other, and the only differ-
ence must consist in the  manner  in  which the bladder is modified
by means of the impression.  In both instances, the impression is
the same in reference to the organ of sight, and to the  brain; since
it always consists in the  perception of a man making water;—but
in the one, the bladder, feeling no interest in the idea, transmits
nothing to the brain; whilst in  the  other, the contrary being the
case, it solicits the centre of perception, by making it experience a
sensation.
  The same occurs in respect to all the other organs capable of trans-
mitting the  sensation  of a want; but I have selected the bladder,
because I have already spoken of the other internal senses.  They
are always modified by the ideas  which  stimulate our brain; but
when they are not in that condition in  which they can give the
sensation of a want, they do not transmit it to the brain, even though
our attention were fixed upon objects capable of interesting them;
whilst, on the contrary, if they be in that condition,  they never
fail to give rise to this sensation.
  But we may go even farther, and prove, that although the viscera
do not always transmit to the brain a sensation relative to nutrition,
depuration,  generation, &c they nevertheless transmit others to it 
INTELLECTUAL FACULTIES.
109
during the exercise of the intellectual functions.  It is under these
circumstances that we may appreciate to what degree  the exercise
of thought agitates the whole of the nervous system.  What appears
very remarkable is, that all the viscera do not correspond in an
equal degree with the stimulations of thought. Every time we are
excited in discussing  a question,  even the most abstract, and con-
sequently foreign to  nutrition, &c.  sensations and movements are
developed in the stomach, lungs,  and heart; the skin becomes hot
or cold, red or pale, relaxed,  and  allows  the passage of perspira-
tion, or contracted, and straightens the hair, &c.   It is the  passion
of self-love which is manifested; it doubtless originates in the brain,
but it is increased and maintained by the sensations which this lat-
ter perceives in the different tissues.  This is so certain, that if the
viscera be in a state  of irritation, either from the effect of wine,
or from the existence of an inflammation,  the sensation perceived
in them is muph quicker,  self-love more excitable, and the trans-
ports of this passion much more violent; whereas they are scarcely
marked, if the stomach, the principal seat of the visceral perception,
be cooled by water,  or any other  sedative agent.  Now, this  self-
love is itself founded on  a want.  Agreeably to my view of the
subject, its basis, as well as that of anger, vanity, fear, horror, com-
passion,—sorts of modifications of our consciousness, (moi,) which
are equally observed  in the exercise of the intellectual functions,
is the instinct of self preservation.
   It is in this way, that the most abstract  ideas, as those of the
beautiful,  of the  great, the regular, the sublime; of virtue, vice,
justice, oppression, tyranny, and all the most subtle ideas of com-
parison between the qualities of bodies,—in a word  all that consti-
tutes the immeasurable domain of human intellect, are linked in the
most intimate manner with the nerves of the viscera, and exert an
influence on the organic movements of their different tissues.
   It will perhaps be  objected, that these passions are  only deve-
loped when the intellectual operations are exercised with the great-
est degree of energy; and that the viscera, by which they are nour-
ished,  are not in the least degree affected when the  mind  acts
quietly; but this opinion is erroneous.  If the brain  did not diffuse
the irritations it experiences, in the viscera, these latter could not
respond to it and recognise the ideas which may interest self  pre-
servation or any other instinctive want.  The proof that they  par-
ticipate in these irritations, is, that they are agitated, and very ac- 
110
OF THE PASSIONS.
tively too, when these intellectual operations are exercised in the
most calm manner.   A man is very quietly occupied in his library
with abstract ideas,—with a mathematical problem, for example—
the image of his rival offers itself to his mind, and he instantly ex-
periences pain in the epigastric region,—his heart is agitated,—hit
colour changes,—he  experiences the transports of a passion;  it is
emulation, jealousy,  envy, &c.   But even such motives  are not
necessary; for it is sufficient he should experience  some difficulty
in solving his problem, in order that he should become irritated,
and  that self-love should be  revived.   If he operate with facility,
he  experiences a pleasure,  which is equally felt  by the  viscera,
especially at the epigastrium, and stimulates him to further efforts.
Now, let me once more ask, how could all this take place, if the
viscera were not always ready to respond to the intellectual opera-
tions? If they are ready to do so, how could this occur, were they
not agitated  on the  occasion of the stimulations which the braia
receives  in the most tranquil exercise of thought.
  It is therefore very certain, that the nervous apparatus,even that of
the viscera, is modified by intellectual operations. This question is
not purely speculative;  so far from it, its solution is indispensably
necessary towards forming a correct idea of the relations,  and ex-
plaining  the so powerful  influence of intellectual labours.   We
shall soon examine them in this point of view; at present  it  will
be of service to us in establishing the distinction between the intel-
lectual faculties and the passions, and in determining the physiolo-
gical nature of the latter.

                Section V.—Of the Passions.

  Potior, I suffer, or more generally, / feel; or in other words,
I experience pleasure or pain; such is the idea we must form of the
passions.  This cannot occur unless sensibility be aroused, or unless
the brain execute the intellectual operations.   Has Bichat been too
exclusive in circumscribing the passions to the viscera? This very
ingenious author perhaps thought, that it was sufficient to say,  that
a man feels, in order that every one  should comprehend, that his
brain is in a state of action.  Has he only meant, that the sensations
which accompany the passions are felt in the different viscera? If
such has been his meaning, I think he is perfectly in the right; but
it appears to me, that in asserting that, during the exercise of the 
                       OF THE PASSIONS.                   Ill

intellectual faculties, sensations were only felt in the head, he has
greatly erred; since, from what I have said, it results, that the in-
tellectual operations are not executed without a mixture of passions,
or at least  of affective sensations.  His great  error consists  in
having,  in general, isolated too much the passions from what are
called intellectual faculties, or more  properly  intellectual ope-
rations.
   In truth, our passions and our affections are a result of our intel-
lectual operations; but the following are, according to my view of
the subject,  the conditions necessary for their existence.  The pas-
sions cannot exist without a number of sensations referable to the
viscera; and all these sensations are founded on our wants,  or, in
other words, on our instinct
   In  order to convince ourselves of  the  truth of this assertion, it
will only be  necessary to pass in review the principal divisions
which have been made of our affective sensations.  Let us endea-
vour to start from an incontrovertible principle,  namely—all our
sensations are reducible, for the physiologist, to pleasure or
pain.
   Our  affections are  founded on our  sensations, and the former
sometimes degenerate into passions.  When we experience plea-
sure,  we are cheerful; whereas, we are sad  when we feel pain.
Cheerfulness and sadness are often produced,—the former, by a good
state of health,—the latter, by a contrary disposition.   The state
of health exists, when  the organs execute well their functions, with-
out being too much or too little excited;—this constitutes the natural
state of our economy.    The diseased state, on the other hand, oc-
curs when the organs  are too much or too little excited;—in other
words,  when the natural  state is interrupted.   This  latter is kept
up or disturbed by many causes, which we can only examine here
in a general manner.   For our present purpose, we must  divide
these causes into two grand  series;—some  are physical,  others
moral.   The physical  causes give rise to what are called physical
pleasures and pains; whilst moral causes occasion moral pleasures
and moral pains.   The latter series are felt by the same organs as
the pleasures or pains produced by physical causes; consequently,
for the  physiologist, these pleasures and these pains  are all physi-
cal, since he can only perceive in them a modification of the living
tissues.   Wherefore, then, do we admit moral pleasures and  moral
pains?  Because we have regard to the agent by which they are 
112
OF THE PASSIONS.
produced.  When these causes consist in the exercise of our intrl
lectual faculties,—in other words, when it is a result of thought, we
call them  moral;  consequently,  by  moral pleasures and  moral
pains,  we  understand a state of contentment  or uneasiness, per-
ceived in the viscera by the centre of  relation, during the exercise
of thought, which, as we have seen, is always accompanied by a
modification of the organs,—a modification which is nothing more
than a state  of irritation.   But, on the  other hand, the physical
modifiers, such as air, light, heat, or cold; foreign substances depo-
sited on our internal surfaces of relation; and all those bodies which
have occasioned a solution of continuity in our tissues ;-^-all these
agents excite in our organs a state of irritation, similar to that pro-
duced in  them by moral causes,  and thus give rise to the perception
of physical pleasures and pains, analogous to like  sensations pro-
duced by moral causes.   Let us now see how these considerations
will lead us to a knowledge of the affective movements, and of the
passions.
  We  are fond of the causes of our pleasures, and we hate those of
our pains, whenever we can discover them; but, we cannot love or
hate, in an equal degree,  physical  and moral causes.  Thus, even
were we  positively assured,  that cold, heat, certain indigestible sub-
stances, or vulnerary bodies, are the causes of the pain we suffer,
we could never entertain towards them the same feelings of hatred
that we would towards a person who had furnished  the moral cause
of our  sufferings.  We only experience  for cold,  heat, or the in-
struments by which we have been wounded, a sentiment of aver-
sion; and for the aliments or odours which have been agreeable to
our senses, only a relish more or less keen; but, neither of these sets
of causes excites in us what is denominated a passion.  In  respect
to the moral causes of our pleasures and pains, they  may likewise
only inspire us with a slight feeling of affection, of aversion, or ol
disgust; but these causes, or, in other words, the individuals from
whom we derive pleasure or pain, are sometimes the object of a
violent passion, either of love or hatred.  It follows, therefore, that
even were  we to discover the physical causes of our pleasures or of
our pains, they could never be the object of a passion.   But it often
happens, that we are ignorant of these physical causes; under such
circumstances, our dislike or our fondness,—our hatred or our love,
are often directed towards  the  individuals by whom we are sur-
rounded, as if they were the moral causes of our pleasures or of our 
OF THE PASSIONS.
112
sufferings.   Moreover, although we may be apprised of the physi-
cal causes of our pleasurable or painful sensations, it is often noticed,
that instead of directing towards them our hatred or our love, we
select, as objects of the one or other of these passions, the individu-
als with whom we have been, or still are, in habits of intercourse.
  Consequently, our affective movements, and our passions, which
have always for their objects individuals of our  own species, may
equally arise from the action of physical  or moral  agents.  Yet,
whichsoever of these causes produces them, our affective movements
and our passions suppose always an irritation of the viscera,  causing
pleasure or pain, and the actual exercise of the faculty of thought,
by which we are enabled to perceive the one or the other.   It more-
over results from this, that the affective movements and the passions
will possibly be kept up or destroyed by the modification of thought,
as well as by that of the irritation of the viscera.   Thus, if the se-
ries of ideas be changed, by means of new impressions, when  the
affective movements and the passions are  excited by moral causes,
the brain will no longer keep up the irritation of the viscera, the
pleasure or pain of which gives rise to the affective  movements, or
to the passions; and, on the other  hand, when both these are  the
effect of the irritation of the viscera, produced even by a physical
cause, if the irritation be removed,  it will  no longer direct the
thought towards the series of ideas which contributes to keep up
the affective movements, or the  passions.   It is easy to  conceive,
however, that such cures will cease to be  possible, if, in consequence
of its  intensity, or its  continuance, the physical irritation which
maintains the  existence of the passions, has destroyed for ever the
healthy organization of the seat of  thought, which  is the brain, or
that of the organs in which it perceives pleasure or pain,—that is
to say, of the other viscera.  But  this  new  truth  is only another
proof of the correctness of our assertion.
  By the foregoing observations it  is seen, that I apply  the name
of affective movements, or  simply  of affections, to those feelings
of love or hatred which are  but transient,  and do not derange, in a
continual and dangerous manner, the natural  state of our economy;
whilst I reserve the name of passion for such among these feelings
as are violent, persisting, and imperious;—which enslave and be-
come the real tyrants of our intellect—serve as pivots of almost
all our actions, and threaten,  in a greater or less degree, the inte-
grity  of our organs.  In reality all these  feelings are of the same
                              15 
114
OF THE PAssIONS.
nature; since their seat is the same, and they arc equally founded
on pleasure or pain; but they differ sufficiently in respect to their
intensity and consequences, to justify us in dividing them into two
series.  Yet we  cannot speak of the former without alluding to
the latter.
   The first of the passions,—that from which all the others ema-
nate, is self-love.  It is founded on the  instinct of self preserva-
tion, and  on that of the propagation of the species;  for both are
blended together; and  this instinct, which is  often disguised, is
kept up by the pleasure we have in feeling that we live.  All that
makes us actually experience this pleasure, and affords us the pros-
pect of again experiencing it, is loved;—all that produces the con-
trary effect is hated,—unless indeed the intellect has created for us
moral motives for feeling otherwise; but as I have already alluded
to this subject, I shall not recur to it in this place.   I shall content
myself with remarking, that when we  think we are the objects of
our hatred we still love ourselves.  It has been asserted that this ex-
planation destroys every principle of morality; but  than this, no-
 thing is more false. Of what import is it, when we do a meritorious
 action, whether it be or not on our own account?  Is  it the less use-
 ful to society? Do not apprise all men of the secret motives of their
 actions, because  some  false and  vicious minds would draw deduc-
 tions from  them  unfavourable to  social  order.   But it becomes
 the duty  of all  legislators,  who  are aware  of  this  motive, to
place man in such circumstances,  that it  shall produce all that is
 good and useful to mankind;  for they must be aware that what con-
tributes to the welfare of individuals, contributes, in like manner,
to that of the whole species.   Let them create such motives of ac-
 tion as will  prove of general utility, and let them do so either by
 means of  their laws,  or by  habits they  will  make men  contract
 from the earliest periods of life, and which will  become the foun-
 dation of their morals; but let them not interdict us from telling the
 truth to those who are able to comprehend it.   As respects myself,
 I willingly abandon to philosophers all profound discussions on the
 subject, and content myself with considering the passions in  their
 relation with the organs, the functions of which  they may, more
 or less, contribute to derange.
   As we have just seen, our passions are  susceptible of a grand di-
 vision.   Some are founded  on  pleasure,—others on pain; but as
 pleasure and pain may succeed to each other  in the same passion, 
OF THE PASSIONS.
115
 it follows, that we may form a third class, which we shall denomi-
 nate compound  or mixed passions.   Joy is a state  of pleasure
 which may originate from a variety of causes,  either physical or
 moral, and which in this way is allied to all  the passions founded
 on pleasure; but whatever its effects on the system may be, I can-
 not view it, properly speaking, as a passion.  The words content-
 ment, satisfaction, happiness, only express  modifications of joy,
 or of that sensation of well-being, which accompanies all the pas-
 sions founded on  pleasure.    However this may be,  joy, content-
 ment, satisfaction, happiness, all are founded on agreeable sensa-
 tions which we perceive in the viscera,—sensations which can only
 be felt when the  viscera are hot in a pathological state.  The causes
 of these sensations are either moral or physical;  the  former may,
 it is true, tend to produce them,  but they cannot succeed in giving
 rise to and maintaining them, so long as the viscera are painful.
   At  the head  of the  passions founded  on  pleasure, we  find
 sexual love.  The organs which nourish it are those of generation,
 in which are experienced the most keen sensations.  The passion of
 love supposes always the action of the intellect, for representing the
 image of the beloved object; and the action of the genital organs,
 for furnishing the sensation of pleasure, which solicits the centre of
 perception to revert unceasingly to the idea of the cherished being.
 In order to demonstrate the coincidence  of these  two actions, it
 will only be necessary to remove the genital organs,  or to occupy
 the centre of perception with another series  of ideas; for,  under
 these  circumstances,  the passion is  annihilated.   The instinctive
 want,  on which the passion of love is founded, is that of propaga-
 tion; when this want acts feebly, or momentarily, or when felt in-
 discriminately for every individual of the other sex,  there is only
 a general fondness or propensity,  more or less marked, for the act
 of generation; but  the passion does  not exist.  Nor even should
 we apply this epithet to the warmest transports experienced during
 the union of the sexes.  But when an individual sees and desires
only one single object,—when its image pursues him every where,
and haunts him unceasingly,—when grief, anger, and jealousy, are
easily developed,  in consequence of the slightest obstacle to the
possession of the beloved object, love is transformed into a passion.
It is now easily perceived, that this passion, although founded  on
the want of a pleasure, becomes compound or mixed, whenever it
attains a  certain degree of intensity;  because  the agreeable sensa- 
116
OF THE PASSIONS.
tion on which it is founded, and which nourishes it, is interrupted
by painful passions.
   After love, properly speaking, we find another passion, which is
in like  manner founded on  pleasure,  and is the sequel and conse-
quence  of the former; I allude to the  love of offspring.  This pas-
sion is not nourished by the sexual organs;—the  sensations which
maintain the brain, or rather the  centre of perception, in the con-
dition that constitutes the passion, reside in the thoracic  and abdo-
minal viscera; hence the expression of paternal ormaternal breast.
The different seats of this  passion may be demonstrated in a similar
manner as those of the preceding one;  and  this  demonstration,
which we shall now attempt, will show that  this passion is, like
love, founded on an instinctive want.  And first, the part which the
brain plays is evident, since to love our offspring it is necessary to
think of them.  The influence of the other viscera becomes con-
spicuous in animals; since by calming the organic action in the abdo-
men of  a hen, by plunging it several  times  in  cold water, or else
by depriving her of her  chicks,  and confining  her with a cock,
for the purpose of exciting the genital organs, she will become un-
concerned about her young.  As soon as a cat, which manifested the
warmest affection for her  kittens, experiences the desire of rutting,
the condition of her viscera changes; the vital action is diverted, by
the turgescence of the genital organs, from the  digestive viscera
and lacteal glands; her kittens become troublesome to her, and are
driven away. In animals,  the love for the young has always a natu-
ral limit, and continues only until the latter have attained that period
of life,  at which they are capable of providing for their own wants.
In this passion I discover  two visceral elements; the first, among
the females of mammiferous animals, is the want of getting rid of
the milk,  which supposes at the same time the existence of an irri-
tation in the breast, and in the digestive  organs;—the  second ele-
ment, among the females of birds, and the males of certain species,
is the sight of  the young: so long as these are weak, they excite
sensations of affection, compassion, or  love,—whence result the acts
necessary for their alimentation, and their defence; as soon as they
become strong, these  sensations disappear. But in what  portion of
the body does the brain of all these animals feel those sensations?
Judging from our own species, and by induction from those animals
that suckle their young, I should be led to admit, that it is always
in the other viscera, and particularly  in those situated in the abdo- 
OP THE PASSIONS.
117
men.  It will, perhaps, be asked, how these instinctive sensations
can take place? To this 1 will answer, that they are not more diffi-
cult to conceive than all the other instinctive relations, which I have
enumerated above; and I will add, that  they are  precisely of the
same nature.  It is the will of the Creator, and the sensations trans-
mitted to the brain by the viscera constitute  the means he employs
to execute it.
   In an example drawn from animals, we have been able, therefore.
to discover the source of the love of offspring, in  an  instinctive
want.  If we  endeavour to apply these remarks to man, we find,
first, that the same passion,  in him, has the  same  organic source;
and next we perceive, that  the intellect, reason,—in a word, all
the intellectual operations, transform this want into one of the most
imperious and lasting of  the passions; and this sort of  demonstra-
tion must suffice.  In order, however, to confirm the correctness of
these remarks, we shall add, that women, being, like the females of
mammiferous  animals,  subjected to the want of lactation, must
always be  more easily moved at the sight of their  children; and
that,  consequently, their attachment to them must be much more
powerfully felt in early infancy.  And, indeed, experience teaches
us, that such is the fact.  In general, man, although sharing with all
warm-blooded animals,  the feelings of  compassion excited by the
presence of a  being of their own species, feeble and requiring their
assistance,  becomes more attached to his children when they have
grown up; whilst the mother, on the contrary, loves them most
when they are young; consequently, maternal love is more instinc-
tive and physical,  and  paternal  love more  intellectual and moral.
 I hope, however, that this assertion will not be carried beyond just
bounds; for I am happy to admit, that women, who  are also endowed
with intellectual faculties, must have the same causes for loving their
children when these have attained the age of reason and maturity,
as those which increase and justify the tenderness her husband ex-
tends to them.  All I mean is, that  woman is by nature more im-
pelled than man, to cherish the fruit of her  love.   Doubtless, also,
 the trouble and the  cares  her children have cost her, contribute
 greatly to increase her affection for them; for it is a fact, which can-
 not be denied, that we feel an attachment for all  persons to whom
 we have been happy enough to  render  some services.   It is thus,
 that moral causes are joined with physical ones, in order to procure
 *o our species those passions, which of all others afford us the sweet- 
! IS
OF THE PASSIONS.
 est enjoyments and the purest happiness.   In fact, the passion of
 the love of offspring is not, like sexual love, necessarily subject to
 a mixture of painful sensations, unless, indeed, they originate from
 causes in their nature totally foreign to that passion.
   The love of offspring, when freed from the instinctive impulse,
 which only continues so long as it is young and weak, is hencefor-
 ward  only maintained by purely moral  motives.   This passion is
 allied, therefore, at this period, to all the attachments that are not
 founded on the prospect of physical pleasure; and all that is  most
 powerful and delicate in  it, is purely moral.  It originates in the
 first place from self-love, which is reflected on our children, and
 from the good qualities we attribute to them, and of which we are
 proud to be the source.—It arises  afterwards from  the community
 of interest between them and ourselves—from the reciprocal attach-
 ment  they bear us,  and finally, from the need which we foresee
 we shall have of their assistance, when our faculties begin to fail,
 and make  us feel all our weaknesses.   It is upon  similar motives
 that all the bonds of friendship are founded; for  it is always the
 moral pleasure  resulting  from  our intercourse with another indi-
 vidual—the services we may obtain from  him, or those we have
 rendered him, and which flatter us with a return founded on grati-
 tude, which attach us to our friends.   We experience, it is  true,
 at first sight, an inclination, or, as vulgarly expressed, a sympathetic
 feeling for certain individuals; but this sympathy, which is purely
 instinctive, is  only changed into friendship  in  consequence of
 our relations with those individuals, when we discover therein the
 motives for those moral enjoyments I have just alluded to.  This
 instinct by which one individual is attracted towards another, we
 possess in common with many of the gregarious animals; it is  true
 that it constitutes the foundation  of the passion of friendship, but
 it is not friendship itself.
   Friendship, then,  such as we must conceive it in  our  species, is
 a purely intellectual passion; but this does not prevent it, however,
 from being attended with sensations referable to the viscera, such
 as there exist doubtless in animals;  for all the emotions it procures
 us are referred to the epigastrium and heart, and thence extend to
the whole  sensitive  apparatus.  The part which  is played in  this
passion by the viscera, is moreover shown by their diseases, which
sometimes  occasion a complete change in  our friendships.   I have
often seen individuals labouring under  gastritis, as  well acute as 
                       OF THE PASSIONS.                    119

chronic, express a dislike for the persons they loved most,  prefer
others, and return, after recovering their health, to their first incli-
nations.  In others, this phlegmasia destroys all the affections, pro-
duces misanthropy, which may be pushed to a horror of life, and
even to a desire for death.  After a consideration of these facts, how
can we not admit, that the brain is not  always free in the exercise
of the intellectual faculties?—But let us  not anticipate here what we
have to say on the subject of the painful passions.
  Pride and vanity are two modifications of our self, (moi,) which
are very analogous to each other; they are both founded on the plea-
sure we experience in  comparing  ourselves with  others; because
this comparison furnishes us  with motives for increasing our self
esteem.  We  then enjoy greatly our existence, and gradually ac-
custom ourselves  to find out opportunities for  repeating this com-
parison: finally, this enjoyment is converted into  a passion; since
we  become  irritated against every obstacle by which we are pre-
vented from enjoying it, and we hate every individual from whom
We  meet with opposition.   Pride differs from vanity in its being
founded on motives of a more elevated  character,  and in its being
often justified, at least in the minds of the generality of men, by acts
which entitle them to the regard and respect of others.  Vanity,
less elevated in its motives, is nourished by trivial things, and con-
sequently finds a greater number of pleasurable or  painful motives;
but they are less acute than those of pride, and give rise, therefore,
to movements less violent and perturbating for our organs.  These
passions are common to both sexes.  Pride is much oftener met with
in man; whereas, vanity is more frequently the portion of  the fe-
male sex: both passions are the effects of civilization. The pleasur-
able sensation which nourishes them, does not at first appear to have
a well defined seat in the viscera; but when it becomes  exalted, it
is distinctly felt at the epigastrium;—the heart seems to be enlar-
ged,—it propels the blood with greater energy;—the face becomes
red,—the eyes sparkling; and the action of the voluntary muscles
appears to  be increased.   The sufferings of the principal  viscera
prevent the development of these passions, and  rather produce a
feeling of humility, by making us sensible of our weakness, and
leading us to comprehend  how unstable are the foundations of the
motives of  the pleasure  we experience in comparing ourselves
with others.   These passions are much  exalted in early life;—are
subsequently diminished in  proportion  as we feel our weakness 
uo
OF THE PASSIONS.
 increase; and finally disappear, together with all the others, when
 we foresee the approaching termination of our existence.   In these
 last cases, pride degenerates sometimes into vanity; hence this pas-
 sion is very often the portion of old age, and constitutes the princi-
 pal moral enjoyment of which it is susceptible.
   Self-love, viewed as a moral affection, is a feeling, the nature of
 which is nearly similar to that of the preceding ones; but its mo-
 tives are more plausible, and do  not always  imply the weakness of
 judgment discovered in vanity; there  is, therefore, but a  slight
 shade of difference between them.
   There is  another feeling, which, like the preceding  ones,  is
 founded on self-esteem; it is honour: it commands us not to do any
 thing likely to  be disadvantageous  to us, when we  compare our-
 selves with others;  it is a kind of self-love or pride, the motives of
 which are worthy of unlimited praise, since they induce us to per-
 form actions useful to society.   Often it is founded on less plausi-
 ble motives;  as for  example, when we make honour consist in sup-
porting a  bad cause, merely on account of our having already  de-
clared ourselves its defender, &c.: but it is clear, that the abuse of
 a  thing is not the thing  itself;  and that true honour,  or that
founded on good motives, is, nevertheless, a very fine and elevated
feeling.  Emulation is nothing more  than this  same  desire of ob-
taining an enjoyment by comparing ourselves with our fellow be-
 ings.   Ambition, and the immoderate desire of grandeur and rich-
es, which  must not  be confounded with avarice,—since opulence
 ;.s sought after merely for the purpose of ostentation,—appear to me
to be founded on sensations of pleasure analagous to those that give
rise to pride, &c.;  their seats are the same, and they differ only in
the means that  are used for attaining  the enjoyments of the com-
parison.   I shall, therefore, not enlarge any more on the subject
   From the preceding observations it follows, that the words pride,
ambition, emulation, honour,  and vanity, express modifications
 of self-love; consisting, as they do, in the pleasure we derive from
 the comparison of ourselves with others.  Whenever this sentiment
of pleasure becomes a want, towards the gratification of which the
greater number of our actions are directed,  it is converted into a
passion, and gives rise, when exalted, to pungent sensations in the
viscera, and to  very violent organic movements, which are agreea-
 ble so long  as  no  obstacle is offered  to their enjoyment.   Is the
 feeling of self-love  peculiar to the human species?  However this 
of" the passions.
121
may be, it is very certain, that we notice in many animals actions
which naturally  lead us  to think they are susceptible of emula-
tion.   Thus it appears to us that a horse stands upon his  point of
honour, and redoubles his speed in order not to be passed by another
of his species.  The same remark has been made in relation to the
dog.  If one of the rivals be surpassed by the other, he loses cour-
age, in the same manner as man; and in the midst of his  humilia-
tion,  does not even display the efforts he might  have done had
he not attempted to contend with a competitor.  Is it a motive of
self-love analogous to that of our species, which serves as the ex-
citing cause in these animals?  Is it not rather the simple law of im-
itation, so powerful in animals, which impels them  to  undertake
this kind of spontaneous contest? In order to  settle this question,
it would be necessary to place ourselves in the situation of the two
rivals;—this, however, is impossible; but as we discover  so many
proofs of intellect among animals  most nearly approaching to our
nature, we can hardly hesitate to consider them as susceptible of a
certain  degree of self-love, although we may admit, that its motives
are different; since  animals are deprived of that reflecting faculty
which constitutes the distinctive mark  of the human species.  If
we concede self-love to animals, it will  be necessary  to attribute it
to their instinct;  and  in that  case we would discover the source of
that passion, as well as of all those we have hitherto examined as they
appear in ourselves, in our instinctive faculties,—or, in other words,
in the wants of our viscera.   We would  afterwards perceive our
intellect, developed under the influence of civilization, impress  on
self-love its peculiar stamp, and render it susceptible of assuming
those different shades or modifications which we designate by the
words pride, emulation, honour, and vanity.   This manner of
viewing the subject appears to me the more plausible, as these shades
of sClf-love are unknown to men who  live in a savage state,  and who
even  have not, in their rude language,  expressions  capable of con-
veying the least idea of these sentiments.  Should any one enter-
tain doubts on this  subject, let him consult the writings of travel-
lers, and more particularly a work  entitled Recherches  Philoso-
phiques sur VOrigine de la  Pitie, by M. le B. de B.
  There exists, in the greater number of animals, an urgent want,
of which I have not spoken under the head of instinct, but  to which
I have alluded indirectly when examining the acts depending on it;
I mean the want of locomotion.  It is very imperious in young
                               16 
122
OP THE PASSIONS.
 animals,  because exercise is absolutely requisite  for the develop-
 ment of their organs.  It is this want, which, when seconded by
 the  feeling of well-being resulting from  health,  excites in them
 that cheerfulness we observe in all those whose organization is al-
 lied to our own.  It is manifested by a fondness for play, for leap-
 ing, and even for violent exercises,  without any very evident mo-
 tives, and from the most trivial causes.  It is OAving to this pro-
 pensity, that a kitten makes us admire its dexterity, its suppleness,
 and the gracefulness with which it  amuses itself with objects sus-
 ceptible of a certain degree of motion.   We discover in it that
 instinct which will  lead it in future to spring on the prey it watch-
 es, as soon as this latter makes the least movement with a view of
 escaping.  The want of muscular exercise  is not less  evident in
 children; it is  founded  on the pleasure they experience in exer-
 cising their growing strength; it becomes converted into a true pas-
 sion; since the prospect of enjoying it gives rise in them to violent
 transports attended with agreeable sensations in the viscera; and if
 they are deprived  of it, they become sad, and  their health is in
 danger.
   The want of exercise diminishes  as we advance  in years, and in
 old  age it is  replaced by the want of repose,—a certain  foreboding
 of that absolute inertia which awaits us in the last  days of our ex-
 istence.
   Such are, in my opinion, the principal passions founded on a sen-
 sation of pleasure.   It is true we discover other shades of affective
 movements, equally founded on'agreeable sensations; but they con-
 sist in propensities and inclinations which are  but rarely converted
 into passions.   Yet, although this conversion be not common, we
 must endeavour, if it does occur, to note it,—as I shall now attempt
 to do.   Among these, I place benevolence and generosity,—kinds
 of tastes which impel us to be serviceable to other men, because we
 derive from so doing a true  enjoyment, which is not solely seated
 in the encephalic nervous apparatuses.  It is first necessary, therefore,
 to draw a line of distinction.  These acts may originate from  pride
 or vanity; or, in a word, from that same self-love of which we have
just spoken: under  such circumstances, they must be referred to
 that passion.  But  there exist a number of persons who do good
 for the mere pleasure of doing it, and without being led to  it by
 the  satisfaction of comparing  themselves with others.   By some
 philosophers it is asserted, that these individuals are influenced by 
OF THE PASSIONS-.
123
 the fear of falling into a situation similar to that of the unfortunate
 whose  sufferings they alleviate; and  it is to such a principle that
 these philosophers attribute compassion, commiseration, and pity.
 These affective movements would, therefore, be founded rather on
 pain than on pleasure.  But is it a well established fact, that indi-
 viduals, endowed with those precious qualities of the  soul which
 we denominate benevolence, generosity, compassion, and pity,
 invariably reason in this way, previously to rendering a, service:
 " Let us relieve the sufferings of this  unfortunate man, for the  mis-
 fortune which now afflicts him may one day happen  to us; and
 perhaps, from gratitude, he may be led  to relieve us?"   I cannot
 believe that such is the case.  That some may  be  influenced by
 such a motive, I am ready to admit;  but that it should invariably
 hold in all benevolent acts, I cannot  readily persuade myself.  It
 is alleged  that this virtue does not exist among men in a savage
 state,—that it does  not appear in the  early periods of infancy, and
 that, consequently, it  is only the  result of the social state,  which
 has insensibly accustomed  us to appreciate the importance of re-
 ciprocal attentions and services.   Our wants, it is further said, are
 so greatly multiplied by civilization, that our own powers being no
 longer adequate to their gratification,  we feel all the importance  of
 providing for ourselves, when occasion requires, the love and grati-
 tude of our fellow creatures.   I have  no. doubt that  these motives
 contribute to render us better than we are; but I cannot admit that
 the inclination to succour the unfortunate is  not natural to man.
 Let us examine several children born of the same parents, and edu-
 cated in the same manner.   The  greater number of them will be
 cruel; but among them will always be found some,  who, although
 the example is daily set before their eyes, will appear reluctant to
 inflict pain on a being endowed with sensation; and it is but justice
 to remark, that  these exceptions  are more  frequently met with
 among individuals of the female sex.  The same  must be the  case
 among savages,—there are always some of them good.  The habits
 they acquire from their mode of life, must divert them  from this
 inclination, and finally succeed, perhaps, in destroying it; but as  it
 is written from all eternity in the heart  of man, or rather in his in-
tellect, that benevolence is in itself a good and laudable thing, as
soon as you will have civilized  these  barbarians, and they will no
longer regard it as honourable to be ferocious and  unmerciful, they
will yield to the example offered by those among them who possess 
124
OP THE PASSIONS.
this virtue, and the acts founded on it will become as  frequent a*
they were before  of rare occurrence.  I  have already said, that
great public calamities, such as famine, the privation of all habitual
enjoyments, the continual  aspect of death, brought civilized men
very soon back to egotism, and to the cold ferocity of the savage
state.  This, doubtless, proves that the majority are not good; but
as amid these terrible circumstances there  have always been found
instances  of  generosity and  self-denial,—as these  examples have
been lauded and  admired  even by  those who did not discover
within themselves sufficient resolution to  imitate them,  we  must
believe, that the pleasurable sensation, attached to these noble ac-
tions, is really natural to man.
   I moreover said, that they depended on the exercise  and de-
velopment of that portion of the encephalum destined to the intel-
lectual operations,  and that they indicated  the triumph of the mind
over instinct.  This is proved by facts; for those  ferocious men,
whom  we have shown to constitute the majority, are always com-
posed of such as have cultivated  in a less  degree their intellectual
faculties.  Hence, benevolence and generosity are rarely converted
into passions, because these latter are founded on instinct.  When
these affections assume that character, however, it is always owing
to an influence of the brain over the viscera; because this influence
possesses the property of producing in them sensations imitatingthose
of instinct.   In other words, the visceral sensations, the primary
object  of  which consists in soliciting the gratifications of physical
wants, may become so perverted, through the influence of the brain
during the exercise of thought, as to induce us to sacrifice the plea-
sure of providing for our physical wants, to that of gratifying our
moral ones,—that is to say, those that are purely intellectual in their
origin.   These remarks are very well adapted to display to us the
intimate union which exists between the passions and the intellect,
as  well  as  that association  of the viscera and of the brain,  on
which  we have already so much insisted.
   After having studied those passions that are founded on pleasure,
we must next occupy ourselves with such  as originate  from  pain.
We must repeat here, however, that all that offers an obstacle to
the pleasure which  nourishes the  passions we  have just noticed,
develope in us painful sensations.   Hence, the passions founded on
pleasure are rarely pure throughout the whole period of their dur-
ation; this pain which interrupts so often their enjoyment, rendering 
OP THE PASSIONS.                   125
ihem almost always mixed, and leading us sometimes to select other
expressions to designate them.  It is thus that love, when it meets,
in a rival, an obstacle to its enjoyments,  assumes the name of jea-
lousy. Love has many more causes of pain; they are, indeed, so mul-
tiplied, that it is sufficient to say of an individual, that he is trans-
ported with love, in order to imply that he necessarily experiences
a mixture,  or  rather  an alternation of  pain  and pleasure.  The
same occurs in all the passions;  for,  from the mere circumstance
that  our affective  movements have risen to that degree  which
merits the name of passion,  it is impossible that our enjoyments
should not be frequently interrupted  by pain.   Thus, the more
anxious we are  to  enjoy,  the clearer we perceive the obstacles
which threaten to interrupt our pleasures, and the more  susceptible
we are of experiencing  pain on this occasion.   It is in this way,
that  the enjoyments of paternal tenderness,  as  well as those  of
friendship, self-love, emulation, ambition, pride, vanity, and of all
the passions founded on pleasure, are  constantly interrupted by
painful sensations, which transform them into mixed passions.
   The  pain may  be felt,  although we  are  not conscious  of  the
pleasure; as may be  exemplified by the new-born  infant,  whose
first sign of sensibility  is expressed  by  a cry  of pain; but it  can
only be well appreciated by comparing it with  pleasure, and it is
from this that it derives its distinctive  character;—in other words,
it  is thus that it presents itself to our minds during the  progress of
life.   Indeed, the  passions  founded on  painful  sensations, attain
the degree  in which we notice them,  only because those who  ex-
perience them have felt pleasure.  It is the regret for the privation
of pleasure produced by the causes of painful sensations, which re-
volts us against these latter.   Were he deprived of this compari-
son, man would suffer pain without moral exaltation.   He might,
like the animal,  become irritated against the cause of his sufferings,
or struggle from an excess of pain withbut regard to the cause;  but
his anger would be of short  duration,  and would not amount to a
passion; because, under such circumstances, he would  only expe-
rience  the physical pain; or rather because he would exercise  his
intellect in the comparison of the present pain with the past plea-
sure, —in the prospect of future pain, and of the future privation
of pleasure.  In this, in fact, consists the essence of the depressing
passions. They are consequently all, at least at a certain period, like
the cheerful passions, of the mixed kind; but as they all have,  for 
12U
OF THE PASSIONS.
exciting cause,  pain, without which they could not exist, I have
constituted them into a separate class, which I have contrasted with
the former.
  The comparison of pain with pleasure constitutes, therefore, the
moral cause of these passions;  but  it produces them only  when
there result from it  a poignant regret for pleasure, and a continual
fear of seeing it one day succeeded by pain.  Consequently, I do
not apply the name  of passion to those  painful sensations that are
but transient, even when  they are produced by moral causes.
I view them as affective movements,—varying in point of inten-
sity,—but only  assuming the name of passions when they become
persisting and chronic.   Having established this point, I now pro-
ceed to the development of the painful passions.
  Grief is a painful  condition of our self (moi), attendant on all
kinds of sufferings,  produced either by physical or moral causes;
it is, therefore,  in reference to those passions that are founded on
pain, what joy is for those based on pleasure.  It is also designated
by the name of pain.   Sadness  expresses, in ordinary language,
the prolongation or  chronicity of grief.   We  experience momen-
tary grief; but sadness implies  an habitual state of suffering,  nour-
ished by reflection.  Sadness is therefore a passion.   It may cease
with the causes  that have produced it;  but, when  they are perse-
vering in their action, sadness seizes our mind;—we acquire, as it
were, a fondness, and even a love for  it,  and we carefully  avoid
all impressions likely to divert our attention from it.   Under such
circumstances the passion is at its height,  and all our actions are
directed towards the accomplishment of one object,—that of pro-
longing the mixed  state of pleasure and  pain under which we
labour.
  Sadness is nourished  by two sets of causes; first, melancholy
thoughts;* secondly, a painful sensation in the viscera, and princi-
pally in the nerves of the epigastric region;  but, as these nerves are
merely conductors,  it follows, that  the  principal  phenomena take
place, on the one hand, in the  nervous  expansions and  ganglia of
of the viscera,  and  on  the other in the  brain.  The nerves,  both
cerebral and  ganglionic, are the intermediate agents.  In the pas-
  * They are not purely painful, as we distinguish in them, first, the recollection
of pleasures past,—a recollection which is itself a pleasure.  Secondly, the feeling
of actual, and the anticipation of future pain,—the latter of which constitutes,, it-
self, an actual pain.  This sadness is therefore mixed. 
OF THE PASSIONS.
127
sion before us, the brain  feels,  as  it does during pleasure, in the
viscera, the consequences of the melancholy reflections which arise
in its own tissue, in consequence of the impressions made upon it
through the medium of the external senses; and reciprocally, the
irritations seated in the nervous expansions of the viscera, and par-
ticularly of the internal membrane of the stomach,  having reached
the brain, compel it to occupy itself with melancholy thoughts.
Hence, whatever be the cause of sadness, it always  implies the ex-
istence of a certain mode  of irritation in the viscera.   I say  a cer-
tain mode of irritation, because that occasioned by a moderate dose
of aliment will give rise to cheerfulness,  whilst a  more powerful
dose will  excite melancholy.   If a proof of the necessity of the
concurrence of gastric  with cerebral irritation, in the production of
sadness, be required, it will only be necessary to produce a gastri-
tis, by means of stimulating ingesta,—for then the individual will
be harassed by melancholy thoughts; whereas,  by giving rise to
these latter by a direct action upon the brain, through the medium
of  the senses, the individual  will  soon be affected with a certain
degree of gastritis.  By  reversing the  question another proof of
the fact will be obtained.   Whenever gastritis is the sole cause of
melancholy, this latter will disappear  as soon as the former  dis-
ease is cured.  If we remove melancholy thoughts, when  consti-
tuting the sole cause of sadness, the gastritis will  disappear, pro-
vided  it has not attained the degree constituting organic alteration.
   I have  selected gastritis with a view of proving the  reciprocity
of action existing between the viscera and brain,  as being the most
ordinary  cause or aliment of sadness.   I could,  however, with
equal  propriety, have selected other examples,  as peritonitis, he-
patitis, pneumonia, or  pericarditis;  because, in these inflammations,
the serous surfaces and the parenchyma; have acquired  a degree of
irritability equal  to that of the mucous membranes, and may, in
consequence, give rise, in the nervous apparatus of the viscera, to
that painful  state which accompanies  gastritis, and which  in all
instances  is a necessary cause of sadness.  Yet, it must be confess-
ed, that these inflammations only necessarily give  rise to it when
acute; for when they have attained the chronic state, the serous
membranes and the parenchyma; lose their sensibility; or at least
it diminishes to such an extent, as  no  longer to occasion a degree
of  pain sufficient to compel our intellect to be occupied with me-
lancholy thoughts. 
128
OP THE PASSIONS.
   When sadness is the consequence of these chronic inflammationv
 it still  depends on the brain, or rather on the  intellect; that is to
 say, on the fear they inspire  in  the patient,—which fear is the
 effect of his sensibility, and of the cultivation  of his mind; but if
 we succeed  in encouraging  him, his melancholy  will  subside;
 whereas it is not in our power to succeed, by the  same means, in
 making it cease, when it depends on a well marked gastritis, or on
 an acute phlogosis of the parenchyma;, and  of the  serous mem-
 branes.  This may further be proved by the fact, that if you stimu-
 late gently, by means of good wine, the healthy  stomach of an indi-
 vidual labouring under chronic  inflammation of the serous or pa-
 renchymatous structures, his sadness will subside; whereas the same
 means will only aggravate it,  if it be kept up  by an acute or even
 chronic gastritis.  To this it may be objected, that wine  and good
 aliments nevertheless enliven individuals labouring under  this com-
 plaint;  but I would reply, that these substances only produce this
 effect when the greater portion of  the stomach is not implicated
 in  the  disease, and when the disordered part is neither very ex-
 tensive nor painful; that is to say, when they do not yet exasperate
 the gastritis: but if we continue to excite the mucous surface of the
 stomach, its partial inflammation will extend,  and become general,
 and the wine will then serve no other purpose than that of adding
 to the sum of melancholy thoughts.
   I have been induced from another motive to cite gastritis as die
 principal physical aliment of sadness,—namely, because, when this
 passion is excited by a moral cause, all the viscera being healthy,
 it finally gives rise to  acute, but much more frequently to chronic
 gastritis, of which it makes its ordinary aliment; whereas, it only
 occasions the other phlegmasia;  when it is carried to that degree
 of  intensity which  resembles all the violent perturbations of the
 economy, and which may give rise to all kinds of diseases.
   In respect to external  inflammations, they have not the privi-
 lege of exciting a state of sadness,  unless it be  as general causes
of grief; but  even then it produces it only in certain individuals;
whilst gastritis gives  rise to  it indiscriminately in all, whatever
be  their character, their fortune, and the moral circumstances in
the midst of which they may be placed.  It must be confessed, how-
ever, that all inflammations, being susceptible of a repetition in the
stomach, may become  organie causes of sadness; but in these cases 
OP THE PASSIONS.
129
they only produce it indirectly,—which affords us a further proof of
the influence of the stomach over the nature of our ideas.
  All these examples were required for the  development of our
proofs of the necessity of the concurrent action of the viscera and
brain, 4n the production and  maintenance of sadness.  They are
not, therefore, foreign to our purpose, and  still less misplaced an-
ticipations on the pathology of the passions.
  The visceral pains  which concur  in keeping up sadness, tend
likewise  to produce dejection of spirits, discouragement, and even
despair; they consequently diminish the intensity of the phenomena
which manifest the  state of life.   But the power that  watches over
the preservation of all it has created, has been able to  derive the
femedy from the excess of the evil; for no sooner does the pain of
grief occur, than, in a great number of individuals, another is de-
veloped in the same viscera, through the influence of  thought, and
reacts upon the brain  in a manner very different from, and indeed
absolutely opposed in  its results to, the former; since, instead of oc-
casioning the diminution of strength, and producing immobility,  it
is seen to develope  a more or less impetuous reaction.   No sooner
does this occur,  than the  individual  who suffered,  obeying the
voice of  instinct, is agitated,  either  with a view of repelling the
cause of the painful sensation he experiences,  or escaping from it.
In the first case,  he is affected with  anger—in the second,  with
fear.  These two affective movements exercise, therefore, an influ-
ence on the brain,  capable of forcing  it to react powerfully upon
the nervous apparatus of relation.  This doubtless is their most or-
dinary effect, when they have not attained their greatest possible
degree of intensity; for when this occurs, we once more observe im-
mobility, but attended with very different modifications of the or-
ganization.   All this  deserves to be developed.   I  shall commence
by offering some observations on anger.
  Anger, when occasioned by a moral cause, originates  always in
the intellect; but the idea which produces it, succeeds only by ex-
citing an acute pain in the epigastrium. It is the perception of this
insupportable sensation, which,  with  the rapidity of lightning, car-
ries away our consciousness, seduces our intellect, and forces us to
obey the impulses of  instinct.    When this occurs, we notice the
most impetuous and irregular movements,—first in the viscera, and
subsequently in the apparatus of relation.   When this passion has
attained its utmost intensitv, the blood is precipitated with violence
                               17 
130                    OP THE  PASSIONS,
to the encephalon and  other viscera;—the face becomes pale, thrr
skin cold, and the muscles are agitated with convulsive movement.'.
But  the vital power soon reacts;—the face becomes red and tume-
fied,—the eyes are injected and sparkling,—the skin is red,—the
pulse which was before contracted and convulsed, becomes full, active,
and  accelerated;—the whole external surface of the body assumes a
higher degree of temperature and redness; the muscles swell, and
acquire a tenfold degree of strength;—the  patient vociferates, ges
ticulates,  and is affected with accelerated  muscular movements;—
he threatens,—is violently agitated, and from the loss of his reason
he becomes liable to commit acts of the most atrocious  nature, and
the most injurious to social order.  Under such circumstances he
becomes allied to the most ferocious animal,—he is maniacal and
crazy,—ira furor brevis.
   Anger may depend on a physical cause;  under these  circumstan-
ces,  it is the states of organic irritation, and even of inflammation
of the sub-diaphragmatic viscera, which produce it, by giving rise
to that sensation of  uneasiness,  which, in anger from a moral cause,
is the result of thought. In all such cases, however, we should pay
attention  to the reciprocity of action; for it always happens that the
inflammation excites in the brain melancholy thoughts, which,  in
their turn, reacting on the nervous  apparatus of  the  epigastrium,
produce in one individual anger, in another despair, &c. according
to their disposition  and to the series of ideas by which their atten-
tion was usually engrossed.
   Abundant proofs of what I have just advanced,  may  be found in
those acute diseases, which,  owing to" an ignorance of physiological
principles, were denominated malignant fever.  The greater num-
ber,* indeed, of these fevers, are cases of gastro-enteritis, with pre-
dominance of irritation in the  superior  portion  of the digestive
canal, and occurring in nervous subjects.   The patient experiences
hallucinations,—he sees objects which irritate, frighten, or gladden
him.  If, under these circumstances, we calm the gastric irritatio»
by means of a local bleeding, before the brain has had time to be-
  * I have said, the greater number, because those who maintain, that in all cases
of delirium and convulsive movements there is arachnitis, labour under a great
error. Numerous proofs of this may be found in the Annals. Besides, these case*
of arachnitis are themselves in general nothing more than the sympathetic irrita-
tion of the brain, carried to the degree of suppurative inflammation, &c. 
OF THE PASSIONS.
131
come altered, these images will disappear, and together with them
the movements of anger, &c. which were their effect.   If, on the
contrary, we  reproduce this irritation, by  means  of  stimulating
drinks, they will return.  In cases of poisoning with certain narco-
tics introduced into the stomach, such  as alcohol,  opium, &c. we
noliee similar results.  The first effects are hallucinations; or in other
words, the patient sees or hears imaginary objects or sounds, at the
same time that he experiences an internal sensation  of  pleasure or
pain, whence results sadness or cheerfulness, and in a higher degree,
anger and fury capable of leading to the most atrocious acts.  It is
well known, that several of  the oriental nations, when under the
excitement of opium, rush like  maniacs on the swords of their ene-
mies, and there perish, or abandon themselves, after their victory,
to the most ferocious acts,—the natural effects of  the anger and of
the factitious  excitement  they produce with a view of inspiring
themselves with courage.  It is in vain to say, that these poisons act
upon the encephalon; for  the modification of the internal gastric
sense precedes, and always produces, that of the  brain.   Apply
alcohol to any other internal surface than the mucous  membrane,
it will inflame it, and, if absorbed, will even produce intoxication;
but it will  never  give rise, unless the stomach has become seconda-
rily inflamed, to that irascibility which invariably accompanies
gastric irritations.*
   The precipitated movements to which men abandon themselves,
generally dissipate the paroxysm of anger;  and if  the cause that
produced it be not very powerful, calm is re-established. If the re-
verse be the case, however, and if the motive  for  anger be of a
serious nature, either by itself, or through the power imparted to it
by the irritation of an organ, it is constantly recalled to memory—
the imagination exaggerates it, and the centre of perception acting
incessantly upon the viscera, the individual  feels,  in the sub-dia-
phragmatic  region, impetuous movements, which appear to be di-
rected towards the locomotive apparatus, as if with a  view of calling
it into action; or rather the perception of these organic movements,
  • Medical wranglers will affect to smile, and allege, that every man who is angry
is not affected with gastritis.  We know this; but also know that individuals are
often long thought to enjoy good health, whilst suffering habitually from gastric
inflammation; and that even under these circumstances they may become extra
ordinarily fat. 
132
OF THE PASSIONS.
which constitute real pains, tend to reproduce the agitation ol the
paroxysm;—anger is then  chronic.   Very often man resists to a
certain degree, and his anger may be in part concentrated, and in
part exhaled;  but, with a little attention, it will be constantly found,
that the sensations he experiences tend to seduce the self (moi), by
inducing it to determine the  contraction of the fists,  and of the
masticatory muscles, as well as the immobility of  the chest, which
is interrupted  from time to time by convulsive sighs, excited by
the want of respiration.  In  such cases,  man, although alone, seems
to prepare for combat, and to place himself in the attitude for attack
or defence.  In  this state, the heart propels the blood with violence
to the viscera;—the vital erection  of the brain retains it in the
Cranial cavity, where it produces pain, especially in the frontal
region, and  at the vertex;—the  spasm  of the inspiratory  muscles
accumulates it  in the lungs  and  large vessels;—the epigastric pain
attracts it in abundance to the mucous membrane  of the stomach,
and to the liver; whilst the cerebral influence precipitates the action
in the nervous apparatus of  the viscera,  and of the  locomotive
organs. We shall examine, at a later period, the pathological effects
of this frightful perturbation.
   If anger  be  more  concentrated,  it is  because  the self (moi)
refuses to radiate  stimulation  on  the locomotive  apparatus:  in
such cases the  viscera  alone suffer, and always by the  accumula-
tion of blood contained in their tissues, arising from  the  circum-
stance, that the muscles do not tend to attract it towards them, and
thus to produce a revulsion.  Nevertheless, there is here a certain
degree of compensation; for the immobility of the chest not occur-
ring, the blood does not  experience so great an obstacle in travers-
ing the heart and lungs.   From all this we may conclude, that in
anger, the more powerfully muscular action is developed, the less
permanent will be the engorgement of  the viscera.
   When the primary cause of anger is of a physical nature,—for *
instance, when it depends on  gastric inflammation, its mechanism
is still the same; because visceral  irritations,  as  we have already
seen, can give rise to anger in  no  other way, than  by occasioning
hallucinations; that is to  say, by creating, for the intellect,  motives
of fury, which, though imaginary, do not the less act as if real,  upon
the organs.  Such, for example,  are those who figure to themselves
they perceive an enemy who threatens, or imagine  they hear a voice
that provokes them. 
OF THE PASSIONS.                   133
  It may, perhaps, be asked, in what manner the hallucinations
which  give rise to the movements of anger, can take place.   In
answer, I say,—in the same way as every other possible hallucination;
and as I think myself as much justified in treating of this physiolo-
gical subject in reference to the  present passion,  as to any other, I
shall offer a few observations upon it now.
  And first I  must repeat the principle already laid down, that, for
the physiologist, every idea is the effect of an  organic irritation.
A sensitive part of the body is stimulated by a foreign agent;—the
cerebral centre receives the perception of this stimulation, or rather
it experiences another, which is the  consequence of  the former.
Hence an  idea: consciousness  (moi) refers  the sensation to  the
foreign agent of which it is apprised, and judges that it depends
upon it.   Let us now imagine,  although this foreign  body be ab-
sent,—let us imagine, I say, in the part already stimulated by it, an
irritation similar to that produced by that agent,  and we shall have
hallucinations; in other words, the centre of perception, accus-
tomed to associate the image of the foreign agent with the stimula-
tion, will continue to produce this association when it will  receive
the perception  of this latter, notwithstanding the absence of the
agent which usually produced it.  Now, examples of  stimulations
analogous to those produced by foreign bodies, are among the most
numerous facts observed in physiology or pathology.  Dreams are
nothing else; and somnambulism  affords us  an illustration of it
when carried to the utmost degree.
  It may, perhaps, be answered, that these errors only take place
owing to the absence of reason; but what does this mean, unless that
the brain is in a different condition from that in which it  is during
a state of wakefulness?   This does not prove that hallucinations can
only occur during sleep; as the delirium  of acute inflammation
shows sufficiently well, that individuals may see  imaginary objects
although wide  awake, and answering correctly to a  number of
questions foreign  to the chimera which engrosses their attention.
All that is proved on this subject is, that hallucinations are of rarer
occurrence in the waking state than during sleep.
  It may, moreover, be objected, that the hallucinations of individu-
als who are awake depend on a pathological state of the brain.
This I am ready to admit; but I maintain, that  this state may be
the pure  and  simple effect of the irritation of another organ. This
influence is satisfactorily shown in those cases of delirium  already 
134
OF THE PASSIONS.
cited, and which disappear as soon as the inflammation of the organ
that disturbed the brain subsides.  With regard to chronic irrita-
tions, the hallucinations by which they are attended are developed
slowly,—the organ becomes diseased,—it acts upon  the brain, at
first, by predisposing it to those hallucinations, and next by com-
pelling it to experience them.   Thus, it is not in their first degree
of irritation, that the organs chronically inflamed cause errors of
perception; but  when they have long tormented the centre of per-
ception by their too active influence.   Hypochondriacs, and those
affected with hysteria, furnish us daily with proofs of the truth of
this assertion; and insanity, which often manifests itself by a series
of hallucinations, is frequently preceded by long  continued irrita-
tions in the digestive and generative organs.
  It is impossible to experience  hallucinations but in reference to
external objects, the stimulations of which have been  felt; this is a
natural result of what has just been said.   A hypochondriacal pa-
tient accuses a taste of sugar, salt, or earth, because he has  felt the
impression resulting from the presence of these substances on the
sense of taste; he never complains of a sensation which he has not
before experienced. His stomach is diseased,—it irritates the brain,
and among the  irritations of which  it makes it sensible, there are
some analogous to those occasioned by external bodies; this is the
whole  mystery.  When a maniac  sees  devils in his delirium, it
proves, that he  has  seen the representation of them in some paint-
ing, or that they have been described to him with the form of some
animal familiar  to him, and the shape of which has been joined to
that peculiar to  man.   It is true that the imagination  may create
forms,  which to some inattentive  persons may  seem new;  but
every sensible  individual will   readily discover  in  them objects
more or less familiar to the patient.   It will be unnecessary to pre-
sent here  further illustrations on this  point;  but it is still certain
that the irritation of the brain is the cause of these errors.
   Are there purely cerebral hallucinations?  There may exist some,
the cause of which has commenced with an irritation of the ence-
phalon; but in  truth these  cases are of rare occurrence; for,  with
the exception  of traumatic lesions, the encephalon never  experi-
ences irritations without instantly transmitting them to all the other
viscera; and in the  traumatic cases, where the irritation commences
in its proper tissue, it cannot advance far, without an affection of the
internal senses of the digestive apparatus, and of their nerves, super- 
OF THE PASSIONS.
135 -
teiiuig.   In vain will I be accused of prepossession on this subject:
1 maintain, and will continue to do so, for I am supported by facts,
that  all impressions,—even those produced by moral  causes, are
transmitted to the whole extent, to borrow the language of Bichat,
of the nervous apparatus of the two lives.  This principle I believe I
have shown to be well founded; were it otherwise, I could conceive
nothing in physiology; but time will  clear up this question for those
who still remain in a state of uncertainty.
  One of the most remarkable among the numerous hallucinations
to which we are exposed, is that experienced by individuals, who,
although deprived of a limb, are subject to pain which  they cannot
help referrihg to it.   This fact is not more astonishing, however,
than those of which we have already spoken.  It shows, that among
the stimulations transmitted to  the sensitive centre, there are some
analogous to those which were before produced by the irritation of
the part that no longer exists.  These stimulations may arise from
an affection of the viscera, as well as from those  of the nervous ex-
pansions, corresponding to the cerebral and  spinal  nerves distri-
 buted to the skin and locomotive apparatus.   They might even be
 regarded, in certain cases, as the effects of a too faithful and active
 memory; but all this has nothing to  do with the main question be-
fore  us.
  Several of the passions belonging to the  preceding series, in-
crease the violence of anger; it is thus  that  sexual love, when it
 meets with obstacles to its enjoyment,  gives rise to   violent pa-
roxysms of  anger.  The same takes place in respect to self-love,
 by whatever name it may be designated; in a word, whenever we
 are opposed in our enjoyments, we are more or less irritated against
 the obstacle; but when the fit of anger resulting from this is feeble
 and momentary, we content ourselves with  designating it by the
 name of impatience. I now proceed to examine the other passions
founded on pain.
  1 have said that the reaction which resists grief and pain in gene-
ral, is manifested under two general forms,—one of  which tends
to repel, and the other to avoid the  cause  of  this kind of pain.
The first of these forms having been examined  under the name of
anger, I now turn to the second, which is fear.
  Fear, like anger, is founded  on a painful sensation which is some-
times developed within us through the influence of instinct, when
we experience pain.  This passion always supposes, in the  animal 
136
OF THE PASSIONS.
 that experiences  it, the exercise of the intellectual faculties, what-
 ever these may be; but the  organic sensations and movements that
 manifest it, take place in the viscera, and sometimes in the whole
 nervous apparatus.   The different shades of fear are very  nume-
 rous; we first notice the sudden contraction of the diaphragm, which
 produces an involuntary inspiration; but the expiration is incom-
 plete,—from which results a convulsive respiration and suffocation.
 If fear increases, palpitations ensue,—the  blood  is retained  in
 the  heart and  lungs,—the skin becomes pale, contracted, and co-
 vered with asperities,—the hair which traverses it stand on end,—.
 cold is developed, at first over the whole surface, and produces a
 chill,—it occasionally penetrates so deeply as to affect'the muscles
 and cause a trembling.
   This passion shows itself in the countenance in a manner peculiar
 to it;—many of the secretions  are altered,—cold sweat sometimes
 supervenes;—tears are shed in  this passion as in grief, of which in
 fact it constitutes a variety.   The urine and excrements are some-
 times discharged  with violence from their reservoirs,—not,  as has
 been said, owing to the relaxation of the sphincters, but rather from
 the sudden and convulsive contraction of the bladder, rectum, and
 even of the colon.  In fact, these contractions correspond with those
 <>f the diaphragm, and even  of  the  abdominal muscles; for fear
 offers this peculiarity, that it determines the convulsive contraction
 of the visceral and cephalo-spinal muscles, at the same time that it
 repels  the  blood from  the exterior,  and accumulates it in the
 viscera.  This involuntary contraction of all the muscles, and the
 trembling of those of locomotion, indicate that the centre of volition
 is swayed by instinct,—that the will does not  react, and that the
 cause of fear continues to act;—if the centre of perception be too
 intensely occupied by it, and if the will cannot develope its action,
 all locomotive  movement  becomes  impossible,  and  the animal
 remains in a state of immobility.  When fear persists with a degree
 of intensity, the repeated contraction of the muscular coats of the
 hollow  organs, prevents matters from accumulating  in them;—
 the  desire of making water is incessantly renewed,—the stomach
 can  no longer be dilated by aliments, and the individual experiences
.in the epigastric region a sensation of permanent constriction. The
 too long continued contraction of the heart arrests the progress  of
 blood to the brain,—the individual falls into a  state of syncope,
 rind  may even lose his life; but  if the influx of blood to  the brain, 
OF THE PASSIONS,
137
lungs and muscles  be simply diminished, there results only weak-
ness, paleness, a universal coldness, and the convulsive shivering of
which I have already spoken.
   Such  is fear,  so long as it is a depressing passion: it is easy to
perceive, that it must be referred to grief in general or  to moral
pain, of which it constitutes, however, a peculiar shade.   It is also
confounded, in certain  subjects, with the  first  degree of violent
anger; for it often happens, that in an imminent peril, fear is the
first to be developed;  but soon self-love awakens  anger, which
gradually warms all the parts of the body that terror had already
chilled.
   There is another mode of resisting the depressing action of fear;—
it is manifested by flight.  This supposes a very considerable deve-
lopment of muscular action; consequently, it can only take place in
those cases in which fear has not attained that high degree  of inten-
sity, very generally designated  by the name of terror, and which,
as we have seen, may produce  immobility,* and even death.   As
soon as a man has fled, fear ceases to  be simple,—hope, which is a
sentiment founded on pleasure, begins to kindle,—it alternates with
fear,—it mixes and is confounded with it, even to a degree difficult
to determine, and fear becomes  a mixed passion.
   If, therefore, we combine, in different degrees, pain and pleasure,—
if we interpose  to the first,  sometimes the  reaction produced by
anger, at others the internal movements which tend to induce flight,
we discover a considerable number  of mixed passions, which it
would be curious to examine, in order to refer each to the organic
modification peculiar to it; since this is the principal point of view
in  which this question may  be regarded as interesting to the phy-
siological physician.
   Let us glance over the passions, or rather  the shades of  passions,
which, as being the result of the faculty we possess of observing all
that surrounds  us, and of comparing ourselves with  the various
objects of nature, and particularly with other men, are  peculiar to
our species.
   Love and hatred necessarily constitute the basis of  all  our  pas-
sions.  Pleasure is associated with love, and pain with hatred. Plea-
  • This immobility, which is attended with a fixed attention towards the enemy,
and which delivers up to him his victim by a sort of spontaneous movement, has
been denominated in animals fancination. Vid. supra, p. 8S-9.
                              18 
138
OF THE  PASSION*-.
 sure, which is the same as joy,* produces transports that are mani-
 fested by the  acceleration of the  circulation,—the  redness of the
 skin,—the vital erection of  the whole peripher)r,—the aptitude to
 muscular movements,—the forgetfulness of some wants, and par-
 ticularly of those of nutrition.  If, under  these  circumstances, an
 individual be afflicted with a melancholy idea, giving rise to a move-
 ment of hatred,—if the reaction of anger be developed, all the
 agitation of pleasure instantly turns to the advantage of this pas-
 sion, and anger soon acquires an  extraordinary degree of energy.
 It is in this way, that the pleasure  resulting from an advantageous
 comparison of ourselves with another individual, during the trans-
 ports of  self-love, which we denominate pride,  is transformed, as
 soon as we are made to feel our inferiority, into a state of fury:—
 hence this passion is the most violent of  all those to which man is
 exposed. It is for this  reason, that we  daily hear it remarked, that
 self-love  when wounded is  terrible in its vengeance, and hardly
 ever forgives.  This kind of  fury is attended with the most painful
 sensations, referred to the epigastric region, and reflected to the
 heart and lungs; as well  as with so violent an afflux of blood to the
 brain, that the engorgement  of this  organ often abolishes for some
 time, or even for ever, the functions of the apparatus  of  external
 relation,—without speaking  of the sometimes permanent conges-
 tions which may  take place in other viscera.
  If anger succeed in being gratified by vengeance,  the individual
experiences a horrid pleasure, which though reprobated by reason
is not the less real, and the perception  of which  always occurs in
the viscera: it may  be referred to  the enjoyments of gratified self-
love. Nevertheless, it is in its nature to  be soon  followed by pain,
which in its turn may develope a  secondary anger,—such as the
transports of despair, which may give rise to all the organic derange-
ments  produced  by  the  other kinds ^of anger,cause  flight, or be
changed into melancholy:—when this occurs, this new modification
  * It might be objected, that some pleasures are attended with remorse, and con-
sequently not with joy. To this I answer, that in such cases there is an alternation
of joy and sadness; for I cannot conceive of the simultaneous existence of two
opposite sensations. In these instances I perceive an habitual state of melancholy,
interrupted, from time to time, by the joy of pleasure,—and surely this does not
invalidate the correctness of my proposition.  It may, moreover, be said, that in
pain there does not always exist hatred. I shall answer this objection when I point
out the  different objects of hatred. 
OF THE PASSIONS.
139
ji/roduces a depressing effect, by concentrating the vital action in the
viscera, at the same time that it prevents the reaction of these latter
on the expansions of the locomotive and sensitive apparatuses.
  I have cited the pleasure derived  from the gratification of  self-
love as the most keen, in order to serve as an example of the modi-
fications occasioned by pleasure, and by  the pain which interrupts
it.  I would even  go further, and assert, that it is the only pleasure
capable of exciting violent transports. What are, indeed, the ideas
that afford us pleasures  capable  of  throwing us into a delectable
state of ecstasy?  Is it glory? Whatever may  be the subject of this
latter, (und we know that they are numerous,) it is founded on self-
love.   Is it the transport occasioned by a  favour received?  I do not
perceive any other  basis for it than this passion, which in this case
arises either from the idea of the  preference granted to us over our
rivals, or from the enjoyments we expect to derive from the means
just procured for  us.  These enjoyments enter  always within the
domain of gratified self-love,—at least as regards the moral part of
them,  under  which point of view I am now considering the pas-
sions.   Is it the pleasure we feel after the performance of a chari-
table act?  However noble  this kind of  pleasure  may be, its sole
element is the enjoyment of comparison.  I have elsewhere said,
that benevolence, could have for  its motive the  hope of gratitude,
or of remuneration; but on close  examination, we discover in this
motive, enjoyments appertaining to comparison.  Will the pleasures
and joys procured  by friendship, paternal and filial love, be cited
against the correctness of  my position?  I answer, that, in all that
is not instinctive, these pleasures must be allied to those resulting
from comparison. Will my opponents refer to the transports expe-
rienced when we escape from an  imminent peril?  If we except all
that is referable to  instinct, there remains, in  those instances in
which we owe our  safety to others,  gratitude,  in  which  self-love
plays a conspicuous part; and in those instances  in which we think
we owe all to ourselves,  sensations which, as respect their moral
part, are always referable to those enjoyments derived from a com-
parison with our  like.  Perhaps the transports of love may be cited
as exempt from the enjoyments of comparison.  Doubtless they are
independent of them  in  an instinctive point of view; but what is
love when reduced to this cause?  If you wish to constitute it into
a passion in which there enters moral considerations,—or in other
words, into a true  passion, such as it must be in order to govern 
140
OF THE FAroIuNS
  imperiously our intellect, you will not succeed without introducing
  into it enjoyments of comparison.  Now, whenever the transports of
  love are deranged by  an obstacle, whatever it may  be,  self-love,
  pride,  and vanity, are  excited with the greatest energy,  and point
  out the moral and true element of this all powerful passion.
     It may be said, that animals that have no moral feeling are, ne-
   vertheless,  susceptible of  the most terrible paroxysms of anger
  when disturbed in their venereal pleasures.  Doubtless this is true;
  but it is only the instinctive part of the passion; or rather it is not
  the passion, but an affective movement devoid  of any moral ele-
  ment.   The proof of this is, that this instinctive movement disap-
  pears with the want; whereas, in our  species, the  passion, nour-
  ished by thought, continues, although this  basis no  longer exists;
   and I maintain, that the nourishment it receives from thought is
  derived  from comparison.  Whoever will  examine attentively
  what occurs within himself, will  find no difficulty in discovering
   the proofs of the correctness of my assertion.
     There are other passions very exalted in  their enjoyments,  and
   very terrible when they encounter obstacles.   Such is fanaticism,
   whatever may be its motive.  This is probably the most moral of
   all the passions; well, it is the one in which  the  enjoyments of
   pride, vanity, in a word, of self-love, play the most conspicuous
*  part.   Is it then astonishing, that anger and  hatred should be de-
   veloped, with so much violence  and tenacity,  against all  that is
   capable of troubling the sublime enjoyments  of enthusiasts of all
   sorts? Hence, no passion  has caused the flow of so  much blood as
   fanaticism, which might be defined the pre-eminent abuse of the
   intellectual faculties.  It is the  most formidable  scourge of the
   human species, and one which,  in some measure, avenges animals
   for all the advantages  which our species  possesses over them.  I
   shall not speak of the  pleasures of honour, as  it is too evident they
   are founded on the comparisons of self-love.
      I now proceed to point out certain organic modifications, to which
   I have not  yet alluded,  and which correspond to some of the
   passions, or else to  some of the  affective movements, I have just
   enumerated.
      In horror, which must be referred to fear, of which  it  constitutes
   a very peculiar modification,  we experience a sensation of cold-
   ness, extending over the  whole surface of  the  skin, and the hair,
   stands on end in a very astonishing manner.   In some instances 
                       OP THE  PASSIONS.                    141

this organic movement appears simple, as,  for example, when we
discover something hideous that displeases us, without, however, oc-
casioning a strong feeling of terror.  But the reluctance we ex-
perience in approaching such an  object, points out sufficiently, that
it is mixed  with a feeling of fear.   In other instances, to  these
symptoms are added a chill, a sense of suffocation, and palpitations
at the heart;—under these circumstances fear exists, such as we have
described it. The sight of certain objects,—the hearing of certain
sounds, give rise to involuntary tremblings, and to convulsions.
I once knew a Prussian officer who could not see an old woman, a cat,
or a thimble, without experiencing convulsive agitations, and with-
out jumping and screaming.  We know that the rubbing of two dry
bodies,—the sounds of a file, or of the harmonica, fatigue, to a
most distressing degree, the nervous system of a great number of
delicate individuals, and  derange the harmony of the  principal
functions.   Almost every nervous subject  has an object of horror
or disgust.   All these effects must be referred to instinct; for pas-
sion assuredly has nothing to do with them.
   The same remarks are applicable to the vomiting which  some
sensitive individuals experience at the instant  they are  told they
have  eaten  something for  which they have  a  disgust.    With
some  of the most  irritable  among them,  it  is  sufficient they
should figure to themselves, that the object for  which they enter-
tain disgust is  in their  mouth or stomach,  in order that this latter
viscus should contract with violence, and  eject even blood.  Al-
though,  in all  these  instances, instinct exerts an agency,  it is,
 nevertheless, certain, that the cultivation of the intellect contributes
 greatly to produce the exalted susceptibility of the  viscera, by im-
 parting to the brain a degree  of influence over the internal organs
 which it would not possess  in  a purely  natural  state.  But it is
 very evident, that the pleasures and pains of comparison exercise no
 influence over the action of the encephalon, or over the derangement
 it occasions in the functions.
   The same does  not occur  in shame.   This affective movement
 consists in one of the numerous modifications of wounded self-love;
 and nothing is more evident than the influence it exercises on the
 organic tissues.  It acts particularly on  the head,  to which  blood
 flows  with violence;  and as, in  this case, the epigastrium does not
 experience that kind of constriction which withdraws the blood from
 the surface of the  body, and  is so often superadded to cerebral irri- 
l-4i2
OF THE TAiSIO-NS.
tations, this fluid is accumulated in an extraordinary manner in the
capillaries of the face;—the eyes participate in it, and sometimes to
such  a degree,  that  vision  becomes deranged.   The ideas are
confused,—the muscles are  no longer at the disposal of the will;
and in the last stage of this singular feeling, the individual affected
with  it, can neither think, speak,  nor  move  with  regularity.
Shame, which sometimes assumes the name  of bashfulness,  is
usually met with in young and  timid  subjects.  It generally ceases
with the progress of age,  by the  habits of social relations;  but in
some instances it is very difficult to overcome.
   Compassion, in which we  may discern  the influence  of the
instinct of self preservation,  and, in innumerable cases, a mixture or
alternation of  the pleasures  and pains resulting from a comparison
of ourselves with our fellow men, exerts a well marked influence
on our viscera.  The internal movement by which this affection is
nourished, is principally felt in the epigastric region.   The heart
participates in it;—it is broken,  agreeably to the language  of the
world; but it should be recollected, that by the  vulgar a number of
sensations are referred to this organ, which depend on the stomach.
Compassion tends to produce a visceral concentration without  re-
action:  hence, it should be classed among the affective movements
which produce a depressing or  debilitating effect.  This sensation
being painful, the individual endeavours to discover the means of
removing it. Some attain this end by succouring the unfortunate;—
others by diverting their attention in seeking out motives capable
of diminishing the interest inspired by the sufferer;—finally, others
avoid its effects  by flight.   It is plainly perceived that benevolence
is not a necessary effect of compassion, but a simple organic move-
ment.  It depends solely  on thought, and is  consequently subordi-
nate to the  series of ideas that  predominate in  the individual, and
which, in most instances,  result from his education.  Hence, bene-
volence is  purely moral; it  is a virtue; whereas compassion is pri-
marily an instinctive movement,  more or less increased by the plea-
sures or pains resulting from the comparison of one individual with
his fellow  creature.   It is  purely instinctive when applicable to
animals, the sufferings of which  we witness;—when it has for its
object the human species, it is,  in most instances, mixed.
   In persons endowed with a large share of sensibility, grief pro-
duces often  a modification in the  organic tissues, as evident in the
interior as on the exterior  of  the body.  I allude  to  the  move- 
OF THE PASSIONS.
143
 ments producing tears.  We weep from various motives;—some-
 times tears result from the regret we feel for the loss of an  indi-
 vidual we cherished;—at other times they are occasioned by the
 distress and  abandonment  in which we  are  left by others.  The
 sight of  an unfortunate being,—the physical or moral picture of
 his distresses,—the idea that we might have been the cause of these
 latter,—the fear of torments,  of death, of ignominy, of the humi-
 liations of self-love when at the height of its  enjoyments,—purely
 physical  pain, may also excite the effusion of  tears.   We also  weep
 for joy,—in consequence of the pleasure of seeing once more a be-
 loved  object,—from the softer  emotions occasioned by a  good
 action,—a  generous sentiment,—an heroical devotedness;—from
 self-sacrifice in favour of a fellow being and even sometimes to the""
 advantage of  a bitter enemy.  In  a word, weeping is not produced
 by any one particular  kind of pain.  It depends always, it is true,
 on a painful  feeling,  even in those cases in which the exciting
 cause is a motive for joy, since in such instances this joy alternates
 with and is  counterbalanced by  pain;—or else it  is a pleasure,
 which, by its excess, is converted into pain. However this may be,
 tears resulting from a moral cause are always preceded and prepared
 by a scries of movements and sensations, which it will be interesting
 to examine with attention.
   We first experience  a  feeling  of compression which  originates
 deeply in the epigastric region,—which  impedes  the movements
 of the diaphragm, and thus  causes a true dyspnoea.  This  kind
 of constriction, produced primarily by the influence of the brain.
 (since it  results from the power of thought,) meets with resistance
 from instinct, which causes from time to time, and in a sudden and
 violejt manner, the depression of the diaphragm and the elevation
 of the  ri'is;—this gives rise to convulsive inspirations, denominated
 sobbings.  During this time, the constriction, following the course
 of the oesophagus, rises towards the pharynx.  This constriction
 is not  imaginary:—it  is in fact so real,  that  deglutition becomes
 impracticable; and the derangement of the mucous secretions, pro-
ducing dryness of the throat and even of the whole mouth,  with
thirst and a sensation of heat,  attest sufficiently that the  organic
functions of the parts to which the sensation is referred are altered.
The  larynx also partakes in this spasmodic secretory affection,—it
becomes somewhat constricted, and its mucous membrane, as well as
that of the trachea, are dry and of a burning heat, which causes the 
144
OP THE PASSIONS.
voice to become hoarse and interrupted  with sobbings.   These
phenomena  are sometimes carried to such an excess that the indi-
vidual experiences acute pain, not only in the throat and pharynx,
but also in the stomach, chest, and in all the inspiratory muscles,—
without excepting those of the  abdomen, which seem  to him as if
likely to be  torn asunder.   He imagines he feels a large and round
body rising  towards the pharynx, and impeding respiration,—he
screams, and sometimes is affected with general convulsions.  In-
stinct has then no longer any  control over the inspiratory muscles,
and asphyxia may be produced, and  even cause  death.  In other
cases, danger becomes imminent from the congestion of blood in
the brain.
  These phenomena, however, very seldom  attain such a degree
of intensity; for in the greater  number  of instances, the con-
striction of  the pharynx, and the stagnation of blood in the head,
face, and globe of the  eye, are relieved by an  abundant secretion
from the lachrymal glands. As soon as this secretion is fairly estab-
lished, a feeling of pleasure is mingled with the painful constriction
of the pharynx,—it interrupts, and finally removes it entirely.
  In a great number of individuals, the flow of tears is much more
easily excited,—as is exemplified in children, many of whom retain,
through life, the same facility in shedding tears.  In such individuals,
grief has no sooner begun to produce the tracheo-pharyngeal con-
striction, than the lachrymal glands are called into action. Hence we
remark, that in them grief is not as intense, durable, and dangerous,
as in other individuals.  There are, indeed, a few who possess the
weeping faculty to such a degree, that the least pain, either physical
or moral, occasions  the flow of tears. These persons acquire by prac-
tice  such a command over their lachrymal glands, as to increase at
will the secretion of these organs,  by figuring to themselves, as we
notice in actors, griefs and pains  they are  far  from really experi-
encing.   However this may be in a correct  physiological jioint of
view, we cannot help regarding the flow of tears, when not the re-
sult of a morbid state, as a modification of pain produced by a moral
cause.
   Although the flow of tears be excited through the  influence of the
brain whilst in the exercise  of thought, it is worthy of remark,
that  this organ can only  occasion it by  acting on  the  visceral
nerves;  and that it imparts, at the same time, to  the inspiratory
muscles, a direction the reverse of that which the movements it 
OP THE PASSIONS.
14*
has given rise to in the viscera tend to impart to them.  It might, in-
deed, be thought, that these latter act on the muscles independently
of the brain.  We shall examine, in  another place, this question,
the solution of which constitutes one of the most delicate points of
human physiology.
   In pointing out the mixed passions, I have not, perhaps, suffi-
ciently enlarged  on the effects  produced on the system by the alter-
nations from pleasure to pain, from love to hatred, from depression
to anger, from fear and  despair to hope, and vice versa.  In these
different conditions of self (moi), lean discover only two things
of any importance to the medical physiologist;—the  sudden tran-
sition from pleasure to pain, and from pain to pleasure.  Thus, when
we pass from love to hatred, we only suffer after having enjoyed;
and when hope succeeds to despair, it is still an alternation  of plea-
sure and pain. Of this we may be readily convinced,  if we reflect,
that to hope is to enjoy, and consequently to love the sensation or
the object which gives rise to it; and likewise if we recollect, that
to fear is to suffer actually from the anticipation of misfortune, and
consequently to  hate either the object that is to cause this misfor-
tune, or the sensation which gives  rise to the idea of it; since, in
the grief anticipated, as well as  in  the despair,  we  can discover
nothing but a pain necessarily hated by the individual who experi-
ences it.
   I have already said, that both love and hatred were only felt, in
a violent manner, for man,—that these passions  were not at all di-
rected to inanimate objects, and only in a limited  degree to animals.
From this it results,  that when our pains and pleasures depend  on
these latter causes, it is  principally the sensation that  we hate, and
very rarely the object producing it. There are, likewise, a  number
of cases, in which we have only as motives for our love or hatred,
objects of this latter  kind. Such are,  for example, our diseases;—
for then our love or  hatred has commonly  for its objects, our own
sensations; unless, indeed, owing to  mental aberration, we direct
it towards our acquaintances; but in such cases, as these passions do
not arise from  a moral cause, they  only  continue so long as the
disease which produced them. In a word,  I regard it  as sufficiently
well proved, that we may love pleasure and hate pain, although our
love or hatred be not directed towards any other objects than our-
selves.
                              19 
146
OF  THE  PASSIONS.
     If wc now examine what takes place in  our organs, when pain
   suddenly succeeds pleasure, we discover, that the state of universal
   nervous irradiation,  and of  vascular  expansion, which  promotes
   every  movement,  sensation,  partial circulation,  and  secretion,
   is suddenly  replaced by an opposite condition of the system.
   Indeed, sensibility becomes concentrated, together with the circu-
   lating fluids,  in the viscera,—the rest of the living machine falls
   into a state of torpor, which is only interrupted, from time to time,
   and in a convulsive manner, by the irregular irradiations originating
   in the suffering viscera; and reciprocally, whenever pleasure is de-
   veloped with  sudden energy, in an individual in whose viscera pain
(   has concentrated the nervous influence and the fluids, the expansion,
   towards the rest of the organs takes place with so much1 rapidity,
   that these latter, and the viscera themselves, experience very vio-
   lent commotions. Hence, 1. In pain there is concentration  of action,
   sensibility, and fluids,  in  the  viscera, with  partial and impetuous
   irradiations on the  other  tissues.  2.  In pleasure there is  a univer-
   sal expansion  of action, sensibility, and fluids, on all the tissues,—
   without excepting the viscera themselves.  Such are the principal
   phenomena resulting from the alternations we are examining. It is
   proper, moreover, to bear in mind  the expansion occasioned  by
   anger, and which  sometimes attains a much greater height than
   that produced by  pleasure; but in such cases, a certain  degree of
   enjoyment is  combined with  the  painful condition of anger; it is
   produced, in my opinion, by the  desire of revenge, which cannot
   be any thing else than a pleasure by anticipation.   I compare this
   pleasure to the one accompanying the transports of despair,  which
   result only from a mixture of anger; and it is proved, at least in my
   opinion, that pain always produces a concentration, and that the
   reaction resulting from it arises constantly from pleasure, when it
   becomes sufficiently powerful to produce a general expansion. We
   shall soon examine the pathological consequences of these contrary
   alternations;—when they  succeed each other rapidly and frequently
   their effects are terrible. 
147
                     CHAPTER VIII.

              OP LAUGHTER, ENNUI, AND SLEEP.

  We are next to examine the physiological states belonging to the
functions of relation—I allude to laughter, ennui, and sleep.

                 Section I.—Of Laughter.

  Laughter, as has been said, is produced by contrasts. Whenever
we perceive, through the medium of the two intellectual senses,—or,
in other words, as soon  as we see or hear something that forms a
contrast with the idea which  before  occupied  us, if the new idea
has  nothing painful in it, we  burst out a laughing.   The sensation
we experience at the moment the contrast strikes us, is instantly felt
in the epigastrium, and  produces  laughter.  The rest consists, as
has  been proved by M. Roi, in his dissertation, of sudden and con-
vulsive movements of expiration.  This mechanism depends, there-
fore, on the abdominal muscles;  and, as the latter are supplied with
nerves from the great sympathetic, I believe, that, in the majority
of instances, laughter is executed in consequence of a visceral influ-
ence.   I simply mean, that the brain does not produce it, without
acting on the whole nervous ganglionic apparatus, at the same time
that it calls into play the expiratory muscles.  When  friction is
applied to these latter, (the tickling of the sides) the cause of laugh-
ter  appears to act directly on the  muscles which execute it; but as
the stimulation of another part of the body, of the soles  of the feet
for  example,  is also sufficient to produce it, we ought to lay more
stress on the cerebral sensation than on  any other cause: thus, in
the  idea of a contrast, of a dissimilarity, in the tickling of the sides,
of the soles of the  feet, in the irritation of  the viscera from in-
flammation, &c. there is always a perception in the centre of rela-
tion, in consequence of which, laughter is commanded and executed.
  I shall not  stop to detail the muscular movements by which the
action of laughter is performed.  It will be sufficient for my purpose
to direct attention to the contraction of the  abdominal muscles,
which, when intense and continual,  offers an obstacle to the dilata-
tion of the chest, and  consequently to inspiration, in order to show
the  danger of these kinds of convulsions.  As regards the contrac-
tions of the muscles of  the face which draw outwardly the angles 
148
LAVG11TEK,  ENNUI, AND SLEEr.
of the mouth, and enlarge this cavity, they depend upon the sanv
sensation that produces the contraction of the abdominal muscles,
and are not more astonishing than the movements of the other af-
fections.  But it appears to me, that laughter confirms what I have
said of the  affective movements and of the passions.  Thus laugh-
ter  is  an  affective  movement; since it is  attended with  pleasure
when moderate, and with pain when excessive; and, consequently,
with love or hatred, either for the sensation or for the  cause.  Now
I will ask,  what would constitute  laughter, if the sensation referred
to the viscera, as well as the muscular movements which accom-.
pany it, did not exist?  Could the  brain  laugh alone?  Certainly
not; nor could the other affections any more exist, if  the modifica-
tions of the viscera,  which render them evident, did not take place.
But I have not exhausted this subject, and will recur to it.   Laugh-
ter precipitates nervous action in  all the senses, and in all the mus-
cles,—it accelerates the circulation, promotes perspiration, and, in  t
general, every function, when it is not carried to that  degree which- -
interrupts the action of the heart  and lungs, and accumulates blood
in the brain.
  The act of smiling has been  with reason  distinguished from
laughter properly  so called.   Contrasts, which are  the ordinary
causes of the  latter, are not at all  necessary for the former.  Every
cheerful affection or passion,—that is  to say, founded on pleasure,
can, when  in a moderate degree, excite a smile; for, in their greatest
intensity, these modifications of self (moi) assume a serious na-
ture, as may be exemplified  by love,  the most  cheerful of all the
passions, but which, in its most violent transports, ceases to be joy-
ous.   At any rate,  laughter has this in common with  smiling, that^
like the latter, it implies an agreeable state of  the mind.   Hence,
the cheerful passions predispose to  laughter;—the one  who smiles
habitually, is disposed, whenever the occasion is presented, to burst
out a laughing;  whilst a melancholic individual is  often unmoved
by the most striking and unexpected contrasts. Every one knows,
that cheerfulness may be feigned; and that, for the same reason, an
individual  may smile at will, and without any cause for joy.
  Fits of laughter are likewise simulated, and we may, to a certain
extent, create within ourselves the feeling fit for  this affection.
Laughter is  susceptible  of imitation;  we  laugh  violently without
any other motive than that of seeing others laugh,—which indicates
another point of analogy between laughter and our passions.  When-
ever,  in melancholic affections of the mind, a smile appears on the 
LAUGHTEH,  ENNUI, AND SLEEP.
149
countenance, it is always, in my opinion, the result  of an idea
that  produces a pleasurable sensation; for we have seen, that in
hatred, anger,  and even in despair, similar  sensations frequently
supervene;__yet, as they are but transient, their  true characteris-
tics cannot be completely established.  Hence, the smile of those
who are in this condition has something sinister,  which distin-
guishes it from that  produced by a continual state of joy and hap-
piness.
  Laughter is sometimes the result of disease;—and  why should
this not be  the case, since all the affective movements may depend
on a similar cause? This constitutes another point of analogy which
deserves to be noticed.  Hysterical women experience sensations
of joy and grief,—cry and laugh violently  without  any  moral
cause, and from the mere effect of the irritation of the abdominal
nerves reacting on the brain, in spite of the will,  But  from the
same influence result  often also the other passions,  and this is an
additional reason for admitting the dependence of the brain on the
other viscera.   In a word,  these latter have the  property of ex-
citing in our minds  a state of cheerfulness, of melancholy, and of
fury; and the movements  which these modifications of the mind
produce in them, are sometimes excited by causes  acting primarily
tm their tissues.

                   Section II.—Of Ennui.
  This is a condition of our mind  which  merits  the attention of
physicians and ideologists.   It depends  upon  that want which I
have pointed out in a former part of this work, as one of the cha-
racteristics of  man, viz. self-observation, and comparing himself
with all surrounding objects.  Hence ennui  is never found in ani-
mals. It is true we sometimes see them in a state of melancholy and
languor,  which might have received that name; but it has been ap-
plied very improperly;  or if it be wished to retain it,  it will  be
necessary to admit, that this condition does not depend on the same
cause as in the human subject  An animal languishes because it is
deprived of the stimuli which its instinct requires; this state is pro-
duced by the defect of nourishment,  of exercise, of an  habitual
companion, of  its female or male  respectively', of its young, &e.
The same species of languor is also met with in man; but this lat-
ter is subject to another kind of sadness, which does not arise from
such a cause, but merely from a deficient moral excitement; and i?
is this languor which constitutes true ennui. 
150
LAUGHTER,  ENNUI, AND SLEE1'
  In my opinion, ennui  depends on a deficient moral excitement
in those who have contracted the habit of such excitations; for the
savage and the countryman, whose education has been  neglected,
are  not susceptible of this feeling.  When their wants are gratified,
they remain in a state of inaction, without any further desire;—by
which they  are rendered very  analogous to the  brute creation.
The same thing does not occur among those individuals who are
accustomed to think a great deal;  for as soon as the external causes of
moral excitement cease to act they begin to  be weary; at any rate
it is right to establish a distinction between  these individuals
Those whose memory is strong and well stored,  from having read,
seen, and  observed  a great deal, find within themselves sufficient
motives for occupation; because  they exercise themselves in recal-
ling to their minds passed ideas,  and in comparing them with those
suggested by present objects.   Hence, learned men, and those ac-
customed to observe and to compare themselves with the various ob-
jects in nature, are but rarely tormented with ennui;  whereas, in-
dividuals  destitute of memory,  or of a large share of  reflecting
faculties, and who are  only accustomed to the  moral enjoyments
they derive from conversation, reading, and sports, are ever una-
ble  to please themselves, and can never resist ennui.  It is in sub-
jects of this description, that this state of things becomes a real tor-
ment.   Moreover,  whatever be the extent  of  our moral means,
whenever we are deprived of things which we passionately desire,
we  are exposed to  suffer  from ennui; because, the imagination
being obstinately fixed on  one object, we  reject  every idea that
might divert our attention and preserve us  from  this  distressing
feeling.
  Many people are subject to ennui when exposed to the conver-
sation of fools,  and even of all those who continually direct their at-
tention towards subjects that displease them, and to trivial ideas;
or who express in an insipid and common manner,  ideas already fa-
miliar to them, and which they have before examined in a more ex-
tended and interesting point of view.   We are also wearied when-
ever some one compels us to fix our attention on  questions of
which we are ignorant, or when a person wishes to make us con-
reive and retain rapidly, a number of things which would require
to be examined successively in detail, and at some length.  But in
all these cases the principle is the same;—because we fail to receive
a moral excitement proportioned to our faculties and bur wants.  In
some instances, however,  anger, which is  awakened in us under 
LAUGHTER,  ENNUI, AND SLEEP
151
these circumstances,  creates a diversion which retards, during a
longer or shorter space of time, the disagreeable sensation of ennui.
  Whatever  be the  cause of ennui, it is announced by a painful
sensation  referred to the epigastric  region, in which is felt a kind
of emptiness, a coldness, and  a peculiar relaxation which seems to
be repeated in the locomotive apparatus.   Gaping takes place, and
is succeeded  by stretchings, and  a  universal  uneasiness.  Those
who are disposed to sleep give way  to it;—others become agitated,
and cannot^ find a single position  capable of relieving them  from
their torments.
  If we now examine what takes place in the viscera, we  shall
discover, that the sensation of ennui  is distinctly felt in their tissues.
Thus, the pain in the stomach is evident, and produces the gapings;
it is  reflected  to  the whole splanchnic nervous apparatus,—it
rivets the attention of self, (moi,) suspends the power of thought,
and  diminishes the  influence of the brain over the inspiratory
muscles.   By this the frequency of respiration is diminished, and
blood is accumulated  in the lungs and heart, which contracts less
frequently.   From this stagnation results the sighing so  generally
noticed in such cases;—the nervous influence is also diminished in
the  muscles  of the extremities,  from which arises that sensation
of uneasiness  that induces us to agitate ourselves, and which I at-
tribute to the thwarted want of locomotive movements.
  We again discover here that reciprocity we have pointed out in
several of the passions. Thus the privation of aliments and of nutri-
tive substances in general, places the stomach in a condition analo-
gous to that  caused by ennui; and the brain  perceiving this, ennui
itself is soon  manifested.  But what points out, in a still  more
striking manner, the influence of the stomach in this feeling, is, that
whatever be  the cause of this latter, it is always removed,  at least
for some time, by the ingestion of aliments, and particularly of fer-
mented liquors.   Wine removes ennui and excites joy: Adsit
Iaetitias Bacchus dator, said Virgil: but wine ceases to exercise
that influence whenever the sensibility of the stomach is too power-
fully excited; for, under such circumstances, yawning  and ennui
may still  occur, although stimulants are in excess in  the stomach.
Let us, therefore,  express the  fact, such as it offers itself to our
observation, by saying,  " the deficiency of moral excitement can
only produce  ennui by affecting in  a painful manner the splanchnic
nerves; that  is to say,  by placing  them in a state of excitement
which may also result from a deficiency of stimulating ingesta-, 
152
LAUGHTER,  ENNUI,, AND SLEEP,
 from their excess, and from a certain degree of irritation,  arising
 from a pathological condition of the stomach; and whenever a cause,
 whatever it may be, has produced, in this viscus, a degree of excite-
 ment resembling that which ennui can give rise to in it, this latter
 feeling may really follow in a secondary manner."  We  should
 carefully distinguish, therefore, the ennui  produced by a moral
 cause, from that resulting  from a physical one; since the first de-
 pends on the brain,  and  the second  on the nervous  apparatus of
 the viscera.   But  as, in consequence  of what I have said  above,
 the latter might be classed among the hallucinations, it would follow,
 that true ennui depends exclusively on moral causes.
   When we endeavour to discover the mechanism of  yawning,
 which may be regarded as the first sign and principal phenomenon
 of ennui, either moral or physical, we encounter many difficulties.
 It has been thought to be produced by the want of respiration, or to
 be destined to renew the air stagnated in the lungs, when respiration
 has been for some time diminished in frequency.  But  such sup-
 positions are erroneous, and it is sufficient to have practised medi-
 cine  to  be convinced,  that  dyspnoea has never alone  produced
 yawning.  This movement is caused by a peculiar sensation origi-
 nating, or rather manifesting itself, at the bottom of the throat, and
 at the superior part of the neck, under the  influence of the same
 causes that produce ennui.  We feel ascend along the trachea and
 oesophagus, and towards the fauces, a  sort of constriction  which
 instinctively impels us  to open our mouth, and to inspire slowly,
 and expire with effort and noise, a large column of  air.   At the
 same  time, we  experience contractions in the  diaphragm,  in the
 muscles of the jaw, of the os  hyoides, of the pharynx, of the face,
of the neck; in the platysma myoides, and in all those that exercise
 some  agency in the act of respiration.   The biceps brachialis, the
 pectoralis major, and some other muscles  of the scapular region,
partake, to  a certain degree, of the irritation; since we often experi-
ence in them a sort of thrill.   All these movements are attended
with a certain degree of pleasure; insomuch, that yawning may be
said to be an  agreeable convulsion.   But what is still more agreea-
ble, is the  inspiration, and especially the expiration of that laru;c
column of air  which passes along the mouth  and trachea,—dilates
the bronchia?,—distends the pulmonary vesicles, and penetrates so
deeply in the pharynx, that a greater or less quantity always reaches
the cavity of the stomach.   A  certain degree of languor, referred
to the region of the diaphragm, succeeds always to yawning; but 
LAUGHTER,  ENNUI, AND SLEEP.
l;*.;
when frequently repeated, we experience in the stomach, itself, a
sensation  of cold, of relaxation, and even of debility.   And reci-
procally,  when this viscus has been cooled and relaxed by the pas-
sage of chyme from it into  the intestines, or by the ingestion of
cold water, the want of yawning is manifested, and the repetition
of this phenomenon seems to promote the  evacuation of the con-
tents of the stomach, and hasten the return of appetite.
   It appears to me, that the lungs  are much less influenced than the
stomach by the acts of yawning; and  reciprocally, when this con-
vulsion is not the effect of a moral cause, (always analogous to that
which  produces  ennui) and not excited  by imitation,  it is  gene*
rally the result of an affection of the stomach, and of the surround-
ing plexuses, and never of a pathological state of the lungs; unless,
indeed, this state produces it by a sympathetic action on  the epi-
gastric regions, as sometimes happens after violent fits of cough-
ing,  which occasion a sensation of uneasiness in that part;  but I
have never remarked that pleurisies, pneumonias, and particularly
aneurisms of the heart, which are the most effectual causes of the
diminution of the volume of air contained in the lungs, gave rise to
yawning.
   The next question which it would now be proper to answer, is
the final cause of yawning;  in other words, the object which in-
stinct proposes to attain by exciting it.
   This  question seems to me  difficult to answer; for if the want of
air does not constitute the principal object of this great inspiration,
what purpose can it serve?  Is it  to obtain a deglutition of air, and
by this means to relieve the uneasiness of the stomach? or does this
uneasiness require, in order to be relieved, the sympathetic influ-
ence of an ample dilatation of the pulmonary tissue?  I am aware
that the gaping of animals placed  in vacuo,  and of newly born in-
fants, is brought forward in proof of the want of air for the lungs
themselves.   But against this opinion it may be alleged,  that pneu-
monia and other pulmonary congestions, do not give rise to yawn-
ing.  On the other  hand  it may be answered, that a deficiency in
the stimulus of air, cannot fail to cause a sensation of uneasiness in
the epigastric region, and that hunger  may suffice, in the new born
infant,  to  carry the  uneasiness to a  degree capable of inducing
yawning.   I do not deny, that the want of air may concur in the
production of yawning: but I believe,  that it does so by producing
                             20 
154
LAUGHTER,  ESM'I,  ASH  SLEEP.
j sensation of uneasiness in the epigastric region, and that thin un-
easiness is the most ordinary cause of this phenomenon; since it
can, by itself, produce it; whereas, the want of respiration docs not
produce it when  the stomach is agreeably stimulated by ingesta,
although  the act of digestion invariably increases the  quantity ol
blood circulating  in the lungs, and, consequently, adds to the  in-
tensity of the  dyspnoea.*   Experimentalists  will, perhaps, one
day solve these  difficulties.  I  therefore  commit  them  to their
charge, in order to pass on to the examination of other subjects.

                     Section III.—Of Sleep.

   Sleep is defined,  by modern  physiologists,  the repose of those
organs charged  with the external relations.   Thus it is manifested'
by a cessation of the functions of the senses,—of those of the mus-
cles submitted to  the will, and by  the abolition of the intellectual
and affective faculties.   Sleep ought to unite all these  conditions
to be complete; but it is susceptible of numerous shades, and, in or-
der to form a just idea of it,  it is necessary it should be described.
   Sleep is announced by a diminution in the activity of the senses,
by that of attention, by the aversion for voluntary movements, and
by a kind of languor,  which is believed to be  universal.  We ex-
perience towards  the frontal  region, and especially about the eyes,
a sense of heaviness, and, as it were, of fulness; the conjunctiva be-
comes injected, the eyes appear tumefied,  the upper eyelid falls,
and, if we attempt to raise it again, it appears as if heavy.  This
congestion of the  fore  part of the brain, is often accompanied with
yawning, and a feeling of fatigue in the limbs, which leads us to
stretch them in different directions; this is what is called pandicu-
lations.  While  we abandon  ourselves  to this feeling, we expe-
rience, in the muscles  thus stretched, a kind  of convulsive trem-
bling.   When we feel an inclination to  sleep,  we experience at
  * Yawning is also manifested in the beginning of the paroxysms of intermittent
fevers; and this is another reason, agreeably to my opinion, for referring its prin-
cipal seat to the epigastric region; for it appears to me certain, that the uneasi-
ness of this region, which calls the blood into the viscera and causes the coldness
of the exterior, is likewise the exciting cause of this yawning.  I shall, hereafter,
prove that all irritations, suddenly developed in any part of the body whatso-
ever, can excite a chill, and that the cold stage  of intermittent fever cannot be
explained otherwise. 
LAUGHTER,  ENNUI, AND SLEEP.
155
1hc epigastrium a peculiar sensation, similar to that of ennui and
gapin<>-; it is a  kind of languor which cannot well be defined.   In-
stinct leads us to seek the most proper posture for repose.   Respi-
ration becomes slower,  and, in some individuals, stertorous from
the commencement; afterwards it  is more  calm;  the sleeper  no
longer manifests any signs of sensibility to  external impressions.
His intellectual faculties appear no  longer to exist, and we cease
to discover any voluntary movement.  In the first moment, that
of somnolency, the  individual has some confused ideas;  he still
thinks,  but judgment  fails him; he speaks in an unintelligible
manner, and, in fact, is delirious.   Soon he loses every idea, after
having lost every movement,  even those of the  respiratory mus-
cles: for the  centre of perception does not  cease to feel the want.
of respiration;  but as this want is less felt, the inspirations are few,
md as they are retarded they become fuller;—this is  what causes
slerior. Sleep,  having lasted for sometime, becomes less profound;
the centre of perception feels, in addition to the want of respiration,
the uneasiness which arises from a fatiguing posture; the individual
moves,  turns over, without, on that account, awaking.  His  me-
mory  begins to  resume its  action:  he combines the  ideas  it
retraces  with  confused impressions  he receives  from without,
as  also with the  irritation of his  internal senses;   he dreams.
Sleep  becoming  still  less  profound, the  sleeper feels  certain
wants,  such  as those  of  making water  and  of coitus.    He
awakes an instant to gratify  the  first, and  sometimes the second
rouses him from his rest by feigning the act of copulation. Finally,
the disposition  to receive external impressions is restored,  in  pro-
portion as the want of sleep diminishes.  Light penetrates through
the eyelids,  noise is  heard, all the wants are felt;  that of exercise
is developed  last;—when this occurs the waking state is complete,
and very  soon a desire for motion engages  man  to quit his plac£
of repose.
  If nothing  be opposed to the want to sleep, man abandons him-
self to it without feeling any thing; but if efforts are  made to op-
pose it,  it appears to him as if he were deprived of a pleasure, and
threatened with pain; for then he strongly feels that state of languor
of which  we have spoken;—he finds it agreeable, and becomes
irritated against the causes that tend to rob him of it.  Pain is also
felt in the head, the eyelids, the eyes, &c. to the last of which liglit
is insupportable. 
156
LAUGHTER,  ENNUI, AND SLKEr.
   Hence it is by pleasure that we are invited to abandon ourselves
to sleep.   This pleasure  re-appears once  more  immediately on
awaking too early,  and it is so  much the more  keenly felt, as the
period of sleep has been shorter.   But if  it  has continued all the
time necessary for the gratification of the want, external  impres-
sions, far from being painful, are agreeable, and the state of sleep
is not regretted.
   If we judge of it by the appearance of the sleeper,  the principal
phenomena which characterize the state  of life are  considerably
diminished during sleep.   Yet many physiologists pretend, that
if the external functions are diminished, the internal  ones acquire
a new degree of energy.  According to them, heat is concentrated
in the viscera, and nutrition becomes predominant.
   I cannot admit the correctness of this opinion; since the want of
action in the senses, the muscles, and the intellect, must necessa-
rily give rise to a diminution of energy in the internal functions;
for it is proved that the action of an organ is reflected to the others
by means of nerves,—which  constitutes sympathies; and every one
knows, that this mutual communication of sensations between the
various organs, is one of the principal causes of the maintenance of
life.   Facts prove my assertion;  for during sleep circulation, and
consequently respiration,  are diminished; perspiration is  less ac-
tive, and digestion is effected in a much longer time than during the
waking state. The difference upon this point is so great, that appetite
returns many hours  before the usual time,  in those  persons who
abandon themselves to unaccustomed watchings, and they require
one meal more than customary. Thence the common proverb, who
sleeps dines.   Secretions, such as  those of mucus, urine, saliva, and
bile, are also less abundant.  Where then can we find this pretended
increase of the internal functions? to solve this question, let us ex-
amine the facts upon which its supporters have founded it.
   I.  The pulse, they  say,  is fuller than during the waking
state.  If this be so, it is because the heart beats slower, and because
the external part of the body, being  protected  by thicker cover-
ings, is warmer and more penetrated by blood than it was before.
But cover the skin  of one  who is awake as much as of one who
sleeps, his pulse will be quite as  full, and  more  frequent; hence
circulation will be more accelerated.  One of the reasons which
cause this proposition to be  supported i?,  that often we abandon
ourselves to sleep, with a stomach filled  with stimulating ingesta. 
LAUGHTER,  ENNUI, AND SLEEP.
157
In these cases the acceleration of the course of the blood depends
on the irritation of the  gastric  apparatus,—an  irritation, which,
being revulsed neither by the action of the muscular system, nor
by that of the intellect,  nor by the senses, must necessarily be re-
flected to the heart and skin.  But if you observe one who sleeps
with  an empty  stomach, you will never remark this  pretended
acceleration, unless it be occasioned by dreams; but we have already
said, and will prove very soon, that dreams only belong to incom-
plete sleep.
  II.  The temperature of the skin is increased.  This increase is
purely factitious and accidental; it depends on the coverings, and
on immobility, two causes that retain caloric in the cutaneous tissue;
it may also proceed from too copious a meal, the influences of which
are united to those of the preoeding causes.  But cover the man who
sleeps, less than when he is awake; his skin will  cool faster, and
the external cold will produce an internal inflammation sooner than
if he were awake. Besides, if it be certain that circulation is retarded
in sleep, it is utterly impossible that the heat  of the skin should be
then greater.
   III. Persons who abandon themselves a great deal to  sleep,
are more fleshy than those who sleep little.  From this it is infer-
red, that nutrition  is more active in the first than in the second.—
This conclusion is  erroneous. Thus we have seen above,  that diges-
tion is performed slower in the sleeping than in the waking state.
How then could it happen, that nutrition should be in inverse ratio
to the digestive assimilation? The absorption of the chyle is retarded,
as is proved  by the state of fulness of the abdomen which we expe-
rience after  awaking, and by the urine we discharge several times
before the abdomen lessens in bulk, and before appetite is felt.  Are
those, then, signs which announce that nutrition has been increased
during the sleep which has just terminated? It is only young subjects
who awake with an appetite.  Every adult, and more particularly
persons advanced  in  age, are  obliged to wait some hours for their
appetite, before they can breakfast; whereas, if those persons have
passed the night awake,  they feel  much sooner  the  want of food.
It is then very certain,  that sleep retards  digestion.  But we are
again told, that sleep fattens.   Well, if it does, it is an additional
proof in favour of  my opinion; for it shows, that persons who sleep
much have  assimilated  less, and this occurs as follows:—If they
have fattened, it is because they have lost less, and  not because they 
I5S
LAUGHTER,  ENNUI, AND SLEEP.
 have digested more; since the contrary has just been  proved: but
 if they have lost less, they have been less in want of reparation;
 and if this has been the case, they must have digested and conse-
 quently assimilated less.   The whole of this amounts  then to say-
 ing, that if sleepers fatten more than other persons, it is not because
 they assimilate more, but purely because they lose less.
   Sleep acts, then, as it respects fatness, in the same manner as
 idleness: now, no one can say that idle persons  assimilate more
 than active ones;  we  know, on the contrary, that they assimilate
 less; since we know they consume a less quantity of food; but every
 one agrees in attributing their corpulence to a much less considerable
 waste.
   Sleep, then, maybe considered as the diminution of all the prin-
 cipal and most apparent phenomena that constitute the  state  of life:
 this diminution is a want,  but one which is far from existing in the
 same degree in all species, or all individuals of the same, species.
 This, then, is the reason why certain individuals sleep so lightly,
 that the  least noise is sufficient to  awaken them;  and  why  certain
 animals  never sleep in a complete  manner: such are all birds, the
 muscular action of which, so far from being annihilated, as  in the
 mammifera, is yet so considerable, that they make prodigious efforts
 to maintain themselves in equilibrium, whilst the tempest agitates
 and troubles the weak branch that supports them.  See  the crane ex-
 posed to the wind upon a tower, where it is only supported  by one
 of its claws: does its sleep resemble that of the dormouse or of the
 sloth?
  Now,  our species,—that of all others  which  is susceptible of
 offering the greatest differences between one individual  and another,
 presents also,  as regards sleep, almost infinite varieties: with some,
 it is so profound, that we can scarcely interrupt  it; many persons
 have been rudely agitated  in the midst of the greatest bustle, and
 carried to a considerable distance,  without being awakened, whilst
 others cannot resist the least noise.  Some require eight or ten hours
 of sleep, and others are contented, throughout the whole course of
 a long life, with one or two hours.   We find some who sleep so
 tranquilly, that they are ignorant of what a dream is;  while others
pass their nights in talking, in agitating themselves, in recalling to
 mind or  repeating aloud what they have said and  thought  during
 the day: others  do  more,  and even go so far as to repeat the acts
 they .have been accustomed to when awake; such are somnambu- 
LAUGHTER,  ENNUI, AND SLEEP.
159
lists, who only differ from other sleepers  by the degree of their
sleep.
  This is what ought, in my opinion, to be said of sleep; but we
must not infer from what happens to persons subject to dreams, and
to somnambulists,  that the state of sleep supposes always a con-
siderable increase in the energy of the brain.   We must consider
every imperfect sleep as proofs that certain portions of the brain,—
certain intra-cephalic nervous apparatuses, preserve some degree of
irritation, while others lose theirs.  The sensitive expansions, and
their prolongations in the brain,  are always at rest in those kind of
sleepers; but there are  some, the portions of which correspond to
the locomotive muscles, that are inactive, while those which belong-
to certain intellectual operations,  and  to the muscles of speech, do
not sleep; such are the persons subject to speaking in their dreams.
As to somnambulists, who  act without speaking, and who never-
theless do tilings over which the intellect presides, they indicate,
that with  them  a part of the intellectual  nerves,  and the greater
number of those of the locomotive muscles, are awake; while the,
sensitive  apparatuses  are in a state of torpor.   Nevertheless, it is
certain that these dreamers, and these somnambulists, are not rest-
less during the  entire period of their sleep; they have always some
hours, either  before  or after  having  dreamed, in which sleep is
diffused through all the organs: this short rest is sufficient for them.
Ought we then to be astonished, that a number of other persons,
who never dream, can, as we have already seen, resume their work
after two  or three hours sleep, without there ever resulting from it
any inconvenience to their health?
   But if there are some who can be contented with so short a sleep,
many others can be found whose health  suffers from it; and it is
those with whom the shortness and restlessness of sleep are the ef-
fect of a pathological state of some organ.   Thus every affection of
the brain deranges more or less the continuance and  profoundness
of sleep:  such  is hydrocephalus, (chronic cerebral inflammation,
attended with effusion) which causes  too much sleep; and insanity,
(chronic cerebral inflammation, without effusion) which allows but
little sleep, or destroys it altogether.   Besides this, we find many
individuals in whom the interruption of sleep, as well as dreams, is
produced  by pain  of the digestive  organs; in others, it depends
upon an affection of the lungs, or on some obstacle to the circulation
of the blood, and to the regularity of respiration, occasioned by a" 
 ICO            LAUGHTER, ENNLT,  AM*  SLEEP.
 affection of the heart  The exuberant activity of the genital orgain
 disturbs the rest of many persons during the  vigor of age, and
 after certain excesses.  Sometimes it is uncertain whether the cause
 of these latter derangements comes from the sexual organs,  or from
 the portion, whatever it may be, of the encephalic apparatus which
 corresponds to them, or from some other viscus.  I was consulted
 by an individual who was almost impotent whilst awake,  but who
 experienced the most violent erection when he abandoned  himself
 to sleep; his penis  became  erected, with the rapidity of a spring
 which straightens itself, as soon as he fell asleep—(such were the ex-
 pressions of the patient.)  This erection was unattended with de-
 sire, and was  even painful; it  persisted during the whole course
 of his sleep, which it rendered painful, and more fatiguing than re-
 storing; it happened without any effusion of semen, and ceased the
 moment he awoke,  with as  much rapidity as  it begun  when his
 drowsiness commenced.   This unfortunate man was yellow, thin,
 debilitated; digested badly, and presented some signs of gastric ir-
 ritation.  I prescribed to him the treatment proper for chronic gas-
 Iritis, but I have not learned the result of this plan.  I would con-
 clude from such a fact, that sleep is  a most active  function of the
 brain; but I am far from wishing to reason in this.way; since I select
 myT examples from cases, unquestionably the most numerous, of good
 health, which are those where sleep is  truly a rest; that is, a well
 defined and universal diminution of the phenomena that character-
 ise the state of life.
   Yet,  although sleep be a rest, we  have  remarked that it is an-
 uounced by certain  active phenomena, such as the afflux of blood
 towards the anterior part of the brain,—the injection of the eyes,—
 the contraction of the orbicular muscle of the  eyelids, whilst the
 levator of the  upper lid  is slow and difficult,—yawning and the
 kind of uneasiness, and anger, which are evidenced when this want
 is opposed.
   These phenomena have struck physiologists, who have  particu-
 larly remarked this occlusion of the eyelids, which is not a relaxa-
 tion; since the action of  the levator is more powerful than that of
 the orbicular muscle, as is proved by  death, which  leaves the eyes
half open.  What must we infer from all these facts?—that the di-
 minution of activity  in the organs is a want, as  well as their excite-
 ment;  that the economy becomes irritated  against any excitement
 carried  too far, as it  is exasperated at the  unmeasured want of it; 
LAUGHTER,  ENNUI, AND SLEEP.
161
(we have seen the proof of this last fact in ennui, and will again
find it in hunger;) that, to procure the rest which it wants in sleep,
it excites the action  of certain organs  destined to keep  away the
perturbating stimuli  of this state;  that it has established as a sen-
tinel for its rest, the  orbicular muscles of the  eyelids, by giving
them an alternate  action with the  other  organs,  and by forcing
them to activity, while the others enjoy  a salutary inertia.  In
fact, of all external  stimuli, the most proper  to disturb sleep is
light.  Well, the organization of animals is such,  that the uneasi-
ness which constitutes the want of sleep becomes an exciting cause
for the orbicular of the eyelids, so that it is forced  to act, while the
rest remains quiet.  It will, perhaps, be said, that this is an hypothe-
sis ; for my part, I maintain that it is a fact.  Do we not see numerous
others that are exactly of the same nature?   I have noted down the
irritating effect arising from a want of moral excitement; the others
will be  presented in their respective places.
   But it will be objected—would it  not have  been  sufficient  for
nature to have constituted the palpebral muscles in such a manner,
that their relaxation might give rise to  the occlusion of the eyelids?
I answer, that if this had been the case, the operation of keeping
the eyes open would  have been too painful; they would have closed
from the least fatigue;—the expression  of the face would have been,
at every instant, such as it  is at the moment of sleep, and  given
that appearance called hebetude, and we would  have been deprived
of sight in numerous instances in which this sense is very useful to
us.   It is much more convenient for animals, that the open should
be the most natural state of the eye;  that  it should  cause no disa-
greeable feeling, and only become painful  when the whole system
is in need of immediate rest.  What a mistake would  it not have
been, had we found ourselves deprived of sight when we  are in
need of locomotion.
   This does not appear to  me to be an idle reasoning;  it tends to
demonstrate, that  the state of activity of a small muscle  during
sleep, does not lead to the conclusion of  the activity of the  entire
brain, in the same manner as the irritation of  the stomach during
hunger does  not  necessarily imply  a  similar  irritation  in  the
heart,—in the action of cellular tissue, of the serous,   and  many
other membranes.
   But what must be thought of the cerebral engorgement, which is
equally active at the commencement of sleep?  That it is the means 
162
LAUGHTER,  ENNUI, AM» SLEEP.
employed by nature to diminish the innervation which consumes
life, in muscular and sensitive movements.   We have no idea of
the intimate structure of the organs, and much less of that of the
brain.   Is  it then impossible, that this accumulation of blood may
take place in vessels different from those whence  emanates that
influence which determines the phenomena of sensibility, of mo-
tility, and  of secretion; so that the engorgement which  would take
place in them, instead of  exciting these phenomena,  would become
the means of preventing them, by the effect of a kind of antagonism,4
which would then be no more than a displacement of fluids;—in a
word,  a true revulsion?  Whatever may be the immediate seat of
the soporific accumulation of blood in the brain, it still remains de-
monstrated, that during sleep the phenomena of sensibility and of
motility are diminished,  as we have shown, in all the tissues of the
living body, with the exception of the orbicular muscles of the eye-
lids, which must preserve their.action in order to prevent the admis-
sion  of light,—the penetrating activity of which would always be
opposed to sleep, and would  raise the cerebral irritation to the de-
gree constituting inflammation.   This is verified by the cruel pun-
ishment inflicted by a removal of the eyelids, the invention of which
makes nature shudder, and is a disgrace to the human species.
   Numerous facts, furnished by pathology, can be advanced in sup-
port of this proposition.   All cerebral irritations increase innerva-
tion, so long as they have not produced strong congestions. When,
however, they have produced these, the soporific state supervenes,
and innervation diminishes.   Narcotics act in  the  same manner;
and I cannot but applaud the fundamental propositions  of an es-viy
by M. Fallot, inserted in the second volume of the Annates de la
Midecine Physiologique,—propositions that are deduced from those
I laid  down in L'Examen  des  Doctrines Medicales.  It is thus
that  men of genius will enrich the truths  of the physiological
doctrine.
   I have said in the Examen, that it appeared probable to me, that
the displacement  and revulsion of the  fluids, which produce a so-
porific engorgement in the brain, are determined by the influence
of the great sympathetic. I shall examine this proposition when I
treat of this nerve, and we will see if facts and inductions will lead
us to doubt or confirm  it, in a positive manner.  In the  mean time,
the preceding arc the  principal among the important facts relative
to sleep.   I might pursue the  examination  yet  farther, under the 
    COROLLARIES ON THE INTELLECTUAL OPERATIONS, &C.  163

head of ages, sexes, and temperaments; but what would be the use
of such minute details on this subject?   Who does  not know that
sleep is longer and more tranquil in infancy than at any other pe-
riod of life;—that it diminishes, and  sometimes  becomes null, in
old age;—that women  can support better the  waking state than
men, although  their strength is less considerable;—that plethoric
constitutions, in which fluids abound, enjoy a more tranquil and pro-
longed sleep than individuals of a dry and nervous temperament;—
lu short,  that an undue exercise of the intellectual faculties prevents
sleep, renders it more restless, less renovating,  and sometimes de-
stroys it  for ever?   Besides, I shall have occasion  to  touch upon
these different  questions,  when I treat of the pathology of sleep.
I therefore pass to some general considerations,  which  are only co-
rollaries  deduced from what I have already said on instinct, on the
intellectual faculties, and on the passions.
                       CHAPTER IX.

  OOROLLARIES ON THE INTELLECTUAL OPERATIONS AND ON THE
                          PASSIONS.

  Before recapitulating what I have said on the subject of the in-
tellectual functions, of the affections, of the passions, and of their
etlects upon the  system, I ought to make here the formal declara-
tion, that 1 do not pretend to offer  in  this work a treatise on ide-
ology.  I point out the source of our intellectual faculties; but do
not follow them  in their developments in relation to the ideas on
which they are exercised.   I notice the elements of our passions;
but abstain from describing all their shades in an intellectual point
of view.   I ->nly examine their  effects on the system,  with a
view of discovering in them the causes of,  and  remedies for, our
diseases.
  The intellectual domain is immense; and I do not wish to en-
gage in it.   I would wish to  point out the line of demarcation be-
tween it and the  physical; but I am far from  flattering myself of
ever being able to attiin this  object.   The following is my view of
the subject. 
164
COROLLARIES ON THE
  I wish metaphysicians, since they  so  style themselves, would
never treat of physiology; that they would only occupy themselves
with ideas as ideas, and not as modifications of our organs; that they
would never speak, either of the brain, the nerves, temperaments,
nor of the  influence of climates, of localities,  or  of regimen; that
they would never inquire whether there are innate ideas, or wliether
they come through the medium of the senses; that they would not
undertake to follow their developments according to age or the state
of health; for I am convinced  that they cannot reason justly on all
these points. Such questions belong to physiologists, who can unite
a knowledge of the  moral nature with that of the structure of the
human body.
  It is only in relation to sacred and profane interests that me-
taphysicians can examine ideas.  This field  is very extensive; it
comprehends the art of reasoning,  considered  in  itself;  next reli-
gions, laws,  and customs; manners deprived of every physiological
consideration;  politics, and the arts; the description and  classifies
tion of bodies; the description of nature; that of thought in writing,
in calculation considered in an abstract manner, or applied to the
laws of inert bodies, as in natural  philosophy properly speaking,
and in chemistry; the picture of thought  in style; that of our feel-
ings, in the arts, in music, and in the exercises of the body, such as
dancing and all  the  gymnastics,  &c.   The  domain  that  I assign
them ought to be sufficient for their meditations; for all our actions
which are the consequences of our thoughts, have very extensive
influences over our destiny. Let metaphysicians calculate, let them
examine thoroughly  these influences, and let them deduce from
them rules of conduct, always founded on particular or general in-
terest.  They can accomplish this without leaving the  subject of
metaphysics; but let  them never seek their source in the action
of the organs,  nor their effects on  the harmony of the  functions;
otherwise, their labour will be of no avail.
  It is possible, that particular circumstances may oblige  them to
introduce physiological  considerations in their calculations;  such
are the cases in which it is necessary to estimate  the influence of
certain laws or customs, in relation to temperature, to the nature of
the soil, to the prevailing diseases, &c.; but  then they should avail
themselves  of the experience of physiologists and  physicians.
   It will, perhaps, be answered, that if metaphysicians confine their
meditations to  these subjects, they will only be moralists.   I main- 
INTELLECTUAL OPERATIONS, &C
165
tain the contrary.  They  may, after  having distinguished simple
ideas,  which are representations of the bodies in  nature, from
abstract ideas, which are only conclusions,—that is judgments,
discuss with ease upon the faculty we possess of recalling  those
ideas,__which constitutes memory; of foreseeing future impres-
sions,—which is prescience, and gives rise to prescient judgments;
of feeling those  impressions  more  or less  acutely, and represent
them with more or less force and truth,—which constitutes ima-
gination; they can, I say, examine whether  abstract ideas of move-
ment and of rest, of attraction and repulsion, of formation and de-
struction, of growth and diminution, of extent, height, and depres-
sion;—of greatness and smallness, of beauty  and ugliness, of justice
and  injustice, of divine, spiritual, and temporal right;  of power,
sacredness, profaneness, hatred, friendship,  fear, audacity, benevo-
lence, harshness, sensibility, cruelty, pride, vanity, jealousy, envy,
&c., represent qualities inherent in  objects,  or modifications of our
consciousness, (moi,)  relative to general or particular, real or ima-
ginary relations; or else to true or false, eternal or purely accidental
interests.  They may also point out how one judgment produces
another;—establish the advantage  or disadvantage  we  have  in
considering  all  these questions rather  under  such a point of
view than  under any other;  in a word,  they may exercise them-
selves in discovering the truth under the  deceitful masks, with
which the science of ontology (that despotic  ruler of social life) has
covered it   Such is the task I have imposed upon myself relative to
medicine; and it is with a view of continuing its execution, that I
am going to present the short sketch of the passions, considered in
their relations with the state of the organization of man.
   I. Organs  being given to  man placed in  the midst of the  uni-
verse, there are two general sources of perceptions; (a) the wants;
(b) the external bodies destined to  gratify them.
   II. The wants have their source in the viscera; certain impres-
sions originate from  them, reach the cerebral centre, and keep it
in a waking state.  If man recognises the external body required
by his viscera, there is a determined  desire; if  he do  not recog-
nise it,  this desire is vague  and confused.  These  phenomena
are purely instinctive.
  III.  The wants are either physical or moral.
  IV  The physical  wants are those (a) of calorification, (b) of 
166
COROLLARIES  ON THE
respiration, (c) of nutrition,  (d) of the evacuation of the residue of
nutrition, (e) of exercise, (/) of rest and sleep, (g) of self  preser-
vation, (h) of generation, (i)  of the expulsion of its product, (k) of
the preservation of this same product  These phenomena are still
instinctive.
  V. Moral  wants, though apparently very numerous, seem to me
to originate from a single source,—the necessity in  which  we are
of observing  all the bodies in nature, and of comparing them with
ourselves:  I define it fhewant of being excited to thought.  This
phenomenon is purely intellectual.
  VI. The external bodies that produce an impression upon  us,
relate either to our physical or moral wants.
  VII.  External bodies in relation  with our physical wants, are,
(a) external heat for calorification, (b) oxygenated air for respiration,
(c)  food and water, either pure or charged with  some principles, for
nutrition, (d) a proper place  for defecation, (e) a convenient space
for  exercise;  but numerous  external bodies develope and  fortify
within us the impulse which directs us to gratify  this want; (f)i
proper place for rest and sleep, (g) animated or inanimate bodies to
repel the danger which threatens us, and cause a cessation of  our
pains, or room to enable us to escape, (h) an individual  of our own
species, but of a different sex, for the want of generation, (t) a pro-
per place for the expulsion of the product of this latter, and an indi-
vidual who can assist the woman in labour, (k) all animated or inani-
mate bodies  which can concur to the preservation of our children.
These phenomena have their source in instinct.
  VIII.  The external bodies in relation with our  moral  wants, are
as numerous  as objects in nature;  for we do not content ourselves
with observing those  which serve for our physical wants: our rest-
less curiosity pervades the whole universe, and feasts itself on every
impression that comes from it, either directly or indirectly.  This
is the principal characteristic of man, and it is purely intellectual.
  IX. Instinctive impulses reach incessantly the  centre of percep-
tion by means of  the nerves,  which,  from all parts of the body,
converge towards the brain;  and this transmission takes  place even
during the absence of external bodies proper to gratify  the wants.
  X. As soon as the  external bodies, adapted to the gratification of
a want, act upon the external surfaces of relation,  they produce on
them an impression which is transmitted to the brain. 
INTELLECTUAL OPERATIONS, &C.
167
  XI.  Impressions made by  external bodies, agitate instantly the
entire extent of the nervous system, and in this way reverberate
into the viscera.
  XII.  If some viscus be interested in the impression, it evidences
it to the centre of perception by a sensation which the latter refers
to the  said viscus, and the individual  is instinctively solicited to
seize the body which has made the impression, if it be favourable to
system; to repel it, or to fly from it, if it be injurious.
  XIII. The intellect observes these relations; but they have been
pre-existent to its development; it cannot put a stop to the acts which
are  commanded by certain wants, and only suspends them; but
there are numerous others which it can prevent, even at the expense
of the life of the individual.
  XIV. If the impressions made by external bodies  do  not affect
any viscus in an immediate manner, they remain in the purely intel-
lectual domain, as  serving to gratify the want of thought.  It is
thus that one  may occupy himself with the arts and with abstract
subjects, without  feeling any internal sensation.   But,  although
these  impressions  do not cause any sensations in the viscera, nor
instinctive impulses,  they  nevertheless agitate the  whole nervous
system, and consequently reach the viscera.   The proof of this is,
that such an impression, which causes no sensations in certain states
of the viscera, occasions some in others.
  XV.  The impressions of external bodies, which at  first only in-
terest the want of thought, soon interest, slight as they may be.
the viscera, by renewing, by means of memory or prescience, ideas
relative to first wants.
  XVI.  When the impressions of external agents are very strong,
if they are not transmitted to the viscera by means of  other wants.
they reach them by those of self preservation, or by ideas of com-
parison which always awaken self-love.
  XVII.  It results from the  preceding propositions,  that intellect
is always  stimulated by the viscera, and the viscera  by the intel-
lect; and that they never act separately.
  Will. The two sources of affections and passions, are pleasure
and pain;  pleasure produces love, and pain, hatred.
  XIX. I call passion a persisting state of love or hatred, whicli
masters our  intellect, and  constantly determines a series of acts
which tend either to prolong the pleasure, or to cause  a cessation of
the  pain that  produces them.  Every time that love or hatred :s 
168
COROLLARIES ON THE
feeble or of short duration, I name them inclinations, tastes, dis-
gusts, aversions, affect ire movements, or simply affections.
   XX.  Love and hatred  have for their objects, either the impres-
sion itself, or the cause of the impression.
   XXI.  When love and  hatred are directed towards the  impres-
sions, the affections and passions which we feel have ourselves for
their only object; because  it is always in proportion to the love
of ourselves, that we love or hate the impressions: such is avarice,—
a passion founded on a false judgement,  concerning the means of
making us happy; but which still has for its basis the love of our-
selves.
   XXII. When love and hatred have apparently for their  object
the causes of the impressions, this object is not the only one; for it
is through a love of ourselves, that we love or hate other objects.
There is then, here, love of ourselves, in the love or hatred of the
causes of our impressions.
   XXIII. When, in a passion, we sacrifice ourselves either in favour
of certain causes of our impressions, such as our equals, or to pro-
cure for us the pleasures of a future intellectual life, or to free us
from an actual pain brought on by a moral cause, such as ignominy,
we are forced to this by the love of ourselves;  but then, instead of
making our happiness consist in the gratification of the wants of
instinct, we place it in certain enjoyments relative  to the want of
thought. It is usually the love of ourselves, in the comparison with
our like, which leads us to this sacrifice. Hence, this love is an en-
joyment purely intellectual, and which can only exist  in our own
species;  because, when an animal  sacrifices itself to the preserva-
tion of its young, it does not foresee its own  destruction.  Kut,
when we die, in order to free ourselves from physical pain, it is an
aberration of the love of ourselves, and instinct triumphs over our
intellect.
   XXIV. To determine  the true sense of the expressions  used to
convey an idea of our affections and passions, we must consider the
sentiments of love or hatred which constitute them; first, as it re-
spects the nature of the want gratified or opposed; secondly, as re-
lates to time.
   XXV. If we consider the affections and passions in relation to
the nature of the want, we find (a) for instinctive wants, first the
love of ourselves in that of the feeling of this want, when it is agree-
ble,—as for example the desire of coitus; secondly, the  love of our- 
               INTELLECTUAL OPERATIONS, &C             169

selves iii a hatred of the sensation of the want when it is painful; for
example, hunger; thirdly,the love of ourselves in that of the external
body proper to gratify the  want; but, when this  body  is one of
our own species,  the affection or the  passion seems only to have
this  body for its object; fourthly, love of  ourselves in the hatred
of the external cause which opposes the gratification of our wants;
but,  when this cause is a being like ourselves, the affection or pas-
sion  appears only to have this cause for its object  (b) For the want
of moral excitations or of thought;  first,  the love  of ourselves in
that  of the sensations which exercise  agreeably  our intellect,  be-
cause we are satisfied  with ourselves: this is gratified self-love;
it is  the source  of ambition,  of the love  of power, of  command,
and  of instruction, of the pleasure we feel in destroying,  as well
as that  we find in benevolence: secondly, the love of ourselves
in that  of the  causes  of the impressions  that  gratify  our  self-
love; and, if these causes  be individuals of our own  species, the
affection or  passion  appears to  have  them for its object; hence
arise friendships, founded upon  what  is called a conformity of
disposition;  a fondness for the instruction we receive, that is a love
of our instructors; hence arises  the love for flatterers, as well as
affection for those to whom we render some service:  thirdly, the
love of ourselves in the hatred of the external causes of sensations,
and  of the series of ideas that fatigue our  intellect;  and when these
causes are individuals of our species,  the affection  or passion ap-
pears to  have no other object than them;  hence arises the hatred
for  rivals who  have some  advantage  over us in science, the arts,
riches, power,  great actions, &c: this is called jealousy, and  envy.
This hatred is  almost  always concealed, because  our  self-love is
humbled by the confession of a feeling  of jealousy or  envy; we
then do all in our power to persuade others, that our hatred has
for its object the ideas, labours, and actions of our rivals, only be-
cause they are bad.
   XXVI. When we consider affections and passions in relation to
time, we must  refer them to the present, to the passed, and to the
future: (a) if we consider them in relation  to the present, they are
^uch as we have just seen them in number  XXV.   (b) Considered
in relation to the passed, they enable us  to observe, by the aid of
memory, first, as respects love,  the remembrance  of agreeable
sensations, whatever may have been their  cause,—a remembrance
which is an  actual pleasure, and which produces the love of passed
                              22 
170
COROLLARIES  ON I IIK.
impressions, and that of their cause; secondly,  for hatred,  the re-
collection of  disagreeable sensations,—a recollection which is an
actual pain, and which produces a hatred of passed impressions, as
well as of their causes; thirdly, for the comparison of passed plea-
sure with present pain,  and passed pain with actual pleasure, we
find alternate sensations of pleasure and pain, producing alternately
a love and hatred of passed and present impressions, and the love
and hatred of their causes; hence arise  regrets which torment us,
as well as  rancour, inveterate hatred, §c. very complicated pas-
sions, in which the  love of  ourselves is concealed in a  thousand
ways more or less specious,  but which cannot impose on the true
observer,  (c)  Considered in relation to the future, our  affections
and our passions  offer us  by means of prescience, first,  for  love,
the prospect of agreeable sensations, whatever may be their cause,
a prospect which is an  actual  pleasure, and  which  produces the
love of  the  impressions,  and  the  love of  their  causes;  hence
arises hope: secondly, for hatred,  the prospect of disagreeable sen-
sations, which  is an  actual pain, and  produces a hatred  of  future
impressions, and  a hatred of their causes; hence arise fear and de-
spair: thirdly, for the comparison of passed or present pleasure
with future pain,  and of  future pleasure with present pain,  alter-
nate sensations of pleasure and pain, which produce alternately the
love and hatred of passed, present, and future impressions, as well
as  the love and hatred of their causes;  hence arise  passions ex-
tremely  complicated, in which we again find  regret,  rancour,
fear, hope, discouragement,  despair, and all the moral  conse-
quences they give rise to.  Avarice is naturally referred to this se-
ries; since this passion is composed of the fear of the future, founded
on the observation of the present and the recollection of the passed.
   XXVII. Joy is always the effect of pleasure, and consequently
of love;  sadness is invariably the effect of pain, and consequently
of hatred.  These constitute, therefore, two passions  which, in
some manner, are general.
   XXVIII.  Anger and flight are two instinctive movements of
reaction;  having for their objects,—the first,  to repel the cause of
pain; the second, to avoid it: both are founded on hatred;  but an-
ger being a sudden exaltation of hatred, forms a part of the move-
ment which constitutes this passion;  whereas the determination
which produces flight, can only be considered as one of its effects,
and not as the passion itself. 
INTELLECTUAL OPERATIONS, &C.
171
  XXIX. Anger can be  developed in all kinds of hatred; but its
object varies; for it may be  directed either against  the  sensation
itself, or against its cause.  When directed against the sensation, it
is more or less reflected upon the men or things that surround the
individual. Hence arise that fretful temper, and the abruptness, of
persons who suffer. When anger is directed against some determined
object, it is less reflected upon others.
  XX X. Anger belonging to all kinds of hatred, whether produced
by passed, present, or future causes, gives them always an impetus,
more or less well marked, and thus causes a change in the name of
these passions; from this arises, jealousy, in the love of  the sexes;
emulation, confusion, envy, in offended self-love; pride, indig-
nation, in the same passion; transports, in despair;  impatience,
in the expectation of pleasure; for this latter is a pain, which pro-
duces movements of hatred; impatience  also,  in all kinds of pain,
either from physical or moral causes; fanaticism, in the hatred of
persons who irritate our self-love, by opposing obstacles  to enjoy-
ments of an intellectual origin, and relating either to forms of wor-
ship, power, or to any sect whatsoever; to the arts, &c.
  X XXI. All the passions are susceptible of being communicated;
this  is the effect of imagination; that is,  of  the faculty with which
man is endowed of representing to himself,  more or less keenly,
the impressions he has  received from others, and of substituting
himself in  the place of  him who actually is or has been enjoying
or suffering, or  who must hereafter enjoy or suffer: hence arise
mutual enjoyment and compassion; which offer a new  proof that
we refer every thing to ourselves, and that self-love is the sole ori-
gin of our affective movements and of our passions.
  I will develope more fully the following propositions, on account
of the discussions to which they give rise at the present day.
  XXXII.  The affections and passions are always composed of two
elements; the exercise of thought, which  furnishes the  primum
mobile, and the visceral sensations, which afford the means. With-
out lively sensations  referred to the  viscera,—without impetuous
movements in  their tissues, thought  would not  produce  those ex-
traordinary acts  that characterise  the passions; because the will
would not be led away; there would only be feeble suggestions, and
no action. It is thus, that  passions escape with the  blood, and that
the  most perfect intellects can produce  nothing which  resembles 
112
COROLLARIES  ON 1 HE
 passion in men endowed with anemic constitutions.  In such sub-
 jects there can only exist affections.
   XXXIII.  Prevent thought, the passion it  excites is destroyed;
 exalt the action of the viscera, the passion increases; weaken vital
 action in the viscera, the passion diminishes; impair the state of the
 viscera, the passion is perverted or destroyed.
   XXXIV.  The passion having lost its sensitive aliment by a be-
 ginning of alteration of the viscera, the series of ideas which excited
 it can be kept up by external causes; but it no longer produces any
 other than weak  affective movements; there  remains  hardly any
 thing but intellectual operations.
   XXXV.  The passions which are founded on  instinctive wants
 are the most easily destroyed by the  modification of the viscera;
 such is  sexual love, which  disappears with the progress of age,
 although thought has lost but little of its energy. Those  that depend
 upon a want of thought, resist more powerfully this modification.
 Itisthus that friendship survives certain deteriorations of the organs;
 but friendship is  then nothing more than an affection.
   XXXVI. Were there nothing proved, but the destruction of the
 passions, affections, and  even of the purely intellectual faculties, by
 a profound deterioration  of the viscera,—the brain remaining sound,
 it would be sufficient to  attest, that this organ  can do nothing with-
 out the aid of the others.  How could it act,  since  its  instrument
 would be destroyed?  Now, the instruments  put in action by the
 brain, are not merely the muscles; but it also excites the visceral
 movements,  in  order to  react upon  itself,  and  determine  it to
 overcome the obstacles which ideas, foreign to those of the passion,
 oppose incessantly to the will. But, on the other hand, if the irri-
 tations excited by the brain in the viscera act  upon it, why should
 not those, originating from any other cause, produce the same effect?
 Surely, they do,  and it  is of little consequence by  what means
 the viscera are irritated; it is sufficient that  they be so, in order
 that the  brain should  become also affected,—that certain series
 of ideas should be necessarily excited, and that the will should be
 more or  less  led  away, according to the intensity of the visceral
 irritation. It is thus that nascent  love only determines hesitating
 steps; whilst,  when more decided, this  feeling,  having  become a
passion,  triumphs over all opposition;  that the lover satiated with
 enjoyment, becomes indifferent for the  beloved object, and re- 
INTELLECTUAL OPERATIONS, &C
173
covers all his ardor when the spermatic plethora is re-established.
Let those, who deny a necessary concourse of visceral  influences
in the passions, examine a man whose stomach  is excited by the
wants of alcoholic drinks; they will see him fly into a passion on
the least contradiction, which would scarcely have moved him had
his thirst been quenched by water only.  If they pretend, that alco-
hol acts here only upon the brain, they will advance an absurdity;
for, in certain gastrites, a broth, and  a simple mouthful of  meat,
are sufficient to produce all the effects of intoxication.  If this fact
be not sufficient to convince them, let them examine the same man
suffering greatly from hunger, and they will find him as irascible
as when drunk, and  often more  intrepid and cruel. Have they not
then remarked, either in the  facts, or in history, the frightful ex-
altation of all the feelings of hatred and fury,—the abolition of those
of pity, compassion,  generosity, and of filial and paternal  love,
which constantly take place in assemblages of men exposed to the
horrors of famine?   Have the cerebral eminences enlarged under
these deplorable circumstances?  I have already said, that there were
always, in these cases, exceptions honourable to the human species:
they are referable to the intellectual  operations, which  overpower
instinct; but in producing this effect, the intellect still excites the
passionsi this is the subject of the succeeding proposition.
   XXXVII. The passions of a purely intellectual origin, can only
be raised  to a great degree of intensity, by the organic  sensations
and  movements which  the exercise of thought determines in  the
tissue of the viscera.   This law is founded on an indisputable fact,
already too fully  proved in this work, if there did not exist some
men whom self-love engages to feign an ignorance of the arguments
by which their sophistry has  been refuted.   This fact is, that love,
hatred,  and  anger,—feelings without which those passions  deno
minated intellectual  could not  exist, are necessarily accompanied
with sensations and movements in the viscera.  Consequently,  in
cases of opposition offered by the intellect to the voice of the physical
wants, thought excites in the viscera a sensation different from that
produced by the want:  it  is  either a pain or a  pleasure,  but
of a  very  different shade from the  pain  and pleasure produced
by the want; in the same way that the visceral pain of anger  is dif-
ferent from that of terror, and that the visceral pleasure of gratified
self-love differs from that produced by friendship, or maternal ten-
derness.   Why should  these differences exist,  if they were  not 
 174   HOW THE EXERCISE OF INTELLECT, THE AFFECTIVE
 necessary? And, if they are necessary, is it  for any other object
 than to react upon the intellect, and assist  it in determining itself
 to the acts which the actual series of thoughts may require?  Now,
 the fact  proves this to be their destination; since old and anemic
 men simply think, and do not act.  Hence those who maintain the
 independence of the brain  in  the passions, support a great error.
 It is, therefore, very certain,  that intellectual operations only take
 place without developing sensations in the viscera, when thought is
 exercised upon impressions that are connected with the first wants,
 or which only interest them in a distant manner.   See propositions
 XIV,  XXV, and XXVI.
   It may be seen by this analysis, that 1 have not the pretension of
judging ideas as such,—that is, in their relations with the objects they
 represent; I only consider them in their relations with the organs,
 and  it is right I should do so; since  the  movements of  pleasure
 and of pain, of love and hatred, cannot exist without affecting the
 tissues, and  consequently without exposing the functions to some
 derangement.   It is for this reason, that I have taken the liberty
 of classing ideas in the order of such of these movements as they
 can excite, and I abandon all interests, either spiritual or temporal,
 sacred or profane, as constituting no  part of the science of  medi-
 cine
                        CHAPTER  IX.

M  THE  MANNER  IN WHICH THE EXERCISE  OF THE INTELLECT,
  THE  AFFECTIVE  MOVEMENTS,  AND  THE  PASSIONS,  BECOME
  CAUSES OF  DISEASE.

  It is constantly repeated in medical writings, that  intellectual
labours and  the passions produce derangements in the organs; and
still it is attempted to limit all the intellectual and affective phe-
nomena to the brain.   It is agreed, that the encephalon acts on all
the viscera,  and physicians refuse to these last a power of reaction
upon the encephalon capable of modifying thoughts and affections.
They affect  to suppose, that I place the passions exclusively in the
viscera,  in  order  to  procure themselves the  pleasure of an easy
refutation, and they do not perceive the vagueness and absurdity
of such a reproach.   Where, indeed, is the physiologist who can, 
          MOVEMENTS, &C. BECOME CAUSES OP DISEASE.       17')
 at the present day, advance simply that the passions are indepen-
 dent of the  brain?  Is there  not  as much absurdity  in supposing
 that a man who has some faint knowledge of anatomy, can be likely
 to advance such a proposition, as there would be to say that a reason-
 able  person is persuaded, that one can think after having been be-
 headed?  This method of lending absurdities to those who enter-
 tain an opposite opinion from that which one professes, in order to
 divert himself with refuting  them, is the characteristic of super-
 ficial, or at least of inattentive minds, and cannot mislead  sensible
 persons.  There is nothing wanting to these dull wits, but to an-
 nounce to the public, in seeing the part I have attributed to the en-
 cephalum, that their objections have made me alter my opinions on
 the subject.    Well, to spare them this new inconsistency,  I refer
 them to my thesis on hectic fever, published in 1803.  Surely, I
 am very far from adopting, at present, all the medical principles it
 contains,  but  I admit those propositions which relate  to the intel-
 lectual and affective faculties.   They will there see in substance,
 what I have just developed in the  preceding  chapter,—that  the
 passions are composed of two elements,  the exercise of thought,
 which belongs to the brain, and the internal sensations, accompanied
 with  organic movements,  which the individual perceives more  or
 less distinctly in his viscera.   I never thought  of professing any
 thing else; and this may be proved by all those who have attended
 my lectures on pathological physiology.   But I  have already suf-
 ficiently spoken of  myself; and will now resume our subject.
  In  examining the action of each of the senses  in particular, I
 have  pointed out in what manner  impressions produced by exter-
 nal agents could derange  them; that is  to say, we have  seen  in
 what manner impressions became causes of disease, at the  instant
 of their passage over the points of the tissue, through which they
 penetrate  to  the  interior.   It  becomes us now to follow them in
 this interior, in order to discover, there, the causes of those diseases
 to which they give rise.
  As soon as they have reached the tissue of the brain, impressions
are  immediately reflected  through the whole nervous apparatus,
and we cannot, at first, foresee in what part of this vast system they
will develope  a perturbating irritation.  Idiosyncrasy, the relative
predominance of action of certain viscera, an  accidental focus of
sensibility or phlogosis, often determine the seat of this irritation.
In other cases we  have no data for the  solution of this question. 
176    HOW THE EXERCISE OP INTELLECT, THE AFFECTIVE

We  oniy  know  that the  organs  entrusted  with  the principal
functions are affected in preference, and that they reflect the  irri-
tation upon the other tissues.  To treat this subject with some de-
gree of method, it becomes  necessary to establish  the following di-
visions:  1. Lesions arising from the  exercise of the intellectual
functions without passions; 2. Those arising from the  exercise of
the intellectual functions with affection or  passion.   It is also ne-
cessary to examine these last, (a) in reference to the vivacity of the
passion, (b) according to its nature; in determining which of the le-
sions, among those we have just alluded to, belong to each of the pas-
sions in particular.

Section I.—Of the Manner in which the Exercise of the Intel-
              lectual Faculties disorders  Health.
  In the lowest grade of the intellectual operations, that in which
thought produces theleast disorder in the economy, either on account
of the nature of those ideas which do not relate to the first wants, or
at least to wants  actually urgent, or by the effect  of the individual
constitution, there never arise sudden  perturbations;  the trouble!
are slight,  and the organic alterations are only slowly formed; the
brain is then the first affected, and the other tissues only suffer after
a period of time of greater or less duration.  It is thus, that purely in-
tellectual labours, without any mixture of passions, such as the ab-
stract  sciences, which  are very numerous,—the description  and
classification of the  bodies  in nature, or the products of art,—the
descriptive sciences,—mechanics,—a forced exercise of memory,—
t!he labours of the copyist, of the analyst, or the historian; philology,
bibliography,—in a word, every thing which only  exercises thought
by requiring a lively and constant attention, keep up in the ence-
phalon a state of vital erection which sensibly transforms it into a
permanent focus of irritation. Under these  circumstances, the head
becomes heavy and painful; there is an inclination to sleep, or else
an obstinate state of wakefulness is established; an inflammation of
the brain,  either acute or chronic, as well  as haemorrhages of this
organ, are  on the point of  being developed.   They appear very
often under the forms of insanity, of paralysis, of idiotism, and even
of apoplexy.
  The  nervous expansions of the domain of relation, undergo a
simultaneous exaltation  of action;—the individual  becomes  irri-
table, and convulsions are easily  excited; the sight becomes altered 
        MOVEMENTS, &.C BECOME CAUSES OF DISEASE.      17/

by the effect of inflammation or by a collapse which terminates in
amaurosis, commonly called gutta serena.   In time, the same ir-
ritability is established in the  ganglionic  nerves; and the move-
ments of the viscera,  as well as those of the vascular apparatus in
general,  become  disordered, under  the influence of  the  slightest
causes, with as much facility as the movements of the locomotive
muscles.  It is thus, that a number of constitutions which were not
nervous originally, become so; and that those which were so before,
acquire a degree of mobility, which fatigues the patients, and be-
comes the torment of the physician.
  Having acquired this  degree of irritability, individuals  easily
contract  inflammations through  the  influence of food, drinks, of
atmospherical vicissitudes, &.c.   These inflammations are rarely
very  intense; but in return they are difficult to cure; because they
arc renewed  very easily,  and health  finally  becomes completely
ruined.
  Another modification of the system, is sometimes associated with
the cerebral irritation produced by the excessive exercise of thought
It is a state of debility in the muscular apparatus, a sluggishness of di-
gestion, accompanied with costiveness and  with a remarkable lan-
guor  in the cutaneous transpiration.  Hence result a  multitude of
evils; for food, by remaining too long in the upper  region of the
digestive canal, finally developes, there, an  irritation.   This irrita-
tion is  always  circumscribed;  and as it is but slight at the com
mencement, it is easily removed by purgatives and  tonics;  but it
never fails to reappear, if the same causes continue  to act.  A period
arrives, however, when those means that  usually removed, now
aggravate it, and the stomach, finally,  is  no longer  in harmony
with  the stimuli necessary to support life; hence result gastro-en-
terites, with  hypochondriasis, melancholy,  &c.
  Some  robust  and plethoric constitutions become  neither ner-
vous  nor  weak, by the influence of study; they only experience
such effects as arise from a want of exercise, joined to a too consi-
derable hematosis; hence plethora and obesity become the torment
of these persons, when they have attained the term of their growth,
;>nd especially when  they have arrived at the  age of manhood.
At this period the hacmorrhoidal irritation and the sanguineous en-
gorgement of the viscera  are established; whence result, for the
digestive canal, gastro-enterites, which do not progress beyond the
pniall intestines;—for the liver, a painful tumefaction, with excess
                              2:i 
178    HOW THE EXERCISE OF INTELLECT, THE AFFECTIVE
of bilious secretion;—for the lungs, a state of fulness and dyspnoea;—-
for the heart, hypertrophy and aneurism;—for the brain, a soporous
and apoplectic disposition.
  In all those who study too much, the skin easily becomes affect-
ed with herpetic eruptions;  either from the languor  of perspiration,
which leaves this membrane covered with an irritating deposit, from
congestions, or from  the violent afflux of blood which  takes place
from time  to time in  its tissue, when  the  external temperature is
raised suddenly to a high degree, by the influence of the sun, or by
that of an artificial source of heat.
  Irritability, united  with plethora, produces also other disorders,
such as gout, erysipelas, &c.; but as other causes, besides intellectual
labours, can give rise to them, their etiology will be better placed
in the physiological history of the digestive and circulating organs,
on which they depend in a more immediate manner. It  is sufficient
to have mentioned them here.
  Intellectual  labours  give rise,  in  early  life,  to effects  cor-
responding with the  actual state of  the  individual constitution,
Thus the brain, the growth of which  is not complete, acquires, by
the exercise of thought, an extraordinary energy and volume; the
moral faculties become truly prodigious; but this advantage is sadly
compensated by the cerebral inflammations,  which give rise to hy-
drocephalus, and by a languor in the rest of the body, the develop-
ment of which remains imperfect.   The muscles are  slender and
weak,—the chest narrow, the abdomen large,—the mucous mem-
brane  of the stomach  perpetually irritated,—the skin  without en-
ergy, and always pale; since study necessitates seclusion in places
sheltered from  too vivid a light.  The inconveniences arising from
a want of exercise, are therefore united to those which  result from
a super-excitement of the brain and its dependencies.   It is easy to
conceive what a number of evils must result from  a kind of life so
little in harmony with the wants of youth; hence we rarely see all
those prodigies of premature intellectual education  prospering.—If
encephalitis does not carry them off, they  infallibly perish  with
gastritis or scrofula:  most generally,  all these evils oppress them
at once; and, if they do not sink under them in infancy, they carry
along with them, in mature age, an irritability which does not allow
of their resisting the morbific influences in the midst of which man
is necessarily forced to live.  They are seen to  decay and  die in
the prime of life, if they are not destroyed, in spite  of all the efforts 
          MOVEMENTS, &C. BECOME CAUSES OF DISEASE.      179

of the art, by the first violent inflammation that attacks them.   If
the  simple exercise of thought  can  occasion  so many evils, what
will it not be when the passions are associated with it!  This im-
portant question deserves to be  treated in the greatest detail.

Section II.—Of the Morbid Effects of Lively Emotions and
  of the Passions,  united to  the Exercise  of the  Intellectual
  Faculties.

  The least power/ul effect of the passions is to produce that ner-
vous irritability which we have seen to result from the excessive
exercise of the intellectual faculties: but how many other evils may
not be the consequence of it!  To treat  them with order, we must,
as we have already proposed, examine the effects of  the  passions
according to their degree and nature.
  In the most intense degree of the affections and passions, we find
primarily an irritation of the encephalon, incomparably  stronger
than that which accompanies  the exercise of the intellectual facul-
ties.  The passions will therefore be able to occasion,  at the instant
we  feel them, violent cerebral congestions, capable of occasioning
death, and this accident can take place without there occurring any
rupture of the vessels, or any sanguineous exhalation.  It is thus
that violent  transports of anger, surprise,  terror, and joy, have
caused sudden deaths, after which no apparent changes were found
on dissection.   I say apparent, for I am persuaded there must have
been some in the brain, and that, if they have not been  perceived, it
is because sufficient attention has not been paid to the state of the
cerebral pulp, which in these cases is commonly much harder and
more  injected with blood than usual.   Now, I consider such a state
to be a true  organic lesion, produced by an extraordinary afflux  of
blood  in the animal matter of the encephalum, and that this fluid,
penetrating too deeply in this texture,  the delicacy of which is ex-
treme, has produced in it a true disorganization.   Do we not see,
in fact, an alteration very similar to this after phrenitic deliriums?
Formerly, it did not fix the attention of practitioners;  but now,
when  pathological anatomy is more advanced, we are  aware of the
degree of importance that should be attached to it; and  if it has been
found  in a person carried  off by a transport of joy, of love, of enjoy-
ment, or  by fright, we  would not fail to refer to it  the  cause  of
death, instead of attributing this latter, as formerly done, to an unap- 
180   HOW THE EXERCISE OF INTELLECT, THE AFFECTUM-'
preciable modification of the whole  extent of the nervous system
Another circumstance that leads me to adopt my explanation, is,
that  every time our feelings are extremely  lively,  we perceive
distinctly the cerebral  congestion, which  sefcms to distend exces-
sively the cavity of the cranium, to raise its vault, and which often
goes so  far as to obscure our ideas.   Now, from this state to a com-
plete abolition of the cerebral functions, there  is but one step,
and it is easy to conceive that it may with facility be got over.
   Sudden deaths, produced by violent passions, may  likewise de-
pend on the spasmodic state of the heart, which remains contracted,
and ceases to keep up the action of the brain.   In such cases, the
sick  perish discoloured, and in a state of syncope.  An extraordi-
nary irritability of the central muscle of  the  circulation can alone
explain  this kind of death; and I do not doubt but it has often oc-
curred.   This accident might be distinguished from the preceding,
by the  suffocating anguish,—by the  precordial  oppression,—by
the paleness of the face, and the weakness of the pulse, opposed  to
a lively coloration of  the face, the turgescence of the  veins, and a
fulness  of the pulse,  which  always  precede deaths  determined
by the congestion of the brain.   This distinction is important  to
be made:  for bleeding, which might restore life in this latter case,
would be fatal  in the other, and ought to be replaced  by diffusible
stimuli, called antispasmodics, which would solicit the contrac-
tion  of the heart.
   Violent percussions  on the epigastrium, the often horrible  pain
of gastric inflammations, may determine sudden deaths.   Hence,
I  would not  be surprised, that sudden fits of the  violent passions
should  occasion death, by the nervous irritation of the epigastric
centre.  For this, it would be sufficient, that  the sensibility of the
mucous membrane of  the stomach should  be  exalted by a state  of
inflammation, at the moment when thought would excite an ex-
traordinarily violent passion; because the irritation of the  gastric
papillae  keeps the whole of the abdominal nervous apparatus in an
extreme state of irritability.   If this case  could be suspected to ex-
ist by the commemorative signs,  and the seat of the pain, which
often assumes the name of agony,  bleeding and cold  water would
perhaps prevent  death; but there are circumstances, in which it i>
so sudden, that medical aid is always unavailing.
   Such  are,  in my opinion, sudden deaths, purely nervous, which
may be  produced by an excess of the passions; but there are others 
        MOVEMENTS, &C  BECOME CAUSES OF DISEASE.      181

which I call vascular, although  they derive their primary source
from the influence of the nervous system:  it appears to me,  that
they ought to be placed after the preceding.
  The first  .still belongs to the  brain, and may be classed among
the apoplexies: it is occasioned either by the rupture of the vessels
which are distributed to the cerebral substance, where we find, after
death, masses of fluid or coagulated blood; or by the exhalation of
this fluid, either in the tissues of  the pia mater, which is most com-
mon, or at the surface of the arachnoid; but this disorder is rarely
the instantaneous product of an  acute passion, unless there existed
a prior irritation of this membrane.   It is perfectly well felt tnat
these kinds  of extravasations are very analogous to the rapid hard-
ening of the brain, of  which we have already  spoken; since they
are always produced by an extraordinary afflux, and by the devia-
tion of the blood abandoning its accustomed route.
  The second kind of sudden deaths, which I call vascular, is oc-
casioned  by the rupture of the heart or of a large vessel.   It is
usually  in the chest that the vascular trunks are ruptured  by the
effect of strong fits of passion; except when the ventral  aorta, or
some other  vessel of the abdomen, is already predisposed to it by a
partial inflammation of its coats, or by an aneurism; and when it
is the heart which is lacerated, it yields sooner at the right auricle
than at  its other cavities,  because this part is the weakest.   This
organic lesion,  it appears  to me, ought to be explained in the fol-
lowing  manner.  The too  acute feeling of the  passion  produces a
constriction  of the right  ventricle, which  refuses to admit the
blood of the auricle;  and this, constantly propelled by the torrent
which comes from the vena cava, overcomes the resistance of the
coats of the auricle.   It is  easily conceived, that if rupture be pos-
sible, aneurism is still more so, as has been but too often demon-
strated  by observation.  It is also felt, that a heart,  the ventricles
of  which are already in a state  of aneurism, may be  ruptured by
the influence of a violent passion; this arises from the circumstance,
that the irritation having accumulated and retained the blood in the
brain,  in the lungs,  and in the viscera of the abdomen, the  two
ventricles can  no longer propel, in their  respective arteries,  that
with whicli  they are filled,  and on which they act with so much
more energy, as the brain, stimulated by the passion, does not cease
to excite them to contraction.   If any one should think it strange,
 that I  make the  brain act  upon the parietes of  the  heart, I would 
 182   HOW  THE EXERCISE OF INTELLECT, THE AFFECTIVE
 ask him, if he has never palpitated in consequence of any moral
 affection, and if this palpitation can be otherwise explained than
 by the direct influence of the centre of sensations upon the muscu-
 lar tissue of  the heart.   I will resume this  subject, when treating
 of the apparatus of circulation.
   After sudden deaths  from passion, which have been determined
 by the rupture of large internal vessels, I must place those which
 depend on haemorrhagies by exhalation; they are, it is true, less fre-
 quent and sudden, but we have examples of them.  I have read in
 a  work, that a lady, who was sitting on the grass, felt a living frog
 fall in her bosom,  from the  claws of a bird of prey  which  was
 passing over her; she was seized with so  copious an hemoptysis,
 that she only survived a few minutes; so true it is, that moral af-
 fections reverberate with the rapidity of lightning, in all the sensi-
 tive tissues of the system.   Hematemesis is also the effect of strong
 passions; and uterine haemorrhages are frequently occasioned by the
 same  causes.  I have often seen blood rush from the nose in anger;
 and we have examples of sudden cutaneous  haemorrhagies, deter-
 mined by moral affections.
   If the blood can be extravasated, either by rupture, or by exha-
 lation upon the membranes of relation, it can also be propelled from
 the vessels that contain  it into the  cellular tissue, and  in the large
 parenchyma;; but this disorder is seldom followed by death.   We
 frequently see, in sanguineous women, large sub-cutaneous ecchy-
 moses (morbus-maculatus of certain  authors), occasioned  sud-
 denly by strong moral affections; and we know, that hemoptysis,
 which may depend on the same cause, is almost always accompa-
 nied with, and even preceded  by, an extravasation of blood in the
 areolar tissue of the lungs: examinations after death have manifested
 this kind of disorganization.  In a word, moral affections can ex-
 travasate the  blood into  parts corresponding  with the brain, either
 from the nature of their functions, or from the effect of an inflam-
 mation, which, from insensible as they were, has rendered them
 irritable and mobile even to  excess.  It is thus, that the pleura, the
 peritoneum, and some synovial membranes of the large joints, are
 liable  to haemorrhagies from the influence of powerful affective com-
 motions, when  these  tissues are rendered excitable by a certain
degree of inflammation.
   After the influences of the passions acting upon the vascular sys-
tem, we must treat of those that are directed  upon the secretory ap- 
         MOVEMENTS,  &C.  BECOME CAUSES OF DISEASE.      18*3
paratuses;  since we proceed from disorders that are most promptly
produced to those less so, in order to terminate by those alterations
which advance slowly, and which, on this account, have been less
noticed than any others.
   There is no secretory organ, the action of which  cannot either
be increased or diminished, or else the product of which cannot be
altered by  the influence of thought in that state of exaltation called
passion.  We know with what facility fear, horror,  surprise, and
anger, at the moment of their onset, may suppress sweat, and even
what is called insensible perspiration.  This suppression is nothing by
itself, when it is instantly replaced  by the secretory action of the
kidneys; but either from this vicarious action being insufficient, or
from any other cause, morbid irritations  are often developed after.
these accidents.  But it is sufficient to indicate them here, since they
resemble those that are produced by cold; and because we intend
to treat of them in speaking of the functions of the vascular system.
  The kidneys are not less affected than  the skin, in strong moral
affections;  fear increases, in a singular manner, their secretion,—
so much so indeed, that it is hardly conceivable whence can issue
the astonishing quantity of urine furnished, in certain cases, by these
organs.  Every one knows, that the milk is suppressed in nurses, in
consequence of the paroxysms of strong  passions; and  that some-
times it becomes so irritating, that children who suck plentifully of
it arc affected with colics, and even with violent gastrites. We have
studied the influence of the passions on the secretion of tears; which
are also seen to become burning, and so acrid as to inflame the con-
junctivae, the  eyelids, and even the cheeks.
   The saliva is secreted  and even ejaculated with much  force in
the mouth,  by the idea of an article of food which flatters the taste;
and anger,  as  well as the venereal orgasm, communicate to it poi-
sonous qualities  capable of provoking convulsions, and even mad-
ness, in those  persons bitten by a man agitated with  the transports
of these two passions.   Every one knows with what energy ideas
of love  act upon the testicles: the  semen is then  so abundantly-
formed  in  certain subjects,  that it chokes up the seminal  vessels,
the epididymis,  and the vesiculaeseminalis; and the mere influence
of thought  suffices, in many persons, to determine the ejaculation,
even during the waking state.
  Shall I speak of the action of  the liver? It is so powerfully in-
fluenced  by the exercise of thought in lively moral affections, an& 
181    HOW THE EXERCISE OF  INTELLECT, THE  AFFECTIVE
especially in anger, that bile flows abundantly into the duodenum,
whence it sometimes passes into the stomach and produces vomiting;
or it is poured into the intestines, which it stimulates to  such a de-
gree, as to cause colics, diarrhoeas, and even inflammations.
  We cannot judge so well of the changes suffered by the pancreas;
but as it is subjected to the same influences as the liver, we may be
allowed to presume that moral  affections exercise a strong action
upon its secretory function.
  The secretion of mucus is so greatly influenced by violent pas-
sions, that this humour is suppressed, thickened, or altered, during
their paroxysms; and that so much the more, as the membrane
which furnishes it approaches  nearer to an  inflammatory state.
The pus of inflamed surfaces, although an extraneous humour, sel-
dom escapes undergoing considerable alterations in moral affections
of any intensity.  This fact is so well  known to those who prac-
tise surgery,  that I believe it useless to dwell upon it here.
  The influences exercised  by the passions upon the locomotive
muscular apparatus are  so much the  more active, as all the muscles
that compose it are submitted to the orders of will.   They are such,
that the least affective movement  is manifested on the exterior, at
least  by the modification of the contractility of the muscles of
the face.   But if the passion declares itself, other muscles, as we
have already seen, participate in it; and it is always to an inter-
mittent or continued convulsion that this modification tends: hence
arise violent agitations, and even tetanus, which may prove fatal. But
it is necessary to observe, that, in these cases, the  encephalo-spinal
apparatus  undergoes a stimulation, which may give rise  to all the
disorders I  have sketched, when speaking of violent deaths pro-
duced  by strong paroxysms of passion.  When the results of the
convulsions of which we  now speak, are not  carried to this ex-
treme, they  can  still be  such,  that persons retain  a convulsive
mobility,  manifested in consequence of the  least stimulation; and
it is  thus  that epilepsy and  hysteria are frequently the results of
anger, of  terrors, and of all those passions capable of strongly agi-
tating the apparatus of external relations.
  The visceral muscles are far from being sheltered from the in-
fluence of the passions.   We have already  seen with what energy
they act upon the  heart: their action upon the muscular  layers of
the digestive apparatus, of the bladder, and  even upon the mem-
branous tissues of  the bronchia;,  and of the pulmonary  vesich> 
         MOVEMENTS,  &C  BECOME CAUSES OF DISEASE.      18";

arc not less conspicuous; since we often observe after violent emo
tions, vomitings, which in some instances become habitual,—the
discharge of excrements,—sudden ejection of urine, and a spasmo-
dic constriction of the bronchia;, which opposes itself to inspiration,
and produces obstinate asthmas.
   After nervous and haemorrhagic modifications produced by the
passions, we meet with those of  an inflammatory  and sub-inflam-
matory nature.  They may be observed in almost every region of
the body in which the two preceding ones are apt to appear.  Do
we not see, in fact,  the strong affections of the soul produce inflam-
mations in the encephalum, in all the mucous membranes, and in the
parenchyma; of the viscera? Do we not observe, that the passions,
which I  may call chronic, determine scirrhi and indurations of
every kind in those parts?  Every one repeats, that the scirrhus of
the pylorus may be the effect of long continued  griefs; it is pos-
sible that in such cases the  lymphatic  affection is not the direct ef-
fect of the passion, but rather that of the mucous inflammation
which this latter has occasioned in the interior of the gastric or-
gans.   But how often has it not been seen, that moral affections de-
termine suddenly herpetic affections? Does not this prove that the
exercise of thought may stimulate directly the white tissues, and
different secretory  organs  of the  skin, in the same way that it
stimulates the mucous follicles, and the largest and most important
of the secreting parenchyma;?
   Such are the tissues upon which moral affections exercise an influ-
ence in the natural state. The areolar tissues, the serous and synovial
membranes, may, in some cases, though very rarely, become affected
with a sanguineous exhalation produced by violent passions; but mo-
ral affections only cause in them a sensation of pain,  when some pre-
vious inflammation has exalted their vital properties,—has put them
on a level with the other tissues, naturally more sensible; and has, in
some manner, converted them into artificial senses. It is thus, I think,
that we can explain how a fit of anger may become the exciting cause
of a paroxysm of gout, of a pleurisy, of a peritonitis,  and of an arach-
nitis.   In all these cases, the inflammatory predisposition exists in
the ligamentous or serous tissues, and the moral affection is limited
to determining its explosion.  Every one knows, that gout is often
preceded  by a gastritis,  attended with a  plethoric state; in such
cases the irritation of the stomach, exalted by the moral affection, is
transmitted to a joint, the vital properties of which had been ip-
                              24 
18b'   HOW THE EXERCISE OF INTELLECT, THE APFECTIVE

creased by cold, and gout is the consequence.   We may even con-
ceive the production of a paroxysm of gout by the effect of a pas-
sion, without admitting a previous gastritis, when cold, a contusion,
or any other cause has  predisposed a joint to  irritation; since the
articular ligaments are in a direct  correspondence with the brain,
by means of the nerves of the encephalic  and spinal domain.
Another time the inflammation was already developed in the brain,
in the pulmonary parenchyma,  or in the gastro-intestinal  mucous
membrane: a movement of anger or of terror supervenes; it com-
municates a new impetus to the inflammation, which traverses the
whole thickness of the organ, and extends with  extreme rapidity
to the serous membrane.  From this we perceive the great neces-
sity there is of managing carefully the minds of persons attacked
with an  acute inflammation, and why nostalgics and timid persons
fall so often and so suddenly victims to febrile diseases, in spite of
the most multiplied and of the best directed efforts of the art.
   The cartilages, the fibro-cartilages, the periosteum, and bones, are
the only tissues upon  which the mind exercises no influence in a
natural state.   Long continued  inflammations are necessary to de-
velope sensibility in them, and place them  in  relation with  the
encephalic apparatus; but when they have arrived at this state, they
cease to be beyond the influence of the passions; as may be shown by
cases of exostosis, osteo-sarcoma,  and spina-ventosa, accompanied
with deep and persisting pains,  which violent  moral  commotions
rarely fail to  exasperate, at least in subjects of a nervous consti-
tution.

Section  III.—Each  Passion exercises a Morbid Influence
                      over certain Organs.

   Having now pointed out, in  a  general manner, the influence of
the moral on the physical system, it is proper to assign to each pas-
sion the organ over which it exercises a peculiar influence.  After all
that has just been said, this labour will be easy, and will not fatigue
the attention of our readers.
  All the passions founded on pleasure, possessing the property of
precipitating all the organic movements, and of propelling the fluids
towards  the surface,  are commonly favourable  to  health.   Yet
they are not always free from inconveniences; for, in this violent
state, sensibility is so acutely exalted, that it  may be completel) 
          MOVEMENTS, &C  BECOME CAUSES OF DISEASE.      187
 exhausted, and life annihilated by its excess.  I have already said,
 that in such cases it appeared to me,  that the encephalon was not
 always exempt from a truly sanguineous congestion.   The predo-
 minance of cerebral irritation in excesses of joy, is further shown
 by the circumstance, that insanity is frequently the result of them.
 All passions founded  on pleasure, may produce this disease; and
 experience proves,  that it is often as difficult to cure as that which
 depends on melancholy and painful passions.
   Certain pleasures which are too keen, as those  for example that
 accompany  the  venereal orgasm,  have, moreover,  the  incon-
 venience of stimulating the heart with so much energy, that it be-
 comes aneurismatic, or undergoes a rupture  which necessarily and
 suddenly proves fatal.   The extraordinary afflux  of blood towards
 the tissue of the lungs, may also, in these cases,  give rise to hae-
 morrhages and inflammations.  It is thus,  that  excessive enjoy-
 ments always hasten the progress of phthisis pulmonalis in young
 persons predisposed to chronic pneumonia; it  is also by a similar
 influence, exercised over the encephalon, that onanism  determines
 and keeps up epileptic fits.  Much has been said of the debility
 which always results from excesses of this nature, and not sufficient-
 ly of the consequences of the sanguineous congestions they always
 occasion in the principal viscera;  yet this is the most important
 point; for weakness is easily corrected  in youth; whilst visceral
 irritations, which have not been combatted at their onset, constitute
 so many germs of languor and destruction, which must necessarily
 increase under the influence of stimuli and tonics, which are too often
 and abundantly prescribed to persons who have made  a long and
 immoderate use of venereal pleasures.  Nevertheless, debility ought
 not always to be neglected, and this is the proper place for tracing its
 signs, in order to compare them  to those of the visceral irritation.
 Persons who abandon themselves up to these kinds of  excesses,
 finally end by being affected with dulness of their eyes, which be-
 come surrounded with a livid circle; their sight is weak, the senses
 are blunted,  and the  muscles so weak as to become unfit for the
 slightest exercise.   The influence of the  emission of semen  upon
 muscular strength, is so considerable, that I knew  at college a very
robust young man,  (who usually made  a parade of his muscular
strength,)  who raised fifty pounds less than usual on the days he
abandoned  himself  to  a single act  of masturbation.   Hence, the
ancient Greeks took the utmost care in forbidding  all kinds of 
188   HOW THE EXERCISE OF INTELLECT,  THE  AFFECTIVE
amorous enjoyments to the athletae whom they raised in their gym-
nastic establishments.   Venereal  excesses have, among other in-
conveniences, that of affecting, in young subjects, the intellectual
faculties; their attention is  diminished, their memory weakened,
and the habit of only exercising their thoughts on the series of ideas
relating to their ruling  passion, renders them unfit for study, and
is singularly injurious to their education.  The readers may consult,
on this subject, Tissot's work on Onanism.  Although he has attri-
buted to  the vice  he attempted to deprecate, a  number of evils
which did not depend upon it,—which even,  sometimes, were
rather the effect of  the tonics that were lavished  on those  unfor-
tunate persons, whose deplorable  situation  he has described; yet
he has treated of the debasement of the intellectual faculties which
too often afflicts them., in so superior a manner, that it  would be
rashness to undertake to go  over the same ground.
  The epigastrium becomes painful in  libertines; the sensation of
languor which they  refer to it, is at first removed by stimuli; hence,
they seldom fail to carry them to excess, which contributes to bring
on gastrites; and these are necessarily exasperated by the persever-
ing use  of tonics.
  The enjoyments  of comparison have all  the inconveniences of
the passions founded on pleasure.   In many instances insanity is
occasioned by inflation of pride; and this word itself truly portrays
the acceleration of the course of the blood, its afflux towards the
external tissues, which seem to increase the volume of the body,
and the great turgescence which takes  place in the encephalum and
in the erectile tissues of the face  and  neck.  At any rate, it can
only be by its extreme exaltation that the pleasure of gratified pride
can become dangerous; in most cases, on the contrary, this passion
is favourable  to the exercise of the functions, and to the  develop-
ment of every kind of strength.
  There are  numerous tranquil intellectual  enjoyments, which do
not derange the functions in a direct manner,—but, on the contrary,
favour them, and in this way concur to the maintenance of health.
Such are the  pleasures of study;—those procured by the cultivation
of the arts;—those  that result to the man of probity and delicacy
from  the fulfilment of his duties;—those that an  industrious man
obtains from  his labour, when fortune crowns his efforts;—those of
friendship;—of the  love of parents and  relatives;—in a word, all the
pleasures which mildly excite the nervous system without develop- 
         MOVEMENTS, &C  BECOME CAUSES OP  DISEASE.     189

ing any passion.   There results from  these a continual  feeling  of
well-being, a moderate joy, which maintains the regular influence
of the nervous system or the  harmonic  distribution of the vital
powers.  It is true, that one may sin by carrying every kind of en-
jov ments to excess; but then they cease to be included in the series
of which I am now speaking, and their bad results must  be assimi-
lated to those that accompany the abuse of the intellectual faculties,
and of the passions above mentioned, or that of which it remains for
me to treat, under the head of painful  passions.
   The passions founded on pain  having been  distinguished into,
first, painful passions without reaction,—secondly, painful pas-
sions with reaction, I must follow this order, with a view of point-
ing out their particular effects.

    Section  IV.—Of Painful Passions without Reaction.

   Melancholy and terror, which constitute this series, have for their
effect the production of a painful internal sensation, at the contem-
plation of which the consciousness  (moi) is arrested, whilst it for-
gets, as it were, the  locomotive apparatus and the external sensi-
tive expansions, the  activity Of which is  diminished.  The  skin
becomes cold,  perspiration diminishes, the muscles languish, and,
when  these  passions continue  long, they lose a part  of  their con-
tractility.  Under these circumstances, man lives, in some measure,
within himself.  This sensation, which thus concentrates the cere-
bral action residing in the viscera,  supposes that the  organic acti-
vity of the nerves which are distributed  to  them, is permanently
increased.   In fact, the heart is tightened, as melancholic persons
say, since it  contracts in too persisting a manner, and does not al-
low itself to  be sufficiently dilated by  the blood which is presented
to its cavities;  hence, the pulse is small, sometimes accelerated, but
never full, unless a reaction supervenes.   Circulation is then im-
perfectly performed;  from which results a state of uneasiness and
agony in the lungs, which produces sighs, that are determined  by
instinct, solicited by the want of respiration.   This uneasiness must
naturally add to that  depending on the melancholy ideas by which
we are filled.  As the  muscular coats of the digestive canal parti-
cipate in the  constriction of the heart,  and in the effects of the stag-
nation of the blood, the uneasiness is  likewise  referred to the epi-
gastrium and to the liver, but rarely to the small intestines; because. 
190   HOW THE EXERCISE OF INTELLECT,  THE  AFFECTIVE
in the natural state, they are but slightly sensible; as to the large
intestine, no sensation is referred to it.  The stomach seems to
cool,  as, on the contrary, it appears to become heated in joy.
   These phenomena, which at first are nervous, are soon accompa-
nied  with vascular lesions;—melancholy feelings, too  intensely
contemplated, and too much nourished by the mind, do not fail soon
to occasion a congestion in the viscera in which they are seated, or
rather to which they are referred,—these viscera become overheated
and  pass into a state  of vital erection already morbid; when this
occurs,  the uneasiness increases,—the over-stimulated viscera react,
through the medium of the brain, on the apparatus of locomotion.
The individual  affected with melancholy, after remaining for some
time in  a state  of immobility, agitates  himself instinctively, and
experiences a movement  of hatred either against the sensation or
its cause; under these circumstances anger is on the point of being
developed.  But if the ideas, which have given birth to the melan-
choly passion, renew incessantly the movements  of concentration,
anger is repressed, and melancholy without reaction becomes pre-
dominant and habitual.
   Let us now suppose, that this condition persists a long time, as
happens in weak and timid  individuals: there will necessarily re-
sult in the viscera, engorgements, which will be inflammatory in san-
guineous constitutions, and lymphatic or sub-inflammatory in those
of a reverse temperament   Nervous mobility will always be esta-
blished  in the suffering organs; but will be carried to excess if the
temperament be of that  species denominated nervous.   In indi-
viduals  of a mixed temperament,  there will be at  the same time
inflammation,  sub-inflammation, and neurosis;—all of which will
terminate in the disorganization  of  the principal  viscera  of the
economy.   It is in this way, that we daily see developed and kept
up, chronic hypochondriacal gastrites, scirrhi, hepatites, fatty and
tuberculous livers, hypertrophies and  aneurisms of  the heart, and
asthma; and for the brain, mania, dementia, epilepsjr, and apoplexy.
Women, whose generative  apparatus  is very nervous," will expe-
rience, under the influence of similar causes, the symptoms of hys-
teria: this affection, however,  will not exist alone, but will be
combined with  irritation  of the digestive organs; and woe  to the
physician who  will not suspect the existence of this complication.
   All varieties  of melancholy may give rise to the effects we have
pointed   out; but they produce them more frequently in  young 
        MOVEMENTS, &C. BECOME CAUSES  OF DISEASE.      191

timid persons of both sexes, who have been brought up in the rules
of decorum and accustomed to dissimulation; whether the passion
consists in a thwarted love, of which such individuals endeavour
to conceal the least symptoms, or whether it depends upon a  dis-
simulated jealousy, or the desire of revisiting their native country
and  the persons whose society constituted  the charm of their in-
fancy.   Such are, indeed, the most usual causes of that melancholy
without reaction, which we are now examining.   It is  plain that
many other causes may exist, such, for example,  as the loss  of a
beloved friend whom it is impossible to replace, &c.  But it would
be useless to enumerate them here.
  Fear does not always produce effects analogous to the preceding,
because it is rarely of as long continuance as melancholy, and because
it occasions, in  most  instances, a nervous and vascular reaction.
The individual affected with fear can, as we have already seen, like
the one troubled with sadness, perish in the first period of the  im-
pression; but if this does not occur, he becomes  agitated, and de-
velopes muscular  movements.  These may lead  to inflammations;
but they often terminate in convulsive  mobility,  and particularly
in epilepsy.
  We have  referred to the melancholy passions  without reaction,
that horribly painful state denominated humiliation, and which de-
pends  on  wounded self-love.   He who  experiences, in a violent
degree, this moral pain, feels as  if prostrated at the moment he
receives the affront.  Like those affected  with melancholy or fear,
he remains in a state of immobility, and may even  perish at  this
cruel moment; for there is no sensation which suspends so power-
fully the action of the heart and respiratory  organs.  If he do  not
perish, existence becomes odious, because he lives only to suffer;—
there is not a viscus but what reflects to the centre painful sensa-
tions;  whilst self (moi) does  not react  with the greatest degree
of intensity.   I think I have remarked,  that under such circum-
stances the heart suffers considerably, becomes enlarged, and receives
an impetus which leads it to hypertrophy, and to aneurism.  The
brain is sometimes so  powerfully irritated, as to give rise to mental
alienation. The stomach is perhaps less seriously affected; yet I have
seen some very obstinate  cases of gastritis result from this cause;
but I should be more disposed to  attribute them to the secondary
melancholy than to the moment of humiliation;  for melancholy
is always an inevitable result of severe  wounds of  self-love. 
 192  HOW THE  EXERCISE  OP INTELLECT, THE AFFECTIVE

   The confusion of ideas, and the kind of prostration, experienced
 in shame, are rarely attended with serious results; because self-love
 is not always greatly humiliated, and because the second ay melan-
 choly does not constantly follow.   They nevertheless give rise to
 cephalalgias  and palpitations, which may be  attended  with very
 alarming effects,  by producing sick headaches, and a convulsive
 habit of the  heart.
   Whenever the painful passions excite the flow of tears, these dis-
 sipate the state of anguish which precedes and occasions them; it
 constitutes a true crisis, which must necessarily be  compared to
 those occurring in a number of acute diseases; but there exists then
 a sort of reaction, which prevents us from assimilating completely
 these passions to  the preceding ones.  Thus, the pain of the epigas-
 tric centre changes to a sensation of rising, directed  towards the
 pharynx,  and tends to produce,  and in fact produces, a strong agi-
 tation in the respiratory muscles;—at  the same time that the heart
 precipitates its contractions, and the blood is propelled with great
 violence towards the head.  It follows from this, therefore, that the
 irritation is not concentrated in the viscera,—the movements of the
 muscles of the arm, and even those of the other muscles, evincing
 its diffusion; but it is a fact worthy of remark, that this visceral
 uneasiness is only removed completely by means of the secretion
 of tears. The results of this uneasiness, and of the  muscular con-
 tractions which are combined with it, are haemorrhages, inflamma-
 tions, and convulsions, which may become habitual; hence persons
 who  cannot weep suffer more and longer than those who shed tears.
 At any rate this advantage is  counterbalanced by some inconveni-
 ences; for the flow of  tears, when  too frequently  repeated, gives
 rise to an engorgement of the brain, and to ophthalmias, and alters
 in time the organization of the eyes.  Indeed, if it cannot be denied,
 that tears  relieve temporarily, it must also be confessed, that in
 some individuals  this momentary crisis does not prevent the return
 of the pain that has caused it, and the tears are shed during a long
 space of time.  Under these  circumstances, the inconveniences of
 concentrated grief are united to those of the passion when vented,
 and an unhappy sufferer of this kind finally  falls into a more deplo-
 rable  state than any other.
   On the other hand, it would be dangerous to rely on the testi-
 mony of those who never shed tears, and yet  maintain, that they
are more sensible and suffer more than those who weep; this asser- 
          MOVEMENTS, &C BECOME CAUSES OF DISEASE.       193

non is, in very many instances, a mere pretext for concealing their
absolute defect of sensibility.  But the physiological physician, who
knows how to interrogate the functions, will  never be the dupe of
this excuse.  There  exist, exteriorly, a sufficient number of sym-
pathies to enable him to judge of the sufferings of the concealed or-
gans. He will make  use of them to form an idea of the condition of
these pretended sufferers, and will not confound the mockish with
the true sensibility.

      Section V.—Of Painful Passions with Reaction.
  I have already  said, that the painful passions with reaction
are those in which anger and flight are developed. Flight soon gives
rise to a movement of expansion, which  at first corrects the baneful
effect of terror; when moderate, therefore, it cannot fail to produce
advantageous effects;  but, when excessive, it gives rise to all the incon-
veniences of muscular exercise carried too far.   As  I shall speak
on this subject when treating of locomotion, I think it superfluous to
dwell upon  it now.
  The movements  of anger  have  already been examined when
treating of this passion; it  only remains, therefore, to discover
their pathological results.   The sensation which  gives the first sig-
nal of the explosion of anger, consists of an acute pain referred  to
the epigastric centre; indeed, it is so certain  that it  exists in this
region, that vomiting of  blood,—excessive secretion of bile,—the
sudden absorption of this latter which produces jaundice a few
moments after, and violent gastrites, are often its consequence.  That
these phenomena are produced  by the direct influence of the brain
acting through the agency of the nerves, does not change the ques-
tion before us;  for it is not  the less certain, that the  epigastric ir-
ritation forms a part  of the  passion  denominated anger, and that
the principal seat of this irritation is  in the stomach and its appen-
dages.   Besides, experience teaches us,  that, when primitive, this
irritation directs the centre of perception towards the ideas of anger.
This passion, when physiologically considered,  is primarily a si-
multaneous irritation of the brain and epigastric centre;  hence, the
vital action of the brain is often changed,  in  the most violent pa-
roxysms of  anger, into haemorrhage or  inflammation.   From this
arise attacks of palsy, apoplexy, and phrenzy, which often resist
the  best directed efforts of the art
  F. Hoffman had understood this truth,  as may be learned from
Ids dissertation De medicina cmeticd et  purgante, post  tram.
                              25 
194   HOW THE EXERCISE OF INTELLECT, THE APFECTIVE

veneno.  This physician, one of the fathers of solidism, had felt
how dangerous the theories of the  humoralists  might be in those
gastric and  cerebral affections, which are so often the result of
anger.  He relates many examples of these affections, and advises
physicians not to allow themselves to be imposed upon, by the bi-
lious  turgescence which is manifested  in such  cases.   For the re-
moval of this latter state, he merely employed antiphlogistics—pay-
ing regard, as he did, only to the irritation that produced it.  Why
has he not made a more extended  application of this happy idea?
And why have not his successors improved upon it?  It is because
the science of pathology was, in great measure, filled with chime-
rical beings,  which,  under the shield of high authorities, were con-
tinually increasing in number.   Let us continue to exert our efforts
in overthrowing all these idols.
   The association of the heart with the head and stomach,  forces
it to participate in the irritation which they experience in anger; but
it will not be constricted, as it is in the painful passions—without re-
action; or, if it is so, it will only be during a short space of time
It will soon  become turgescent,  blood will be attracted with force
in its tissue, and  it will even, perhaps, become predisposed to
hypertrophy.   If it be  already debilitated and enlarged, in conse-
quence of an aneurismatic  state,  some  of its cavities may even
be ruptured.  The aorta will not be free  from  all danger, and the
lungs also, becoming suddenly engorged,  may, perhaps, be ruptur-
ed or become inflamed.   I have seen hemoptysis and violent pneu-
 monia result solely from this cause.  The muscles, agitated by a too
precipitate  innervation, may remain in  a tetanic state, or pre-
serve, ever after, a convulsive and distressing mobility.
   Such are  the consequences of anger, considered as an acute  pas-
 sion, and whatever may have been the painful one  against which
 it has served as a reaction.   If we examine it in its  chronic state,
 we find that its effects are less terrible, though still very alarming.
 The habit of impatience keeps up gastritis, and annuls all the effects
 of remedies and of regimen,—it prepares the way to, and determines
 attacks of, apoplexy,—it occasions the return of epileptic, hysterical,
 and gouty paroxysms,—it brings on with redoubled  violence habi-
 tual  convulsions and tremblings, and excites on the  skin the most
 rapid inflammatory congestions.   An elderly man was seized with
 a violent fit of anger,  in consequence of a visit from some foreign
 soldiers in 1815.   He  was suddenly affected with a large erysipelas
 on the right lumbar region, which became gangrenous, and occa- 
          MOVEMENTS, &C BECOME CAUSES OF DISEASE.       195'

 sioned an extensive slough.   It must also be borne in mind, that
 all the violent passions have the property of bringing on  suddenly
 herpetic diseases, more or less inflammatory, and the cure of which
 is sometimes very difficult to accomplish.
   Anger is one of those passions, that act with greatest energy on
 the various points of acute or chronic inflammation; hence, surgeons
 dread its influence in all sorts of wounds.  If there exist a painful
 part, either internal or external, or if this  part  be  merely  more
 irritable  than the rest  of  the system, anger will excite in  it an
 increase  of sensibility.  In some individuals, it will occasion the
 return of sick headach,—in others it will re-excite the sensibility
 of joints that have suffered from rheumatism and gout, that is to say,
 that have been inflamed; in a word, this passion occasions, in the
 most uniform  and general  manner, the exaltation of contractility
 and  sensibility, which demonstrates, in the  most evident way, its
 expansibly perturbating property.
   Those who endeavour to limit every thing in  the brain, make
 use of these facts in order to show that anger does not act on the
 epigastrium in a different manner from what it does on the rest of
 the tissues; they have not borne in mind, that without the sensation
 felt  in the epigastrium, anger could not exist; and that the  ideas
 capable of  exciting it  cannot succeed in doing so by merely re-
 exciting the sensibility of another part,—^for example,  of a gouty
 Jtn.ec. ■ r It is always necessary, in order that these exaltations of
 sensibility  may occasion fits  of anger, that  they should  react  on
 the epigastric  centre; whilst,  on the other hand, pain in  this part
 cannot exist without  giving  rise to some shades of this passion.
 Must we once more tell them, that individuals who had never  been
 subject to anger, have  been easily excited to it whilst labouring
 under an attack of gastritis, and have got rid of it in consequence
 of being cured of this inflammation?  If I repeat this truth, it is be-
 cause 1 have, within a few  days, met with a new proof of it.  Be-
sides, as it  is indispensable to prove the influence of the viscera  on
 the passions, for the purpose of facilitating the knowledge of  phy-
 siological pathology, I do  not think I have enlarged too much on
this subject
  What I have hitherto said,  might perhaps be sufficient to point
out the great influence  which the passions can exercise  on health;
nevertheless, I think it useful, after studying those that are painful
;&nd agreeable, to direct our attention to such as are of a mixed cha- 
196    HOW THE EXERCISE OF INTELLECT, THE AFFECTIVE
racier.  We have seen, that pleasure produces expansion, and pain
concentration; with these facts before us, nothing will be more easy
than to comprehend  the effects of the  mixed passions; since  wc
shall discover them to consist in these  two opposite movements.
It would be  wrong, however,  to consider them as simultaneous;
they cannot be so, and must therefore, of necessity, occur alter-
nately.
   Let us glance over the passions in which this double modification
is observable.  Grief,  resulting from  an obstacle encountered in
our first wants, is rarely simple,—at least in the adult; but almost
always combined with the agreeable recollection of the pleasures re-
sulting from the gratification of these wants, and from the enjoyments
of anticipation, when  we figure ourselves at a future period, and
desire to obtain the means of appeasing them.   Are  not  unfortu-
nate beings who suffer the torments of hunger,—who  long after
rest,—who seek the means of relieving their  sufferings,—or im-
plore the necessary succour to  escape from  an imminent peril,
placed under similar circumstances?  The passions  under which
they labour are consequently mixed, and the most cruel concentra
tion of pain is counterbalanced  by the  delightful expansion of
pleasure.
   Jealousy, when produced  by sexual  love, supposes always  the
co-existence  of pleasure and pain; when produced by other causes
it is still of a similar nature; for why are we afflicted by the priva-
tion of a pleasure, if not because we have already enjoyed it? and
when we are deprived of it by a rival, we are only afflicted because
the recollection of that pleasure constitutes, itself, an agreeable sen-
sation.   Hence, we enjoy by the exercise of memory, by which
the passed  pleasure is recalled to  the mind; and we suffer, the suc-
ceeding moment, from the idea that we are deprived of this plea-
sure.
   The modifications we experience when jealousy is nourished by
the fear of being deprived of our present enjoyments, are similar in
their nature; but in these cases the pain, instead of being produced
by a remembrance, is excited by the anticipation of this privation;
by this we are made to foresee the possibility of being deprived of
the pleasures we enjoy,  and this fear of loss is  equivalent, as re-
spects the modification  of our organs, to the loss itself; since we in
fact suffer whe.i we  foresee the possibility of suffering.   Conse-
quently, whether jealousy depend on wounded  self-love, whether 
         MOVEMENTS, &C. BECOME CAUSES OP DISEASE.       197

it arise from an obstacle we meet to the gratification of another in-
stinctive want,—or from wounded pride;—whether it has reference
to the past, present, or future, it does not cease to be a mixed  pas-
sion, compounded of alternatives of pleasure and pain.  We suf-
fer  from the idea of pleasures of which we have  been, we  are,
or will be deprived;  as well as from  the  idea that another has en-
joyed,  enjoys, or will enjoy them;—in the same way that we are
gratified by the recollection of pleasures of which we have been,
we are, or will  be deprived.   In a physiological point of  view,
emulation, ambition, and envy, are of the same nature.
  In regrets, in uneasiness,  in fear and despair,  occurring without
any  motive for jealousy or envy,  the  physiological modifications
are similar to those we have been examining; since we invariably
discover in them the comparison of pleasure with pain; with  this
difference,  however, that we do not observe in them the particular
kind of pain depending on the idea  that another  individual has
been, is, or will be in  possession of enjoyments to which we are
entitled; but this merely constitutes  a  minor degree of pain.
  Avarice is also a mixed passion;  but  it differs in this from all
others, that the pleasure depending on the gratification of the first
wants  is in perspective;  that is  to  say, that the avaricious  man
enjoys these pleasures only  from the hope of  one day enjoying
them.   We discover in it, however, an intellectual  enjoyment,
depending on the actual contemplation of the means of enjoyment
which we have in our possession;  such,  for example,  is the avari-"
cious man who enjoys the contemplation of his treasures.   Those
who are free from this ridiculous passion might, perhaps, imagine
that this pleasure is very limited; yet, it must  be very considera-
 ble; since the miser sacrifices all others to it:  and this  is a further
proof of the unlimited  power of the mind, in modifying the acts
required for the gratification of our first  wants.  Avarice is, there-
fore, a purely intellectual  passion: we have directed attention to
its  pleasures; the pains, by which it is rendered mixed, are the re-
sults of prescience, which exaggerates, in the mind of misers, the
bitterness of privations that might  result from, the  loss of  their
 means of enjoyment.
   In compassion and pity,we again discern the sufferings excited by
the fear of pain and of destruction; and  of which we make  the ap-
 plication to ourselves  by observing  them in others.  We likewise
discover the pleasure depending on gratified self-love, when, ahvay* 
 198    HOW THE EXERCISE OF INTELLECT, THE AFPECTIV1.
                              • ***
 impelled by the same application, we perform acts of beneficence.
 If anger intervene,  as a means of reaction, in the pain of these
 different passions, their mixed character becomes still more striking;
 since the pain, peculiar to anger, establishes a stronger contrast with
 the pleasure of those passions.
   I say nothing of fanaticism; for it is evident, that  the elements
 of which it is composed,  are reducible to those passions I have
 just enumerated.
   Whenever man is agitated  with the impassioned  movements
 which  I have  sketched,  he  experiences, during the moments  of
 pleasure, movements of expansion, which are suddenly replaced by
 those of concentration, and vice versa.  From this results, in a very
 short time, a vicious state  of mobility, not only in the action of the
 nervous, but also in that of the vascular system.  The least incon-
 venience, resulting  from this state, is the loss of equilibrium; this
 is manifested by nervous phenomena,—by fluxions, inflammations,
 evacuations of all sorts,  which  supervene without  any evident
 cause, and disappear in the same manner.  Affections,  in appear-
 ance the most  trifling, occasion, with an astonishing facility, all
 these derangements.  Moreover, every individual, who has expe-
 rienced a long time the  alternation of the mixed  passions, loses
 the power of resisting atmospherical vicissitudes; so that he  is con-
 stantly a prey to diseases produced by these causes.
   If we endeavour to remedy all these evils by the powers of the
 art, we almost  always fail  in the attempt   Medicines invariably
 either develope a too great degree of their ordinary action, or give
 rise  to effects  totally unlooked for;—the nervous apparatuses of
 the viscera, are almost always  too sensitive; because the passions
 have excited their vital properties to a height far beyond that suit-
 able to health;—the most  trifling irritations of their tissues, espe-
 cially of the mucous membranes, and of the brain, occasion pains
 and extraordinary movements, which in other individuals are only
 producedjby the most extensive alterations.   It is this that consti-
 tutes hypochondriasis.  It is  true that this disease arises  from
 many other causes, but the one we have just noticed is undoubtedly
 the most  powerful. Hence, all individuals who have long been tor-
^nented by the mixed passions, become hypochondriacal or neuro-
 pathic.    This exaggerated nervous susceptibility, occasions a great
 deal  of obscurity in  the  diagnosis  of diseases,  so  that, amid the
 complaints, terrors, and sufferings of these unfortunate beings, it is 
MOVEMENTS, &C.  BECOME CAUSES OF DISEASE.
199
very difficult to ascertain the degree of alteration existing in their
principal organs.   It is on this account, that many physicians regard
them as visionaries,—neglect them, or prescribe  remedies which
the too great sensibility of  their viscera renders them incapable of
supporting.   If, however, we bear in mind the evident alterations
in the secretions,—the flatulence,—the evacuations, and the visible
congestions by which those  individuals are affected, we shall find
no difficulty in understanding, that  real alterations may exist in
deeply situated tissues; and discover, in these alterations, a sufficient
cause for those  painful sensations of which those  individuals con-
stantly complain; but, unfortunately, the sympathies which ought
to point out the concealed alterations, do not correspond to the de-
gree of these latter,  and too often disorganizations are effected in
the viscera,  before they are even suspected to have commenced.
  I have not spoken of the more violent and perfectly characterized
diseases produced by the inverse alternations of the mixed passions;
but they are necessarily  analogous to those which  I have pointed
out, in examining the effects of the   highest degree of the simple
passions.
  Such are the innumerable evils that may,  and do daily, result
from  the abuse of the intellectual faculties and of the passions   It
is not only by the cultivation of the mind,  that they  can be  pre-
vented; but particularly by the study of philosophy.  Philosophy
consists in the study of wisdom, and wisdom implies a knowledge
and love of truth.   It is necessary, to commence early in seeking
for and discovering it; for  it is from  it alone that we derive the
true and only intellectual enjoyments;—every  thing else  is idle
fancy, error, or vanity.   I do not allude to that scholastic philoso-
phy for which  forms are every thing, and which  is made up of
pure ontology.   The desire of discovering truth is natural to  all
men; I even go further and assert, that it is a want,—one, too, which
constitutes our intellectual faculties; for this want of observing  all
surrounding objects and comparing  them with ourselves, this same
want  which I have taken pains to point out as the attribute of our
species, does not  consist in a  vague curiosity,  without any po-
sitive object;  so far from this,  it can only consist in the love of
trutli,—of that sublime and sacred  love, of which  it '? impossible
to discover the least traces in the   numerous aninvi* which, to-
gether with the human family, serve to people this vast universe. 
200
                        CHAPTER X.

  OF THE MUSCULAR APPARATUS  OF RELATION, AND OP  ITs DE-
                           PENDENCIES.

   The muscular apparatus of relation is naturally divided into, 1.
 the  cephalic muscles, destined to progression,—to the  displace-
 ment of the whole body or of some its appendices; 2. the cephalo-
 splanchnic muscles.  The first are  exclusively under the control
 of the  will.  The second are primarily obedient to  instinct  and
 secondarily to the will.   The accessaries of this apparatus are  the
 bones and their uniting substances; the whole of which constitutes
 the skeleton.   Let us first examine in a general manner the whole
 of this  apparatus.
   The  muscles of relation are composed of fibrine,—of a laminated
 tissue,  gelatinous in its nature, and which is placed  between  the
 muscular masses and each of the minutest  fasciculi of which they
 are composed,—of aponeuroses and tendons likewise of a gelatinous
 nature.   The muscles are fixed upon the skeleton, which is made up
 of bones,—kinds of gelatinous masses combined with phosphate of
 lime, from which they derive their  solidity;—of cartilages and fibro-
 cartilages, which differ from bones only in containing a less  quan-
 tity of calcareous phosphate,—of ligaments, the gelatine of which
 contains a minor proportion of salts,—and of the articular capsules,
 which exhibit none in a healthy state.  Another  coat of  gelatine,
 spread over the bones and cartilages, serves as a uniting medium
 between them and the soft parts; it is denominated periosteum or
perichondrium, according as it covers the bones or cartilages.  This
 membrane has received, from Bichat, the title of fibrous. This vast
 apparatus, which  by itself constitutes the greater portion of  the
 volume of the body, is plentifully supplied with arterial, venous,  and
 lymphatic vessels, and with nerves.
   The fibrine of the muscles is arranged in lines, which  form  fas-
 ciculi of greater or less size, and the direction of which determines
 the nature of the movements to be executed.   The laminated  and
 cellular tissue serves to separate the muscles and their fasciculi;—
 to fill up the space existing between them;—to preserve their supple-
 ness  and facilitate their movements, and to contain the vessels  and 
 MUSCULAR APPARATUS OP RELATION AND ITS DEPENDENCIES. 201

 nerves with which the muscular fibrine is supplied.   It is in this
 tissue that the blood-vessels are divided and subdivided, before pene-
 trating into the fibrine; hence it may be regarded as serving to the
 nourishment of the muscles, and preserving them in a degree of
 temperature favourable to the performance of their functions.   The
 animal oil, denominated fat, which is exhaled in great abundance
 in this tissue,  wonderfully contributes in aiding these functions.
   The aponeuroses serve to separate and contain the  muscles, and
 to prevent their displacement;—they are further useful in  furnish-
 ing,  to these latter, points of insertion.   The tendons  are restricted
 to this latter use; but in several parts of the body, the muscular fibres
 are attached to the bones without their intermediate agency.
   The bones constitute the  basis and points of support of all the
 soft  parts,—sometimes they contain  or suspend them, whilst  at
 others they are imbedded in them.  The  muscles are always at-
 tached to the bones, which serve as levers for the various move-
 ments necessary to be performed.   It is for this reason, that the os-
 seous apparatus is composed of various pieces, more or less movea-
 ble on each  other.  Sometimes the bones are moved alone, and
 constitute so many levers;  in other cases several bones are solidly
 fixed together, so that  the whole constitutes but one lever; as  for
 example, the head.  The points of contiguity of bones are denomi-
 nated joints or articulations.   There are  several kinds of them,
 according as  the movement is  null, rotatory,  at right angles, or
 more or  less oblique.  Bones differ in respect to form and con-
 sistence; some are hard, cylindrical, and hollowed in their whole ex-
 tent, by  a canal containing a very fine cellular tissue filled with an
 animal oil denominated marrow; others are flat,—others, finally, are
 large and short, and vary in shape,  according as they are destined
 to different uses.   These two latter kinds have no central canal,
 but are composed  of laminae, more or less compact,  and forming
 their external surface; and of an areolar osseous tissue, placed be-
tween these laminae, and filling up the intervening spaces.  This
tissue is lined by a membrane which  secretes an oily fluid, analogous
to that contained in the cavities of the hollow and cylindrical bones.
All the bones are pierced on their surface with holes, through which
the vessels and nerves, serving for their nourishment,  penetrate.
  The bony pieces which are destined to  the  movements of the
middle of the limbs, (the cylindrical,) are enlarged as they approach
f*ach  other, and form  surfaces, in which are seen eminences and
                              26 
^02          MUSCULAR APPARATUS OF  RELATION,
cavities, corresponding to each other in  the most admirable man-
ner; these enlargements are denominated the heads of the bones.
The medullary cavity does not extend as far as the head, which is
composed only of an areolar and  spongeous tissue, covered  over
with a more solid  crust, and which, like them, contains  in its in-
terstices a medullary substance.   From this arrangement, they ac-
quire,  from enlarging  their points of contact, a greater degree of
solidity,  without increasing their weight.   The heads of the bones
are covered with  cartilages, by which their  contact  is  rendered
much easier,—and these cartilages, which are denominated artier
lar, are themselves lined with membranes denominated synovial,—
kinds of bags  without openings, which pass from one  bone to the
other contiguous with  it,—lining, at the  same time,  the internal
surface of the articular ligaments, and giving them the same degree
of suppleness as they do to the cartilages.
   The use of the ligaments is to strengthen the joints,  and, in con-
junction with the forms of the eminences and cavities found on the
heads  of both  bones,  to regulate the extent of the  movements.
These ligaments are arranged in the form of bands on  the sides of
the joints which move at right angles, and in shape of  sacs around
those the movements of which are rotatory.  Some are arranged
obliquely, and allow a certain rotation,—some limit flexion,—others
extension; they are, in consequence, endowed with a very considerable
resisting power.  It is always remarked, that their gelatinous fibres
cross each other in a greater or less degree, so that their  extension
cannot take place in any direction.  The earthy salts with which they
are combined, contribute to afford them the degree of resistance
of which they are in need.
   There are some  bones, the mobility of  which does not depend
on this kind of articulation; these are united by a substance semi-
fibrous and semi-cartilaginous, which allows of a sufficient degree
in the movements of twisting, of depression, and distention, for the
performance of the functions of the organs.  Such, for example, is
the vertebral column, each fibro-cartilage of which contributes in a
very small degree to the movement of the whole.   These bones,
like the former, are strengthened by ligamentous bands,  which, how-
ever, are not as solid as those of the joints of the limbs; because they
must also contribute  to the different movements of  the column.
Numerous muscles concur with the ligaments,  to strengthen the
joints. 
AND ITS  DEPENDENCIES.
203
   The immoveable articulations are united by uninterrupted and
 almost inflexible cartilages; their use is to lessen  the force of per-
 cussions, and to prevent the occurrence of fractures; they are found
 in the head, pelvis, &c.
   In some parts of the body, and particularly in mammiferous ani-
 mals, we find enormous ligaments, the use of which is to suspend
 certain bones, or a cluster of these; and to  relieve the burden of
 the muscles, which, in other species, are  alone charged with  this
 office: such  is the corvical ligament.
   The  muscular apparatus, and its dependencies,  are put in rela-
 tion with the brain and  the various  viscera, by means of the vessels
 and  nerves in virtue of which they participate in general life,  and
 are associated, in their movements, with the wants of instinct and
 of self (moi). As soon as this double communication is interrupted,
 the muscles lose the power of motion, become smaller in  size,  and
 die together  with all their dependencies; but if their nervous com-
 munication alone be intercepted, we only  notice the loss of motion
 and  of sensibility.    Under such  circumstances,  the  extremities
 retain life through the agency of the blood vessels; but as they no
 longer participate in the stimulations of the rest of the body, and,
 having no movements to perform, cease to attract a larger quantity
 of blood, they only enjoy a very monotonous contractility which
 gradually diminishes; and the  flow of blood,  by which  they are
 nourished, also diminishing in an'insensible  manner,  they are fi-
 nally atrophied together with all the soft  tissues annexed  to them.
 The bones alone, in consequence  of the earthy  phosphate they
 contain, do not diminish in size; but it appears to me probable, that
 their elementary  gelatine must finally be  found in a smaller quan-
 tity than in the healthy state.*
   What proves that the wasting of the muscles, in  paralysis, only
 depends on  want of exercise,  is the atrophy  under which they
 labour, when kept in a state of immobility by causes different from
 that disease,—as for example, fractures, painful rheumatisms,  &c.
 The  atrophy which supervenes in the muscles of  the  thorax, in
 consequence of a chronic inflammation of the lungs, by which they
 are prevented from moving, may be  offered  as a further proof
of the correctness of my assertion; for these muscles do not cease
  • All these remarks apply only to the cephalic muscles, which are exclusively
•mder the order of the will. 
504
MUSCULAR APPARATUS  OP
RELATION,
to correspond with the brain and viscera.   In fact, their immobili-
ty is only the effect of pain or of the provision of instinct,  which
prevents them from aggravating, by their movements, the irritation
of the lungs.   At the same time, they diminish in  size, and their
corresponding ribs become more brittle; from which we derive an
additional proof, that the want of action of the motific apparatus
prevents the  nutrition of the parts entering into its composition.
   The preceding remarks were indispensably necessary, in order
to form a correct idea of the physiology of the motific apparatus.
   The muscles, being endowed with contractility, since this latter
depends exclusively on that form of  animal matter denominated
fibrine, exercise it without interruption;  they consequently always
tend to  shorten themselves, and in this  way contribute, as  I have
already said,  to strengthen the joints, even when the limbs are in
a complete state of repose.  This tendency in the muscles to short-
ening, may be proved by dividing them; it cannot, therefore, be
denied to exist, and  it would be ridiculous to regard it as a differ-
ent property  from that manifested  under the influence of stimuli.
This continual  action in the muscular apparatus, contributes to the
firmness of the body,—to the maintenance of the organs in their
respective positions, and to the attitude.   This same action  dimin-
ishing after death, the cadaverous aspect is manifested, and that too
so much the  more evidently,  as the contractility of the fibrine di-
minishes.
   The stimuli  capable of  exulting the contractility of the muscles,
and  causing  them  to execute movements,  are very  numerous.
Whenever a  muscle is separated from a body which is full of vital
energy, or, in other words, not fatigued by disease or by violent
excitement of any kind, it is found to contract under the influence
of a thousand agents, applied  immediately to the fibrine which en-
ters into its composition; such, for example, as the point of an in-
strument,—certain saline preparations,—the sudden  action of calo-
ric, and sometimes even simple commotion.  But it is by means of
nervous influence, that its contractility is most easily and powerfully
called into play; or, in other words, exalted to a degree surpassing
that which is natural to it.  In the dead body, it is sufficient to ex-
cite, by means  of electricity  or  galvanism, a nerve distributed to
muscles, in order instantly to cause their fibres to contract; but as the
fibrine of these muscles no longer communicates with  the sources
of life,  it soon  loses its energy, and  finally  ceases  to  be  excited
by galvanic   or  electric shocks.  The more  this contractility  i" 
AND ITS  DEPENDENCIES.
20.J
excited, the sooner it  disappears; so that we may say,  that  it is
exhausted by the exercise of its own action.   When the muscles
are attached to the living  body, their  contractility  may,  in  like
manner, be diminished by a too long and often repeated excitement;
but they reacquire it by the exercise of life; a circumstance  that
cannot occur after death.
   In the living and  healthy economy, the influence which deter-
mines the movements of exaltation  of the contractility  natural to
the muscles, is always produced through the agency of the nerves;
several physiologists have even thought, that these nerves did not
excite them into action otherwise than by pouring into their fibres
the electric principle  or  agent.   I  shall  not stop to examine this
question; as it is sufficient for my purpose, that it should be proved,
that the nerves are the natural excitants of this sudden increase of
the contractility of the fibrine,—producing what has been called
muscular contraction.
   When a  muscle is in a state of contraction, blood is called in
large quantity into its tissue, in  virtue of that law we have alluded
to above, and which orders, that whenever a fibre executes a move-
ment of condensation, the fluids flow to  it in order to produce vital
erections. Every muscular contraction is, therefore, a vital erection.
   If the blood arrives more promptly to the extremities when these
are in a state of contraction,  it also  returns with greater rapidity
towards the centre of the body, in order to make room for that por-
tion of it which follows;—the whole of which phenomena are pro-
portioned to the intensity and repetition of the movements.  Hence,
in a given time, the muscles which act, expend a larger quantity of
blood than those that are in a  state of rest, and thus operate a true
revulsion, at the expense of the other organs;—their nutrition is
increased,—they  are also augmented in  size, and acquire firmness.
It may likewise be remarked, that the more the muscles act,  the
more they are disposed to action, unless this be carried to that de-
gree producing the  exhaustion  of contractility.   It is  thus,  that
strength and dexterity are the necessary results of exercise.
   If we examine separately the two series of muscles we have al-
luded to, we shall discover between them differences which deserve
to be noticed.
   The cephalic muscles are only provided with nerves arising from
the brain and spinal marrow.  Such, for example,  are the muscles
of the extremities,—almost all those of the face and neck,—in a 
206
MUSCULAR APPARATUS OF RELATION,
 word, all excepting those of respiration.   Those  muscles present
 this remarkable feature, that in a state of health they only contract
 and relax through the influence of the will; they are therefore ex-
 clusively under the order of self (moi).  It is in consequence of
 thought, that we see them take on an extraordinary action, or sim-
 ply reduced to that degree of contractility  inseparable from the
 animal matter of which they are composed. But the cerebral influ-
 ence by  which they  are called into action, may originate from
 various causes. As we have already  said,  in the greater number of
 cases, it is produced by the action of thought in an individual enjoy-
 ing good health, and influenced by purely moral motives; in such
 cases, the muscles execute movements, the order and co-ordination
 of  which express the ideas of the individual, and indicate the ob-
ject he has in view.  Such are walking, running, jumping, the action
 of  performing on an instrument, and a thousand other movements
 more or  less  complicated, and having for their object to remove an
 external  cause of pain, to escape  from it,  or to approach  external
 agents capable of exciting pleasurable  sensations.   At other times
 the brain causes these muscles to  act, in consequence of an imper-
 fectly defined internal sensation;  such for example are the move-
 ments executed during certain states of uneasiness, of oppression,
 and anxiety.   In such cases the individual is agitated without any
 well defined object,  though still under the influence of the will, since
 he  may modify these movements, according as he abandons himself
 more or  less  to the  contemplation  of the sufferings he experiences,
or obeys the  motives he may have for concealing them. The same
 thing  does not occur, however, in certain pathological states, in
 which the signs of consciousness (moi) have disappeared completely;
 such are  the   paroxysms of  epilepsy, of the violent forms of hys-
 teria, &c.  In these cases, the brain does not cease to  determine
 movements in the extremities, &c. in consequence of an irritation
transmitted to it from the viscera,  or seated solely in its own tissue;
but the absence of consciousness (moi) does not allow us any longer
to apply  to this irritation the name of sensation.
  It may thus be seen, that the point of analogy between all  these
cases  is the irritation of the  brain, which is transmitted along the
nerves, and excites, to an extraordinary degree, the natural contracti-
lity of the muscles.   The most important  part of this subject to be
remembered,  is the  necessity of the intervention of the brain, in the
contraction of the muscles of which we are speaking; its existence 
AND ITS  DEPENDENCIES.
207
is indeed most evident, since, in a state of epileptic or other simi-
lar convulsion, the movements in the limbs do not occur, whenever
the nerves of these latter are tied or cut in such  a  manner as to
destroy their communication with the brain.
  Let us suppose, however, that, in an animal in  which you have
excited convulsions by stimulating the brain, a thigh, of which the
nerve has been divided, remains free from them; you will have it in
your power to cause  this part to participate in the convulsions, by
irritating  the  trunk  of the nerve, or by galvanising it.  By this
experiment, you will acquire the certainty,  that this part had not
lost the aptitude to motion,  and that,  if it has remained calm
when you  irritated the brain or spinal marrow, it was because the
irritation of these tissues was not transmitted to it.  This fact, the
correctness of which is notorious, proves most conclusively, that in
those cases, in which an internal irritation, such for example as that
produced  by intestinal worms, or by a point of inflammation situa-
ted in an ovary, or at the neck of the uterus, excites  convulsions
in the extremities, it can only do it through the intervention of the
brain.  It likewise  proves,  that pain and pleasure are not a ne-
cessary condition to the production of these movements; and it is
conclusively shown, that irritation  is the only cause of these phe-
nomena.
   The following may be laid down, therefore, as so  many positive
facts; that the muscles I have called cephalics, are put in motion by
a  stimulation they receive, through the nerves, from the brain;—
that in the greater number of instances, during  the waking state,
and when consciousness exists,  the brain is induced, by the influ-
ence of the will, to make them act;—that this will  may be deter-
mined by external as well as internal  sensations;—that when these
sensations are very acute,  they may compel the  brain  to call the
muscles  into  action, notwithstanding the express  order of self,
 (moi,) or, in other words, in despite of the will,—that when con-
sciousness does not exist, as for example in certain comatous states,
the causes of these  sensations, that is to say, visceral irritations,
may compel the brain to excite the  contraction  of the muscles;
finally, that no viscus can call  them  into action, without the in-
tervention of the brain, or at least of that part of it  towards which
all the nerves of sensation and motion converge.
   Let us now examine the cephalo-splanchnic muscles. Besides the
 cerebral nerves and the spinal, which also arise from the brain, these 
JOS ,         MUSCULAR APPARATUS OF  RELATION,
muscles are supplied with filaments from the great sympathetic; in
consequence of this arrangement they are at the disposal of the will or
of the intellect, as well as at that of the viscera, and, consequently,
of instinct.  Nevertheless, a distinction must be drawn between
these muscles and the first we have examined. The cephalo-splanch-
nic muscular apparatus, which comprehends  the intercostals, the
diaphragm, all the abdominal muscles, the orbicularis palpebrarum,
and, according to some modern physiologists, the dilating muscles
of the nostrils,—this apparatus, I say, is primarily subjected to the
orders of instinct; yet, as this latter is not continually in need of
them,  they are  left momentarily at  the disposal  of the  will,
which consequently  makes use of them: but as soon as the viscera
claim their aid, a sensation of uneasiness solicits  the will to trans-
fer these muscles to them.  If the will resist, the uneasiness in-
creases;  if it persist in the refusal, the  sensation to which  I al-
lude, and which is only a stimulation, overcomes  the resistance,
and the cephalo-splanchnic muscles obey to the instinctive wants.
It is not only in  reference to respiration, that this phenomenon is
observable; all the viscera of  the two  great inferior  cavities  have
equal claims on  these muscles. Thus wc se j them concur, in  spite
of the will, to the want of vomiting,  to that of  defecation, to the
ejection of the urine, and to the expulsion of the foetus.  Whenever
the diaphragm descends, it is absolutely  necessary that the abdo-
minal muscles should  relax, and vice versa.   These muscles are
even forced to conform themselves to  the degree of fulness or va-
cuity of the stomach, intestines, bladder, and  uterus.   It is not in
our  power to compel them to contract to such a  degree,  as would
oppose the enlargement of the abdomen when we  eat; or to  keep
them in such a state  of relaxation, as would prevent them from re-
maining in contact with  the intestines, after  the expulsion of the
faeces,  or the artificial  evacuation of the serous  fluid contained in
the peritoneum.   So, in like manner, it is not  in our power to
maintain the ribs in  a state of elevation, when we execute the act
of inspiration, unless we exercise a strong pressure under the dia-
phragm, by contracting the abdominal muscles; and even to do
this  it requires, that the mass of the abdominal viscera  should  be
sufficiently large to force up the diaphragm very  high.
   The cephalo-splanchnic or  splanchno-cephalic muscles are, con-
sequently, primarily at the disposal of the viscera for the gratifica-
tion of the instinctive  wants; but do they obey  them without, the 
AND ITS  DEPENDENCIES.
.  20&
intervention of the brain?  This question has never been sufficiently
investigated.   I shall undertake to do so with all possible circum-
spection,__allowing an equal degree of  importance to the reasons
for and against it.
   It is an undeniable fact, that respiration  is a want perceived  by
the brain.  The experiments of  Legallois appear to me to  prove
this physiological point in the most satisfactory manner.  When-
ever he divided the medulla oblongata of the rabbit, above the  in-
sertion  of the  eighth pair of nerves,   respiration  continued;—It
ceased, on the contrary, as soon as he destroyed this point of  in-
Ecrtion, or when he divided  the  medulla below this same  point.
If these experiments be exact, the following is the manner in which
we should reason.   In destroying the point of insertion  of  the
eighth pair, or in dividing its two branches,  Legallois prevented
the animal from feeling the want  of respiration;  and this latter
ceased to command the muscular contractions requisite for inspira-
tion.   In  dividing the medulla oblongata below this point,  he  al-
lowed the sensation of the want of respiration, which is transmitted
to the brain by these  nerves, to remain; but intercepted the com-
munication of this centre of sensation with the nervous cords,  by
the aid of which the animal could determine the contraction of  the
inspiratory muscles; and  respiration in  like manner ceased.   Let
us now make the application of this fact to the living state.  When-
ever we refuse to gratify the want of respiration, the nerves of  the
eighth  pair continue to transmit the  sensation which  manifests
this want; but, by the power of the will, we prevent the transmis-
sion of the stimulation which should take place along the nervous
cords  that are distributed to the inspiratory muscles;  finally,
the sensation  or stimulation of the want overcomes the power of
will;  the whole of which  amounts to this,  that the visceral  sensa-
tion has the privilege of forcing the will.   We have already seen,
that, in the amphibious animals, the gratification of this want may
be retarded much longer; but they are  finally compelled to yield
to it.
   It remains  now to prove, that the other sensations of which  we
have spoken, as the want  of  vomiting, that of defecation, &c.  are
executed by the same mechanism,  and  exercise an equal claim on
the brain.  But why should not  these  wants possess this  claim;
since they make use,  for  their execution, of the same muscles as
that of respiration? This induction appears to rae to be extremely
                             27 
ilO»         MUSCULAR APPARATUS'  OP RELATION,
plausible; nevertheless it is necessary to notice the objections that
might be made to it.
   For example,  it might  be said: "If the cerebral  sensation be
sufficient to associate the cephalo-splanchnic muscles  with the vis-
cera, for what reason has the  Creator taken  the precaution of es-
tablishing a communication between all the cerebral nerves  which
proceed, through the spinal canal, to  the inspiratory  muscles, and
the great sympathetic? Does not this tend to prove, that this nerve
is in immediate want of the spinal marrow, in order to obey the
viscera,  independently of  the brain—-or, in other  words, that the
viscera require,  in order  to be  served by their corresponding
muscles, that their nerves should communicate with each bulging
of the spinal' marrow?  Now, if these  viscera can,  by  means of the
great sympathetic, compel each point  of the spinal marrow to  con-
tribute to their actions, the intervention of a cerebral  sensation, or
of a call upon the brain, ceases to be requisite."
   In order  to reply to this objection,  we must bear in mind,  that
the branches of the great sympathetic,  distributed to the viscera, do
not arise from all the points in which the intercostal nerves are in
communication with  the ganglionic system;  so that the direct re-
lations, with the  spinal marrow, only take place between  the spinal
nerves and those of  the respiratory muscles.   Thus, a  few large
branches are  detached separately from the costo-ganglionic series,
and serve to form, by multiplying themselves, at a distance from
their origin, numerous plexuses, which are mingled with the blood-
vessels, or are distributed to the viscera, where they  are found in
communication with  the branches of the eighth pair.  It must ne-
cessarily result from  this,  that these visceral  cords, which preside
over the life of the organs of the large cavities, do not make an
appeal to the points of the spine, corresponding to these viscera;
but rather to the brain, through the medium of this eighth pair which
belongs to it
   But it may be  repeated, what is the object of this  regular rela-
tion of the respiratory muscles with the spine?  I  believe, that its
object is to establish an association  between  these parts; but the
experiment of Legallois which I have  already  cited, appears to me
to demonstrate, that this association is  not of such a nature as to ex-
clude  the necessary  intervention of  the brain in  causing the ce-
phalo-splanchnic muscles to act  in conformity to the wants of the
viscera.  I am inclined  to believe, that the branches of the tri- 
                   AND ITS DEPENDENCIES.               ,211

iplanchnic which proceed to the intercostals, have  less for their
object to subtract action directly from the spinal marrow, than to
transmit to the viscera a part of the stimulation communicated from
the brain to the respiratory muscles by the intercostal nerves, when
it calls  them into action, for the  purpose of  obeying the wants of
these same viscera,—wants of which  it has been informed  by the
eighth pair, which is always in direct communication with the ex-
tremities of the sympathetic branches  it meets with in the viscera.
I am perfectly aware, that this proposition may appear purely con-
jectural, but it will perhaps  be supported by the developments I
propose to enter into when on the subject of the functions of the great
sympathetic.  In the mean time  we  may remark, that it is sup-
ported  by the following reflection;—that the wants which  deter-
mine the action of the cephalo-splanchnic muscles arising only in
the viscera, and not in the  muscles, it is impossible to admit, that
the communications of the nerves of these latter with the  spinal
marrow, can serve to cause in it an  afflux  of nervous influence;
consequently, the object of these communications can only be, to
establish an association of action independent of  this want; and I
believe, that this association can only be that to  which I have al-
ready alluded.
   The second objection against the necessary intervention of the
brain, might be drawn from the acephali.  Thus we occasionally
see some of these born, not only without brain,  but also, in great
measure, without spinal  marrow.  Now, these  foetuses  have pre-
sented just proportions between the volume of their viscera,  and
that of  the muscular parietes which contained them.  Hence, it
might be said, that the cerebral influence is  not  indispensably ne-
cessary, in order that the muscles should be moulded after the form
of the viscera.
   This   objection appears to me of very little  weight; first, be-
cause the brain and spinal marrow have always primarily existed,
and have only been destroyed by a disease, when the organs  had
acquired some degree  of development; secondly,  because those
children are born dead, or,  not being able  to breathe,  live but a
short time; so that it is impossible to ascertain whether the  cepha-
lo-splanchnic muscles would follow the movements of enlargement
and  condensation of their viscera.    These facts appear to me ra-
ther confirmatory of my opinion; since they prove the indispensa-
ble necessity of the  brain for exciting into action the inspiratory 
 212           MUSCULAR APPARATUS OF RELATION,
 muscles, which, as we have said, are necessarily associated  with
 the  other  viscera, in the same manner as they are with the lunga.
   Some writers speak of acephali which have executed movements
 before  their birth.  If the fact  be certain, I  cannot explain it
 otherwise  than  by saying,  that the disease  which destroyed  their
 brain, had not yet produced its entire effects, and that it had spared
 at least a portion of the spinal marrow, at the moment the mother
 felt these  movements.   Do not the experiments made  on limbs
 separated  from a living animal, prove, that  the  stimulation of the
 tissue in which the nerves of those parts originate, can produce
 in them muscular contractions?  For what reason shall we refuse to
 admit,  that the irritation  (for it is one) which destroys the spinal
 marrow, may excite convulsive  contractions  in the muscles?
   From these considerations I am led to think, that, although the
 cephalo-splanchnic muscles  are at the disposal  of the viscera^ the
 latter obtain only from the brain  the contraction of those musclel
 that are necessary to them;  and if they cannot be  prevented by
 the will, it arises from this, that the stimulation, which manifests
 the want of the viscera, exercises a more decided  influence  over
 the brain than  the will, whatever  be  the degree of  energy it may
 have acquired  by the exercise of the intellectual operations.
   It is plain, that all the convulsions of the  muscles of relation arc
 of the same kind; that is to say, they all depend upon an irritation
 of the  brain, either primary, or originating  in another part of the
 body, and transmitted to that organ  through the medium of the
 nerves.
  Avery ingenious experiment made by M. Magendie, appears to
 prove that the posterior roots of the spinal nerves preside over sen-
 sibility, whilst the anterior regulate  muscular movements.   Thi«
 signifies, in my opinion, that the first are distributed  to the skin,
 and the second to the muscles;* but, be this as it may, these experi-
 ments cannot, in any way, disprove the correctness of the proposi-
tions I have just advanced.
  Such as  I have described are  the cephalo-splanchnic muscles,—
always ready to be called into action,—excited  by every stimula-
  • We cannot conclude from this experiment, that the nerves of motion aredit
ferent from those of sensation.  Nature makes use indiscriminately in a thousand
places, of the same nerves, for both functions, and the idea of the two nervou?
fluids i6 hypothetical. 
AND ITS  DEPENDENCIES.
21 J
non transmitted to them; and having always the brain as an inter-
mediate link between them and the different viscera, the functions
of which  they are destined  to  aid.  It should be remarked also,
that all the points of irritation,  which may arise in  the  other tis-
sues, act always in the same manner upon them. I insist upon this,
in order that these muscles be not regarded as obeying two orders
of laws; they are submitted to  only one, and when the will places
them under contribution, it must act upon them through the medium
of the same point in which they correspond with the  viscera.

Section II.—In what manner the Exercise of the  Muscles may
            occasion, or become cause of, Disease.

   1 have  proved, that  the distinctive character  of the cephalo-
splanchnic muscles, is their greater submission to the influence of the
viscera: I say greater submission,  because the cephalic muscles
also obey  thern; but in order that they should  do so, it is necessary
that the visceral irritation should reach that degree which approach-
es to a pathological state; under such circumstances, the brain is
compelled to place the cephalic muscles at the disposal of instinct,
in the  same manner as it has placed the cephalo-splanchnic.  I  se-
lect as  examples, defecation, vomiting, the expulsion of the foetus,
and even copulation.  Whenever these wants  are urgent, the will
is  compelled to  make use of the  muscles, which she employs in
$uch a  way as to cause the  proper attitude to be assumed, or the
efforts  necessary for their  gratification to  be made.   If, by the
power  of the will, we refuse to gratify these wants,  the call made
upon the brain, or the stimulation it receives from the organ irritated
by the  want, would  become so  considerable as to pass to a  morbid
state:  when this occurs, the  cerebral irritation, converted into con-
gestion, would  cause those  muscles, the aid of which was obsti-
nately  refused by the will  to the viscera, to act in  a convulsive
manner;  or  else, this irritation would  attain the  inflammatory
state, and cause  reason  to disappear,—delirium  would  ensue,
and the will would be changed; or, in other words, a pathological
would  take  the place of the healthy will, and the viscera would
be obeyed.  It is in  this way that  nature is revenged  for  the ob-
stacles  which an improper use of the intellectual faculties opposes
to the gratification of her wants; it is thus also that mania from reli- 
214
MUSCULAR APPARATtS  OF RELATION,
 gious causes, or from thwarted  love, from excess of  study or ti'oin
 meditation, &c. is brought on.
   But  if the unreasonable  opposition of the will,  to the accom-
 plishment of the wishes of  nature, can give rise to all these evils,
 they may equally result from  the improper use of the instinctive
 functions.  By accustoming the will  to obey  the least signal  of a
 want, we augment the empire of this latter; and the cephalic mus-
 cles, too ready to gratify it, finally become as intimately united
 to the visceral irritations as the cephalo-splanchnic.   In such cases
 man becomes the slave of his appetite, he is brutified, and this ex-
 traordinary influence of the  viscera over the brain, produces, occa-
sionally, the unpleasant effect of deranging its functions, of develop-
 ing morbid irritations  in it,  and occasioning mental  alienation.
 Independently of this,  the  muscles  insensibly loseN the power oP
 gratifying the will, when it requires  of them  any other kind of
 movement; they become debilitated and subject to convulsions.
   If next we direct our attention to the locomotive muscles,  exe-
 cuting, under  the influence of the will, movements  too violent or
 too often repeated, we find a number of diseases arise, which, un-
 fortunately, are of too frequent occurrence.   The first of these ef-
 fects is manifested in the circulation;  for whenever a large number
 of muscles are simultaneously called into action, the  blood which is
 called  into  their tissues, is sent  back precipitately to the heart.
 This seldom fails to occur in all great efforts, as in jumping and
 running.  Now, if the heart, notwithstanding the acceleration o£
 its action, cannot suffice to the disgorgement of the venous system,
 there must  necessarily  result,  in the viscera, sanguineous stagna-
 tions, the consequences of which we shall point out  when treating
 of the circulatory function.
   Another result of these immoderate muscular contractions, is the
 rupture of the muscles, or  the tearing and separation of the ten-
 dons,—which  may be followed by very dangerous  inflammations,
 capable of giving rise to extensive disorganization in the locomo-
 tive npparatus, and  of being propagated even to the  viscera.
   Whenever the muscles are subjected to too violent an exercise,
 they are apt to fall into an alarming state of debility.  Under these
 circumstances, they are found,  when  called  into action, to become
 engorged with the greatest facility;—they next are benumbed, and
 exercise becomes almost impracticable.  These excesses of loco- 
AND ITS DEPENDENCIES.
215
moi ion cause them sometimes to pass to the inflammatory state.  I
have often seen, in soldiers, after forced marches, the muscles  of
the thighs become painful, produce  a chill,  fever; in a  word, in-
flame and suppurate as after the most violent attacks of rheumatism.
   The articular  surfaces aTe  liable to similar accidents,  whenever
they are exposed to a too long continued friction.  We occasionally
see violent attacks of arthritis, which arise from no other cause, than
a  too violent exercise.   I have  had occasion to remark, in these
cases, that cold  is not  the only cause of the mobility of articu-
lar inflammations;  for those that depended on this cause, had also
the wandering character.  Originally developed in the knees  or
feet, which had most suffered from exercise, these  inflammations
were seen to be translated upon other joints which  had not  been
irritated by fatigue, when care  had  not been taken to  cut them
short,  by  means of the antiphlogistic  treatment, in the parts  in
which they originated.
   If exercise alone can  inflame both the muscles and the articular
surfaces, with much more reason are these parts exposed to become
violently irritated, if the individual, who has exercised  them too
much, is so unfortunate as to remain exposed to cold  after immode-
rate exertion; it is under these circumstances, that the most vio'ent
and extensive rheumatisms are seen to appear.   The production of
these diseases is rendered still  more easy by sleep, if the  person
who is fatigued abandons himself to it without having the precau-
tion to cover himself well.   It is even sufficient that a single part
of the body should be exposed to cold, whilst all the rest are kept
warm, in order that these painful inflammations should appear: this
is what often happens to soldiers, obliged to  sleep two together in
very narrow beds, the covers of which are not sufficiently large to
protect them completely.  Sometimes, also,  the heat they experi-
ence when sleeping, makes them instinctively draw out and expose
a leg or an arm to  the air; and it is upon this part that the inflam-
mation appears,  with  so  much the more  intensity, I repeat, as the
previous fatigue had been more considerable.
   But the locomotive apparatus  is not the only one which can suf-
fer under these circumstances; the circulation, which exercise had
greatly accelerated, becomes languid during rest, especially at the
surface, and the skin  no longer resists the influence of cold; a sup-
plementary action  is  developed ip  the viscera,  where it produce*
serious inflammations. 
216
MUSCULAR APPARATUS  OP RELATION,
  A strong alimentation may, undoubtedly, prevent such accidents
after undue exercises; but it is not free from all inconveniences, as
I propose showing in examining the influence of muscular exercise
upon digestion.
  Whenever we abandon ourselves to a violent and prolonged mus-
cular exercise, digestion is quickened, and the appetite returns sooner
than usual; if it be not gratified, we experience at the epigastrium
a painful knawing, accompanied with a sensation of cold, and  the
muscles  begin  to lose part of their energy: under these circum-
stances, i£ it  be in a person who takes a long walk, locomotion be-
comes slower, and the will is obliged to act with  much force to
keep up the step.  It is in these cases that the relations which as-
sociate the stomach  with the muscular apparatus, and with  the
brain,  become  most apparent   Thus, a  walker who  abandoned
himself with  pleasure to conversation at the commencement of the
journey, when he had his stomach full and his limbs supple, becomes
insensibly silent, in proportion as the stomach is emptied and  the
muscles fatigued; the attention for  objects which before occupied
him, gradually diminishes, and even becomes so weak, that he not
only shows a reluctance to speak,  but even can  only think of  the
muscular  movement and of  the want of nutrition.   But let  him
reach a place where he can take some nourishment and enjoy some
rest, he will be seen to resume with gaiety his journey,—give him-
self up once more to the pleasures of conversation,  and again enjoy
a degree of strength which he considered as lost:  so true it is,  that
nature only permits us to apply our strength to the exercise of
thought, and  to that of the other functions of relation, when the in-
stinctive wants do  not claim  the employment of it for  the profit
of self-preservation.
  Yet, as there is a limit to every great effort, the uneasiness that
our  traveller had  already experienced does not fail to recur; but
now a brief rest and a light repast are no longer sufficient to calm
it: sleep has become necessary; and, if it be not obtained, a crowd of
evils of the most unpleasant kind, never fail to revenge injured na-
ture.   Under these circumstances, two kinds of pathological states
are  to be feared, viz. inflammation  and exhaustion.   Thus with
certain persons, the stomach, too much irritated by muscular exer-
cise, becomes heated, and even intensely inflamed;  the  painful
sensation  in the epigastrium, which seemed  to require nourish-
ment, becomes aggravated by their presence, and especially if they 
AND ITS  DEPENDENCIES.
217
be of an irritating nature; and the man who expects to regain his
strength,  the evening after a fatiguing journey,  by a substantial
meal, seasoned  with alcoholic drinks, only derives from these a
gastritis,  which soon gives rise to a febrile state, and prepares for
him a most painful night.   It sometimes happens, that this incon-
venience is only temporary, and that an equilibrium is established
by the exercise of the following day;  but if, after being, during a
long time, heated and over irritated by exercise, even after being to
a certain degree exhausted, the person abandons himself to rest and
good|living, it will  be difficult for him to escape dangerous fevers,
which are nothing more than gastro-enterites.
   Hence, it is remarked, that the most dangerous epidemics take
place after long and forced marches,  particularly in a conquered
country, and when soldiers enjoy great abundance.   Muscular ex-
ercise ceasing, in fact, to expend the vital power, this is directed to-
wards the digestive  viscera, by the excesses of nourishment and of
fermented  liquors to which the soldiers abandon themselves, and
gastro-enteritis  rages with a violence and  a  universality,  that
leads to the belief of contagion.   Having often been witness to such
epidemics, I think it will be in my power to treat of this matter
to some advantage.   This question deserves so much the more to
engage  general  attention, as the fatigues experienced by soldiers
induce physicians to consider them as in a state of exhaustion, and
to lavish upon them the most energetic stimuli, such as wine, alco-
hol, camphor,  bark, &c.  The mortality then becomes  excessive
and dreadful;  and,  far from obviating  it by appropriate  remedies,
time is  lost in searching after the means of arresting a contagion,
which only exists in the prepossession of such as witness these dis-
asters.   Not, however, that infection is impossible, whenever
we accumulate, in too confined places, the victims of these deplora-
ble circumstances;  hence,  physicians and  commanders  ought to
neglect  nothing  capable of preventing this misfortune.  But it is
not less  certain,  that the best means of annihilating these epidem-
ics, is to submit the patients to an antiphlogistic treatment, as soon
as they  feel the first attack of the inflammation.
  It is in conformity to these principles, that I was able,  as I have
elsewhere said, to remove, in the course of a few  days, in several
military hospitals, pretended contagions which were attributed to
the unhealthiness of the wards,  without even having employed the
disinfecting fumigations of Guyton Morvaux.  It  was during the
                              .28 
218
MUSCULAR APPARATUS  OF RELATION,
last expedition to Spain, that I was enabled to make these observa-
tions; and I am persuaded, that similar precautions would have been
sufficient to put a  stop to  the progress of the frightful epidemic,
which destroyed the remnants of our army, after the campaign of
Moscow.   What was,  in fact, the situation of these troops? They
had just suffered the united torments of fatigue, cold,  and  hunger;
and attempts were  made to  compensate them, during the period of
rest, by furnishing them abundantly the means for  restoring their
strength; hence they could not avoid gastro-enterites; and the incen-
diary treatment, a fatal consequence of the Brunonian principles of
our schools, did the rest.  It  is not  from mere conjecture,  that 1
thus speak; I  have, in support of my assertion, the formal  declara-
tion of some physicians who  escaped the contagion of  the stimu-
lating system.  From them I have learned,  that this disease was
cured, by them, with as much facility as other gastro-enterites, when
they could oppose to it the  antiphlogistic  treatment, before  it had
reached that degree which has caused it to receive the too fatal name
of adynam ic fever.
   In other individuals less disposed to inflammation, fatigue, arising
from muscular exercise, produces a real exhaustion,—particularly if
the renovation be insufficient.  I have often seen soldiers enter our
hospitals after fatiguing marches,  motionless, withered, silent, and
as in a kind of imbecility.  After being convinced by the examina-
tion of the tongue, which was pale and large, by the want of pun-
gent heat at the epigastrium, &c.  that  this adynamia was not the
result of a gastro-enteritis, I  gave them wine,  at  first  with very
little nourishment; I gradually increased  the dose of these stimuli,
and I soon had the gratification of seeing them entirely  recovered.
In fact, it is for heated and alcoholic drinks, that the stomach has
a relish under  these  circumstances; undoubtedly, because they
diffuse, with  more rapidity than  the fixed  tonics,  the excitement
throughout the whole  extent of the nervous system,  and  repair
promptly the losses it has sustained.   At any rate  we cannot too
often repeat,  that great caution is necessary  in directing the appli-
cation of this plan of treatment; because nothing is more easy than
to confound the adynamia which depends on exhaustion, with that
produced by  inflammation; and because  persons who are fatigued
pass easily from the first to the second.
   When, without"  being excessively violent, muscular exercise is
too much prolonged, its effects are less prompt and  less dangerous; 
                   AND ITS DEPENDENCIES.                 219
 but  they are  still very serious.   Examine  those hard  labourers,
 those workmen of the lowest classes of society, whose renovation
 is no way proportioned to the waste of their strength; they end by
 becoming withered, by having their limbs stiff and  tumid,—their
 movements slow  and painful.   Their skin becomes wrinkled and
 faded; they grow prematurely old, and many among them become
 asthmatic.  This asthma appears to me to be owing, most generally,
 to an affection  of the  heart, which,  after having  acquired more
 energy and volume, by participating in the irritation of the other
 muscles, and by the too hurried circulation  of the blood, becomes
 weak, relaxed, and often aneurismatic; they are also  subject to
 chronic catarrhs,  the resolution of which does not take place,  and
 they fall victims  to a lingering pneumonia, of which physicians
 have endeavoured to constitute a peculiar disease, under  the name
 of phthisis with melanosis. But  what is most remarkable in those
 patients, is the dryness,  the stiffness, or the varices of the lower
 extremities, which deprive them early of the corporeal  labour
 which constituted their only resource.   Their bones are also seen
 to bend, especially towards the vertebral column, and become the
 seat of rheumatic pains, which nothing can dissipate.
   Such are the diseases caused by an abuse of the muscular power:
 from this it is perceived, that they affect the cephalic muscles, and
 particularly those of locomotion.   Such as are connected with the
 functions of the  viscera, suffer much less;  because they are not
 subjected to such considerable  efforts;  yet they are not  always
 exempt  from  fatigue,  and  even  from serious accidents.    The
 diaphragm has  been known  to be torn in violent efforts.  The ab-
 dominal muscles are fatigued, and  even extremely painful, in walk-
 ing.   The intercostals, compelled, in conjunction  with the pre-
 ceding, to keep the chest immoveable, in order  to serve  in violent
 efforts as a  point of support  to the muscles of the limbs, give rise
 sometimes to a feeling of fatigue and pain.   Those of the neck are
 not free from it;  but,  in  general,  the labour of these muscles is
 much less considerable than  that of the muscles of the limbs, of
 the sacro-lumbalis, of the longissimus  dorsi, and of all  the fleshy
 masses situated posteriorly along the vertebral column.
  Fatigue is, for the moving apparatus,  a pain which is  perceived
in those  muscles  that have been  too  much  exercised, and which
warns us of the necessity of rest: it depends on"a local  irritation; 
220
A SUMMARY OF
and  if the self (moi) overlooks, and persists in exciting it, it
changes into an inflammation or into a neurosis, in the same way
as that which follows the excessive action in the  most important
viscera of the economy.
                       CHAPTER  XI.

        A SUMMARY  OF THE FUNCTIONS OF RELATION.

  I. There exists in  perfect animals,  and in man, who more par-
ticularly engages our attention, a nervous apparatus, destined,—first,
fo put them in relation with external bodies; secondly, to establish
relations between the  different organs  composing them.
  II. The nervous apparatus is presented under three forms; first,
sensitive expansions, which are both external and internal, and which
are found  in the skin, and the other external senses, and in the in-
ternal surfaces called  mucous membranes; secondly, the central
nervous matter,  which is placed in the cranium, and extends into
the spinal canal; thirdly, the sensitive cords, establishing a com-
munication between the surfaces and  the central nervous matter;
these are nerves.
  III. It is to the basis of  the  brain (medulla oblongata) that
all the nerves converge. The spinal prolongation, and all the cords
which communicate with the external nerves,  whatever be the
point of the encephalic cavity through which they penetrate, are
regarded as the intermediaries between this point and these same
nerves.    The rest of the  encephalic apparatus is regarded as a
union of nervous systems, which equally terminate at the medulla
oblongata.   These systems preside over the intellectual operations,
and their action gives rise to thought,  ideas, judgments,  memory,
prescience, and to the consciousness of the existence, which makes
man say I feel, I do, I am, which  gives the idea  of self or I (moi).
  IV. The wants are  the source of all the relations; they originate
in the organs, and produce  stimulations in the  internal  sensitive
surfaces.   These stimulations, having  reached, by means of the ex- 
THE FUNCTIONS OP RELATION.
Oil
tra-cephalic nerves, the cerebral centre, produce the feeling of the
wants; but it is confused.
  V.  When  external bodies, destined to gratify these  wants, are
present and act upon the external surfaces of relation, they are re-
cognised, by the  centre of perception, to be in  relation with the
wants; and the feeling of these latter becomes more clear and more
urgent
  VI.  The recognition of external bodies, proper for the gratification
of the wants, supposes that the stimulation produced by these bodies,
has been reflected by the  cerebral centre to the viscera; and that
these, in consequence of their wants, have responded to the centre of
perception,  whence results instinct.   This  recognition supposes
also, that the same stimulation has been reflected to the intra-cepha-
lic nervous apparatuses, which have likewise responded to the cere-
bral centre, in order to unite the intellectual operations with the
instinctive movements.  The proofs of these facts are very nume-
rous.
  VII. The stimulations coming from without, and perceived by
the cerebral centre, after a repetition  in the nerves of the viscera,
and in the intra-cephalic  nervous systems,—these same stimula-
tions, which give the decided feeling of  the wants, are  called per-
ceptions.
  VIII.  The  perceptions  suppose, that  the encephalic apparatus
is sufficiently  developed, and that  it is  in the  waking state; for
every soporous state, natural or pathological, puts a stop to percep-
tion; but it does not prevent the  stimulations of the sensitive sur-
faces, whatever they may be, from  reaching the brain.   Hence,
perception is never continued, even in the natural state; whereas,
the stimulation of the brain, from that of the sensitive  surfaces,
never ceases.
  IX.  The perception and stimulation of the brain determine mus-
cular  movements; but they are  very different  from each other.
Those that result from perception, supposing that instinct and the
intellectual faculties preside over them,  are regular, have a deter-
mined object,  and disclose  the  thought of the individual and the
intention of self (moi); in a word, the will:  these constitute acts.
The movements which are merely the effect of the cerebral stimu-
lation, without perception, are irregular, sometimes convulsive, and
veveal  neither thought nor will. 
TlO
A SUMMARY  OF
   X. Sometimes, in spite of the waking state and of the presence
of consciousness (moi), the brain receives stimulations that make it
execute  movements which  the consciousness (moi) observes, but
which the will cannot prevent.  Hence  stimulation and  percep-
tion may  take place  at  the same  time,  and  in  an independent
manner.   These cases are always unnatural, and consequently pa-
thological.
   XI. When perceptions are occasioned by external bodies which
interest, intimately, a then  urgent  instinctive want, the will  is
strongly solicited to cause those acts to be executed which are requi-
site for the gratification of the want, without  the  intervention of
the intellectual faculties; because the influence of the visceral nerves
predominates over that of the nervous apparatus destined for the in-
tellectual operations. Yet the extreme development of these last ap-
paratuses in our species, and the habit of exercising them, which  is
acquired in adult1 age, give us the faculty of producing the inter-
vention  of the will in these acts, to modify some of them, to re-
tard others, and  to prevent a great number;  so that instinct never
acts with liberty, that is to say, does not carry away the will despot-
ically, in the adult and civilized man.  This resistance is attributed
to  what  is  called  the self (moi), which always supposes the
exercise of judgment.  But in  early infancy and during sleep, in-
stinct overpowers the will;—because perception  is not clear, and
then it is said that reason is wanting.
  XII.  Whenever the brain is too suddenly, that is to say, patho-
logically stimulated, the self (moi) does  not  so fully enjoy the
faculty of modifying the impulses of instinct; often, in  such cases,
the will obeys the last, and it is said that reason is not the mistress,
and often that it is  alienated.   This is what happens in  insanity.
  XIII.  When the brain is stimulated  by pathological  irritations,
either acute or chronic, it  produces, in presence of the will, in spite
of its influence, and often  unknown to  it, a  number of unnatural
movements, and various sensations, which are sympathies of rela-
tion, and become,  in  the eyes of the physician, the signs of the
disease.
  XIV.  When the perceptions that reach the brain, do not interest
intimately an urgent want, they never  fail  to  be reflected to all
the nervous apparatuses; but those of the viscera responding less
to the cerebral centre than  the  intra-cephalic ones,  perception
is more in the domain  of intellect  than in that of instinct, to which. 
THE FUNCTIONS OP RELATION.
223
however, it may be linked by other ideas, that is, by other percep-
tions, to which memory and prescience can give rise.  Perceptions
of this kind are relative to the sciences, to  the  arts,  &c.; they
serve to the gratification of the wants of thought and of observation,
which are characteristic of man.   Hence the  self (moi) is exer-
cised upon wants of every kind;  in other words, on the  instinctive
and  intellectual ones;  hence arise affections and  passions, as has
been elsewhere exhibited in detail.
   XV. Every external  sensitive surface may become diseased in
the exercise of its functions,  by inflammation,  sub-inflammation,
haemorrhage, and neurosis.
   XVI.  The  brain, when  excited to action  by stimulations  and
perceptions, reacts upon the viscera and muscles.  There are,there-
fore, two kinds of action;—the  visceral  and  the muscular.  The
first produces stimulations that are reflected to the brain, and re-
double its irritation; it becomes  a cause of health or of disease, ac-
cording to its intensity and to its repetition.   Even the  diseases of
the viscera which depend upon it, consist of congestions, inflamma-
tions, hgemorrhagies, and neuroses.   The second action occasions
movements of  locomotion.
   XVII. The fibrine of the muscles is  always in  a state of con-
tractility during life, and even sometimes after death; it communi-
cates with the brain by means of the nerves, and  with  the circu-
lating centre by means of  vessels.  When  forced suddenly to an
increase of contractility by the innervation of the brain,  it becomes
condensed; its fibres are contracted;  this  is what is called contrac-
tion: under these circumstances, locomotion of the whole body, or
of some one of its parts, is produced.   The  muscles carry with
them bony pieces, upon which  they are fixed, and which move
upon each other.
   XVIII.  When the brain is in awaking state,  locomotion is per-
ceived, and may become painful.
   XIX.  Whenever the muscles  receive an over increase of nervous
stimulation, and contract,  there is an afflux, into their  tissue, of a
larger quantity of blood, which they propel into the  veins with
a rapidity proportioned to that of the arrival of this fluid.  From
this it results, that muscular action accelerates circulation, and may
give rise to great disorders in this function.
   X X.  The muscles are all under the immediate dependence of the
brain; but they must be divided into cephalic, which, in  the natural 
224       A SUMMARY OF THE FUNCTIONS OF  RELATION.
State, only obey the stimulus of the brain, with the consent of the
will; and into cephalo-splanchnic, which obey the viscera through
the intermediate  agency of the brain, in spite of the will, and aim
obey this  latter, but only when the viscera are not in want of their
assistance.
   XXI. The cephalo-splanchnic muscles never act in obedience to
the will, unless the viscera with which they are associated be modi.
fied.
   XXII.  Muscular action becomes cause of disease, by its  influence
on the circulation;—by the rupture and acute or chronic inflam-
mation of the fibrine of the muscles, and of the other tissues of the
locomotive apparatus;—by irritation transmitted to the stomach;—
by exhaustion of  the nervous power; and by producing a general
languor, which favours the action of causes calculated to derange
the equilibrium, and especially of cold.
END OF PAHT I. 
PART SECOND.
ORGANIC FUNCTIONS. 
 
PART SECOND.
ORGANIC  FUNCTIONS.
                       CHAPTER I.

          OF THE ORGANIC FUNCTIONS  IN  GENERAL.

All the functions have for their object the preservation of the in-
dividual; but some accomplish this  by placing him in  connexion
with external  bodies, such  as  those that  we  have  examined;
while others, the study of which is now  to engage our attention,
fulfil the same  purpose without the intervention of any external
agency.  We find, indeed, relations, but they only take place be-
tween  the different apparatuses of the same  economy j since the
organs charged with the office are connected, on one side with the
brain, to which alone belong the extra-individual relations, and on
the other side with the interior of the tissues.
   It is this connexion that regulates the order of the internal move-
ments, and the direction of the fluid or mobile animal matter,
which always follows in their train.  In fact, when this has reached
its destination, it is obedient only to the molecular affinities of life^
which I have designated  by the term living or vital  chemistry
(chimie vivante).
  The  functions circumscribed to the sphere of the animal, will be
susceptible then of a  subdivision.   They might be divided into
intra-individual  functions of relation, and into  vital chemistry,
the latter comprehending assimilation, and all the transformations
of animal matter, some of which result in the formation of fluids
different from the blood,  and others  in  the  solidification of this
mobile  matter, or in nutrition.   Still, however, as many internal
apparatuses exhibit the union  of these different vital operations, and 
228           ORGANIC  FUNCTIONS IN GENERAL.
as it would be inconvenient to separate  the  histories  of  them, I
shall  not adopt  rigorously any new classification.  When I come
to treat of an apparatus in which several of the phenomena above-
mentioned are combined, I shall speak of all that is necessary to
the understanding of its function;  finally, when  all  the apprecia-
ble movements shall have been examined, I shall then  arrive at
the phenomena in which nothing more can  be observed than the
movements that take place among the molecules.  This arrangement
seems to me  preferable to any other,  in the actual state of our
knowledge; and, to prepare my readers for it, I now offer the ab-
breviated outline:

   1.  The Nerves of the Organic Functions.
   2.  The Function of Respiration.
   3.  The Function of Digestion, or primimary Assimilation, with
evacuation of its superfluity.
   4.  The Absorption of Nutritive Materials.
   5.  Circulation.
   6.  Depuration.
   7.  Secretions.
   8.  Internal Exhalations.
   9.  General Absorption.
  10.  Nutrition.

   Such is the physiological history of the  individual; then will
follow that of its reproduction, in which we shall see the result of
a particular act of nutrition, or a prolific  nutrition, produce the re-
appearance of almost all  the phenomena already observed in the
ph)rsiological life of the parents, by which we singularly  facilitate
the study of it and prevent the confusion that would have followed
the mingling of generation with the other phenomena of the living
body.
   Many authors have already separated generation from the other
functions; regarding these  latter as peculiar to the individual, and
the first as  belonging to the species.  I have  not been guided
by the same motive, but  have only been  induced to imitate them,
because it was impossible for me to separate the phenomena of re-
production,  so as to refer  them  to  the different functions that
compose the history of the physiological  life. 
220
                       CHAPTER II.

   OP THE NERVES DESTINED TO  THE ORGANIC  FUNCTIONS

  Anatomists have bestowed the  name of great  sympathetic on
a very complicated nervous apparatus, situated deep in the interior
of the body, and which, in fact, establishes communications between
the  principal organs.   It is composed of a series of ganglions con-
nected together by means of filaments: these ganglions are red-
dish bulgings of tolerable firmness,  in which  we find  gelatine, and
a little fibrine.  Those of the head are almost entirely buried  in
cellular tissue, and are placed beneath the basis  of the  cranium,
or between the bones of the face; those of the trunk are situated on
each side of the spinal column, in lines, from the upper region of the
neck  to the os coccygis.   Besides the communicating filaments
that join them together as in a kind of chaplet, they furnish nu-
merous cords  which proceed to various kinds of organs.  These
cords have nearly the same intimate structure  as the cerebral nerves;
that is to say, a gelatinous tunic, containing very small cylinders in
undetermined numbers: the white  pulpy  matter analogous to that
of the brain is not distinguishable in them; their consistence is very
great, and their colour of a grayish white.
  The ganglionic  cords  may be divided  into three  series: the
first is connected with the nerves of  the encephalic domain, whether
cerebral or spinal,  and passes with them to the muscles and the vis-
cera;  the second  plunges  directly  into  the viscera;  the  third
embraces the arteries and forms a plexus round their tunics, to the
extent of sometimes enclosing them as in a kind of sheath.
  The known ganglions at the base of the cranium and face are,  1.
the  ophthalmic, situated deep in the orbit; 2. the sphenopalatine,
occupying the region of the same name; 3.  the cavernous, placed in
the  sinus of the same name;  4. the nasopalatine, discovered by M.
Cloquet, in the anterior palatine foramen; 5.  the sub-maxillary,  on
a line with the gland of that name.   These  ganglions, in addition
to their communications with each other,  furnish filaments as fol-
lows:  (a) muscular cords to all the nerves which  excite  to
motion the muscles of the  eyes,  internal ear, palatine arch, and
face;  (b) visceral cords, to the  tissue of the eye,  forming the 
230
NERVES OF THE
 ciliary processes, and  lost  in  the iris;  to  the  salivary  glands,
 and to all the regions of the  mucous membrane which lines the
 cavities of the bones of the face; (c) vascular cords to the arterial
 branches,  that convey the blood to all these organs, or which pe-
 netrate into the cranium.
   The ganglions of the neck are to the number of three: the supe-
 rior, the middle, often wanting, (and then the superior extends lower
 down,) and the inferior.   Connected  at first with  each other, as
 well as with the preceding ones, they furnish besides, (d) muscular
 cords  which proceed to all the muscles of the neck, together with
 the cervical nerves,  that have the same destination; and to the mus-
 cles of the os hyoides, tongue, larynx, pharynx, and to the phrenic
 nerves; (e) visceral  cords to the trachea, oesophagus, thyroid gland,
 and  lungs; (f) vascular cords to the arteries of the neck,  the sub-
 clavian, &c. giving  also branches to  the arch of the aorta,  which
 contribute to the cardiac plexus.
   The thoracic  ganglions begin  by  the  one called cardiac; it
 furnishes the anterior and posterior coronary plexuses, which em-
 brace the aorta at its origin, and pass, with some branches  of the
 eighth pair, into the muscular  tissue  of the heart;  it supplies also
 the coronary arteries, the aorta, and the pulmonary artery.  After
 this ganglion, we meet with  twelve other smaller ones, situated on
 each side of the fore part of the head;  they are united by filaments
 of communication never  numerous, and give (g) muscular cords
 to the  dorsal and the intercostal nerves; (A) visceral cords  to the
 pulmonary plexus.  On each side filaments are detached,  which
 meet at the middle  of the dorsal  column  to form  the splanchnic
 nerves destined for  the abdominal viscera: but let us resume the
 subject of  these nerves, in order  to follow their distribution; (i)
 vascular cords, but few in number, to the aorta.
   The lumbar ganglions are  a continuation of the vertebral series:
 sometimes, however, this  is broken at the last thoracic ganglion;
 then the  communication is  continued by means of the splanch-
 nic nerves, which have multiplied connexions with the lumbar and
 sacral  ganglions.   The lumbar are  arranged on both sides of each
 vertebra, as far as the sacro-vertebral articulation, and always com-
municate with  each other in the same manner as the preceding;
they furnish (k)  muscular  branches directly to  the  psoas, and,
by anastomosing with the lumbar nerves of the encephalic domain,
to the other muscles of the loins, and  to those which form the pa- 
organic functions.
231
rietes of the abdomen; (I) visceral branches; some twigs are de-
tached from these to aid in the formation of the hypogastric plexus;
but the splanchnic  nerves which are given off from the vertebral
series in the thoracic cavity, and also in the abdomen, are destined
to supply the principal viscera of this latter; (m) vascular branches,
forming a net-work round the abdominal aorta.
   The sacral ganglions terminate the vertebral series.   Placed on
each side of the inferior surface of the sacrum, these, to the number
of three or four, furnish (n) muscular branches to the pyramidal
muscle, and to the levator ani, either immediately or by anastomos
ing with the sacral nerves of the encephalic domain;  (o) visceral
branches: the internal filaments of the great sympathetic are united
on the sacrum, with the sacral nerves, to form the plexus called
hypogastric, whence go out cords, of  which many pass directly
from  the great sympathetic to  the bladder,  vesiculae seminales,
rectum, uterus, vagina, and anus; (p) vascular branches, surround-
ing all the arteries  which are distributed to the  above mentioned
organs, by cords  that are given out from the same plexus.
   The vertebral series of the great sympathetic  is sometimes ter-
minated by an arch  formed by the union of the  nerves of  both
sides, and at times ends in a ganglion situated near the coccyx.
   Let us now take up  the two cords called great and little splanch-
nic, which are detached from the vertebral series in the chest, to
be distributed to  the viscera of the abdomen, after having passed
through  the diaphragm.
   The great goes to form the semilunar ganglion; the  little is lost
in part in the first, and in part in the renal plexus.
   The semilunar ganglion is situated,  on a level with the coeliac
trunk, on the aorta and the crura of the diaphragm; the two unite
at the median  line, and  form the solar plexus,  reinforced by the
eighth pair. This plexus, made up of an interlacing of nerves, mix-
ed with ganglions, embraces the aorta, the  coeliac trunk, and the
crura of the diaphragm, and gives origin to the following secondary
plexuses.   1.  The sub-diaphragmatic, which embraces the artery
of the diaphragm  and follows it to its  termination, but furnishing
filaments, which are detached, some to plunge into the  muscular
fibres, the  others to unite themselves to the phrenic  nerves; thus
we find here the three usual destinations of the great sympathetic.
3. The coeliac plexus, or inferior prolongation of the solar; it sup- 
232
NEKVJ5S OK  THE
plies the aorta,  the gastric  coronary, and  the hepatic and splenic
arteries: filaments are given off which enter into the pancreas and
the other viscera.   3.  The superior mesenteric plexus, surround-
ing the artery of that name, whence pass filaments to the intestines.
4. The inferior mesenteric plexus, which is distributed like the
preceding.  5. The renal  or emulgent plexus,  which comes  in
part from the solar and coeliac, and from the semilunar ganglion, and
in part from the smaller splanchnic nerve already spoken of; it fol-
lows the arteries, and furnishes filaments directly to the  kidneys.
6. The spermatic plexus, furnished by the two preceding ones; it
follows the arteries: we are unable to say whether filaments are given
off from it, which penetrate directly into the testicles and the ovaria,
but we may, from analogy,  presume such to be the case.
   We have seen that the arteries have their own ganglionic nerves.
which are blended with their tunics, and moreover, that they serve
as conductors for these nerves to pass, either to the muscles, or to
the viscera, which confirms the more the office of the great sym-
pathetic.   It may also be observed, that nowhere is this nerve so
considerable as  in the abdominal  viscera,  which coincides per-
fectly  with the part that was assigned to the digestive organs, when
examining their relations with the brain, and also  with the intellec-
tual faculties and the passions.
   We have hitherto presented anatomical facts; we must  now set
out from them to form an idea of the functions of the great sym-
pathetic.
   It is proved that the nerves coming from the brain are the chan-
nel for the sensations, which from  various parts of the body go to
the centre of perception and volitions; that is to say, the influences
under which this latter determines movements. These two pheno-
mena which constitute innervation are, on final analysis, but modes
of general irritation.   The cords of the great sympathetic are con-
tinuous with the cerebral nerves, and must be considered, like these
latter, as conductors of irritation.   This granted,  it must of neces-
sity follow, that the irritations which are developed in the viscera,
where the great sympathetic predominates,  should be communica-
ted to the cerebral nerves, and by them conducted  to the encephalic
centre.  It is also equally indispensable to  admit that the irrita-
tions,  or  volitions, emanating from the brain, should be carried
into the ganglionic nerves, and penetrate by means of these latter
into the  tissues in which  these  nerves are distributed.   There 
ORGANIC FUNCTIONS.
233
is then reciprocity of stimulation between the encephalic and gan-
glionic  nerves; that is  to say, they  serve  as exciters  of each
•ther.
  Let us next inquire into the differences of excitation considered
in the two orders of nerves.
  In all the  organs in which we find  cerebral nerves only,  it is
observed,  that a stimulus developes a lively sensibility;  but it is
likewise known, that this sensibility does not force the will; it soli-
cits it, and the percipient centre may resist, and refuse  to execute
the acts which it demands: such is the case with the skin, the sub-
jacent tissues, and the locomotive apparatus.   But if the  parts  to
which the cerebral nerves communicate much sensibility, are at the
same time provided with ganglionic nerves, the stimulations therein
developed  are  no longer limited to soliciting the will by pain  or
pleasure; they force it: such are the  expansions of the  external
nerves, and the internal sensitive surfaces or mucous membranes of
the throat, larynx,  bronchia;, stomach, rectum, vagina, neck of the
uterus, &c.   It is then quite natural to attribute sensibility in these
regions to the cerebral nerves,  and the violence done to the will
to the great sympathetic;  in other words, to the stimulation which
this nerve transmits to the brain.
  There is another fact, confirmatory of the preceding.   The tis-
sues,  in which the cerebral nerves either  do not exist at all,  or
are found in very small quantity, but which are abundantly  sup-
plied  with cords  coming from  the  great sympathetic,  evince  no
sensibility in their  ordinary condition;  and yet, they possess the
property of  forcing the brain to have executed the  movements
which they require; and also of influencing thought, and modifying
powerfully the  intellectual  and  affective faculties: such  are the
small intestines, if we except the duodenum,  which has cerebral
nerves and is endowed with sensibility.  The  influence of these
parts  on the  brain being felt without pain,  may quite naturally  be
attributed to  the great sympathetic  nerve alone.  Thus, then, sen-
sibility, on which the intellectual faculties are founded, would be-
long to the cerebral nerves; and the forced movements, which are all
in the domain of instinct, would depend on the  influence of the
ureat  sympathetic.
  So  far the  distinction seems very clear, but  now come the  diffi-
culties.
                                30 
234
NERVES OF  THE
  Sometimes excessive pains, even of the external  parts to which
the great sympathetic does not extend, such as of the skin and the
articulations, determine an involuntary agitation, and may even go
so far as to excite delirium, as I have seen in a most violent case of
arthritis.
  To this I would reply, that all the perceptions being, as I have
proved,  reflected from the  brain to the viscera, the  irritation
caused by an excessive pain must be transmitted to the great sym-
pathetic, and thus arouse all the phenomena of instinct, to which
is reserved  the  privilege of forcibly drawing after it the will.
Nothing, indeed, is more evident than this transmission, since it is
distinctly perceived  by a sensation which is referred to the epigas-
trium, every time that pain or pleasure is carried  to a high degree
of intensity.  It is thus, that  the intellectual faculties are  linked
with the passions; and, in the case before us, it is by means of the
instinct of preservation,  that the stimulation  of the external tis-
sues succeeds in triumphing  over the most marked opposition of
the will.
  A second difficulty would seem to be raised against the distinc-
tion which we have just established.   Percussions exercised upon
the epigastrium,  produce in it a pain, little acute indeed, but yet
extraordinarily painful, and  which we  characterize by  the epi-
thet dull or obtuse; whilst,  on the  other hand, the small intes-
tines, by the effect of stimulation in chronic  phlegmasia; of these
parts,  ultimately cause different kinds of pains, and are even the
seat of real colics. In these cases, is the great sympathetic nerve not
at all affected?  and  can we avoid attributing the  pains to it rather
than to the cords of the eighth pair, which are here met with in such
small proportion? I had at first, on the faith of experiments, admit-
ted that the  great sympathetic is insensible; but  many celebrated
physiologists, among whom is professor Lobstein, grant that it has
sensibility.   Their reflections have suggested to me others, which
I shall now submit to my readers, in the hope  of aiding in the so-
lution of so difficult a question.
  The experiments made on the sensibility of  this nerve in ani-
mals,  have not, I know, furnished any positive  results.  When the
cords or ganglia were irritated, the animal gave  no signs of pain:
granted; but have we a right  to  conclude, that it did not feel dull
or obtuse pains?   Besides, even though it were certain  that  there
existed none in  those irritations of short duration, it  would not 
ORGANIC FUNCTIONS-.
235
thence follow that a chronic irritation was incapable of making if
feel any; no vivisection can demonstrate the contrary; for, in case
the animal were suffered to live after these experiments, the phleg-
masia; that would ensue from its wounds would interest too many
organs, to allow us to distinguish, in the pains thence arising, those
that belong to the great sympathetic; the more so,  as the animal
is destitute of language, by which alone the thing could be explained.
I will go farther; even though it should happen to be a man, in con-
sequence, for example,  of  wounds of the abdomen, operations for
hernia, &c. yet peritonitis, gastritis, and traumatic phlegmasia;, would
be productive of painful sensations, capable of masking those others,
always more obtuse, which might depend on the great sympathetic.
   No experiment sufficing to prove the insensibility of this nerve,
we must then have recourse to  pathology, to determine  to  what
extent it is capable of feeling pain.  As it seems to me to be de-
monstrated, that, in a state of perfect health,  or regular  order of
functions, this nerve is not sensible, I will next lay down the posi-
tion, that it is not any more so in the acute phlegmasia;, at least in
the "manner of the encephalic nerves;  since enterites of the highest
grade, which correspond  to the  adynamic fevers of writers, are
not accompanied by pains of the small intestines,  in which the
great sympathetic predominates.  But I am  of opinion,  that the
general uneasiness, the convulsive pains of the locomotive appara-
tus, and the cephalalgia, are sympathetic, depending on an irritation
of the ganglionic nerves, and I attribute them to the stimulation of
the brain  by these latter; a stimulation which, though  it be not
painful in  the nervous tissue, where is its primary seat, becomes so
the moment after, either to the brain or its membranes, and to the
sensitive, nervous, muscular, and cutaneous expansions, into which
the encephalon  soon reflects them; hence,  in this  instance,  the
great  sympathetic nerve,  without being itself painful, may  cause
pain to be felt in the cerebral nerves.
  Lastly, we have the  chronic phlegmasia; of the small intestines,
which unquestionably present us with the irritations most circum-
scribed to the domain of the great sympathetic.  Accordingly, in a
great number of subjects, they are not painful; they hardly become
so except in temperaments eminently nervous, and especially if they
have been long exasperated by the employment, of stimuli.  Such is
the case in numbers of hypochondriacs,  who have made inordinate
use of those kinds of medicines. 
236
NERVES Ol'  THE
  I wish we could  determine whether the pains m peritonitis
which are so frightful, have not their principal cause in inflamma-
tion of the abdominal ganglions and plexuses. One fact would seem
to negative this supposition; it is  that inflammations of the coats of
the visceral arteries, which are so abundantly supplied with  gan-
glionic cords, do not cause any great pain.  This question  will per-
haps be solved by pathological facts, or by the experiments of the
vivisectors.
  If, to clear up the subject of the sensibility of the great sympa-
thetic, we were  to appeal to the sensations which accompany pow-
erful passions, some light might perhaps be thence derived. Thus,
the epigastrium, to which the  greater number of them are  referred,
receives many cords coming from the eighth pair, whilst the small
intestines,  and also the liver,  which do not give rise to any sensa-
tions during mental emotions, are almost entirely under the domi-
nion of the great sympathetic  We  may remark, also, that the
bladder, the genital organs, the anus, the throat, the bronchia;, to
which we refer  a crowd of sensations  in the affective movements,
are more rich in cerebral nerves than in cords from the great sympa-
thetic.  As to the heart, so abundantly furnished with these latter,
nobody is ignorant of the great obtuseness of its sensibility, and of
inflammation being required to raise it to the grade capable of giv-
ing rise to acute pain.
   It seems to  me as an  inference from all these facts, that the
great sympathetic is not sensible in its natural state, but that it may
become so in a pathological condition, when modified by inflamma-
tion.  In other words,  this nervous  apparatus receives  from the
brain stimulations,  which cease  to produce sensation when they
arrive at  its tissue; it transmits to that organ stimulations which,
though not felt in its own structure, become more or less so at the
moment when they are communicated to the encephalic nerves; but,
the state of  inflammation, especially of the chronic kind, may en-
tirely change this mode of action, so that the individual acquires
the perception of the irritations  of the great sympathetic, and has
the consciousness of numerous internal movements, from which he
is naturally free in the physiological or ordinary state.
   After having discussed the question of the  sensibility of the
 great sympathetic, let us examine that  relating to the movements
 over which it presides. 
ORGANIC FUNCTIONS.
237
  To understand it, we must still take anatomy^and pathology as
points of departure.
  Since cords of this nerve go to muscles, they must necessarily be
cooperative in the movements of the latter.  These muscles are of
two orders: some form a part of the locomotive apparatus, such as the
muscles of respiration, which we have called cephalo-splanchnic;
others belong to the viscera, and ought to be designated under the
term splanchnic.  The great sympathetic must perform the same
functions  in  these two series; and, if it determines  involuntary
movements in the respiratory muscles, it is quite natural to believe
that  it produces them in the heart, and in the muscular coats of the
hollow viscera  As then  we  know of no  other  influence but it,
which can aecount for the association of the cephalo-splanchnic
muscles with the viscera,  in despite of the  will; so likewise we are
inclined to attribute to it the independence  of this same will, which
we observe in the heart and other splanchnic muscles.   In fact, if
we explain the alternate obedience  of the cephalo-splanchnic mus-
cles to the viscera and the will, by the union,  in their tissue, of
the  cerebral and ganglionic nerves, we must attribute the obedience
to the viscera, and  resistance to the percipient  centre, which we
remark  in the splanchnic muscles, to the  great predominance of
the  ganglionic nerves,  that  never allows  these muscles to stop in
spite of the express command of the will.   Such is a  general idea
Of this grand phenomenon; but it is susceptible of certain develop-
ments, indispensable to an explanation  of various shades, observ-
ed in  the natural stimulations- that keep up and modify the action
 of  the splanchnic muscles.
   In the first place, we find that such of the muscles  of this class
 as are attached to a mucous surface, or to one of  relation,  are obe-
 dient  to the stimulation of one or other of  them.  It is thus that, in
 the  stomach and intestines, the irritation of the mucous tissue deter-
 mines the contraction of the muscular parietes;  so  that we may
 say, that this belongs to the order of sensitive  surfaces.   But it  is
 not so with the heart; the membrane which lines it is not organized
 like a mucous one,  nor  is it furnished with papillae; it performs
 no sensitive  function; it has a nearer relationship with the order of
 serous tissues, which are not required to give rise to a  play of sym-
 pathies in a natural state. Whence comes then the stimulation which
 produces the contraction  of the heart?  It was  at  one time attri-
 buted to cerebral innervation; but if it  depended exclusively on 
238
NERVES OF  THE
 this, it would be in the perceptive series, and volition might accele-
 rate the  systole, prolong and prevent it by retaining the organ in
 immobility: now this is what does  not  happen.   The stimulus
 by intellectual  operations,  and all  irritations of the brain, may
 truly  accelerate the  contraction of the heart, but  this  process is
 independent of the will; and it is not in the  power of volition
 to arrest this organ's movements.   It is  in spite of the will that
 the brain, in its excess of innervation, excites the heart; nor even
 then does it disturb it exclusively, nor after  any fixed  intention;
 its action on it is only of a general kind,  such  as that on all  the
 tissues charged  with  organic functions; and when it has darted to-
 wards it a stimulation, this persists during a certain  time in despite
 of its  most express orders.   Were it otherwise, we  would stop the
 palpitations from fear, anger, &c. which never can be done. All that
 the will can accomplish, is to ward off the ideas  that excite the heart,
 and then the palpitations are gradually calmed, owing to their being
 no  longer supported  by  the causes which produced them;  but
 never  do they suddenly cease at  the wish  of the will, as happens
 in the contractions of the muscles purely cephalic.
   The involuntary influence of the  brain upon  the  heart is then
 proved,  in the circumstances of mental excitations, and  extraordi-
 nary organic irritations of the encephalon.   But does it exist with-
 out these conditions? Is it constant, and is it not merely exalted in
 the cases we have just cited? I think we may reply affirmatively
 to this question.   The experiments of Legallois have shown that
 the destruction of the spinal marrow was  followed by a cessation
 of the  heart's action;  pathology proves that the-contractions  of this
 viscus  become  slower in apoplexy, and in  all  compressions  of the
 brain;  even sleep is sufficient  to produce  the same effect.   Still,
 iiowever, this interruption never takes place suddenly;  the priva-
 tion of cerebral influence must be prolonged for a certain time, for
 the heart to cease acting.  When it  is suddenly  extracted from a
 young and vigorous  animal, we see it of itself perform some con-
 tractions, and, when  at rest, it may  be made to  contract for some
 time,  by stimulating  it  with the point  of a scalpel, or by gal-
vanizing it: but  as it participates  with other muscles in this irrita-
bility,  we do not desire  to draw  from this any  particular deduc-
tions;  we will only remark, that  the heart is the most irritable of
all the muscles. 
ORGANIC FUNCTIONS.
239
  The main conclusion at which we ought to stop, is that the action
of the heart is kept up by the influence of the brain; in other words,
that the cephalic nerves communicate to its fibrine the stimulations
which  cause  it to act.  But, on the other hand, as these  stimula-
tions cannot be regulated by the will, we are led  to the  position
that they are governed by the ganglionic nerves.  Hence, then, we
may lay down as  a maxim, that these nerves receive the irritation
from the cerebral ones, and modify it so  as to make it serve for
supporting the functions of the heart.   Still more, these nerves are
destined to subtract continually from the brain the necessary stimu-
lation for this purpose, without waiting for it to undergo extraor-
dinary exaltations of action,  and even when the will would refuse
to furnish them  with the stimulus.   I  see  no other means of
explaining the continued action of the heart,  so necessary to the
preservation of life.   At any rate, the extreme irritability of this
muscle renders  it sensible  to  another stimulus: the approach of
the  blood is sufficient to  excite it, by an impression  communi-
cated to its mass, and without the necessity of an internal sensitive
expansion analogous to what is found in the other hollow viscera.
  At present I think I may assert, that the part filled by the great
sympathetic, in relation to the other muscles in which it predomi-
nates, and which  I also call splanchnic,  cannot be of a different
nature  from that with which it is evidently charged,  in reference
to the heart.   It must then make a continual call of stimulation on
the  brain and spinal marrow, by means of their nerves in commu-
nication with it,  in order to support the irritability of the muscular
coat of the stomach, intestines,  and uterus, so that this coat  may
respond to the irritation of the mucous surface to wrhich it is adhe-
rent.   It is not necessary that  the muscular fibres, stimulated by
the  excitations received by the  mucous tissue, should wait, before
obeying, for the consent of the  will; such tardiness would not suit
the  purpose of nature; but it  is very certain that, whenever the
brain pours its influence in an extraordinary manner into the eighth
pair, and for the same reason into the great sympathetic, the mus-
cular planes  of the viscera  are more promptly obedient to the
stimulations of their  mucous  surfaces.  It is equally  true,  that
when the  brain is compressed,  and the soporose state exists,  the
stimulations of the mucous surfaces bring into  action, writh much
more difficulty, the muscular planevs that are adherent to them. 
240                     NERVES Or THE
   But if the ganglionic nerves of the  splanchnic  muscles borrow
action from the cerebral nerves, they also communicate it to them.
Thus, when a hollow organ is to expel its contents, and meet* on
the part of the sphincters, and cephalic muscles which strengthen
them, a resistance bej^nd the power of its muscular coat to over-
come, this organ calls to its aid, by means of the cerebral nerves,
the respiratory muscles, especially the abdominal ones, and thedia-
phragm, and their efforts being associated  with its own,  it  suc-
ceeds in performing expulsive movements;  as always happens in
vomiting, defecation,  child-bearing, and even in the ejection of
the urine,  when the bladder,  too  distended, is made to evacuate
the fluid by which it is filled.
   This is my conception of the part performed by the muscular
cords of the great sympathetic; that  filled  by the  visceral ones
cannot  be  very different.   In fact, those of them that are not
destined for the muscular coats of the viscera, must associate the
mucous membrane of the latter with the brain; hence the  call of
cerebral nervous  influence for the  prehension of aliments, when
appetite is felt, and for digestion in the gastric passages;  hence the
expectoration for the tracheo-bronchial mucous membrane;  the ex-
citation of movements  necessary to generation, for the sexual or-
gans; hence, in fine, the augmentation of the secretion  of  mucus
under the influences of the passions, for all the membranes of rela-
tion.  I am aware that such connexions may be attributed to the ce-
rebral nerves, which are distributed to the above  membranes; but
I cannot believe that the ganglionic cords are foreign to these phe-
nomena, since we  find  the  same  relations  in the mucous  mem-
oranes of the small intestines,  where the cerebral  nerves  do not
penetrate.   Besides, the  sensibility of all these membranes is so
different from that of the tissues, in which the cerebral nerves alone
are found, that we cannot but attribute it  to the  great sympa-
thetic.
   The cords of this nerve  which plunge into the large secretors
annexed to the hollow  organs, as the salivary gland, the pancreas,
and the liver, must associate the secretion, on one side, with the mu-
cous membrane of the alimentary canal, and, on the other, with the
brain;  and they can only accomplish  it by their communication
with the nerves of the latter.  As to the kidneys, I believe them
to be  associated with the inner membrane of the stomach, with 
ORGANIC FUNCTIONS.
241
that of the bladder, and with the brain; and, as the ganglionic cords
are the only ones  which appear to animate them,  I cannot but see
in them the agents of these sympathies.  If they receive cerebral
filaments, it must  be in a very small proportion, as in  the  case of
the small intestines and of the liver; all which only serves to con-
firm  the  necessity of  ganglionic cords to establish that degree of
vitality observable in the viscera, whose action  is never interrupt-
ed, whose normal or  standard sensibility is necessarily obtuse,
whose sympathies are, notwithstanding, always active, and whose
influence  on the brain is irresistible.
   It remains for me to  treat of the part performed by the vascular
cords of the great  sympathetic.  At times these cords only accom-
pany  the arteries in their course in order to reach some one of the
precedingly mentioned  destinations,  while again they are lost in
the coats of these  vessels.  It is of the latter  that I  now propose
speaking.
   If attention be paid to the scheme of nature, in giving ganglionic
cords to the arteries, we shall see that they are  furnished to these
latter every time that they pass near a ganglion  or a plexus; now,
this proves in my  mind, that those twigs which had been before gi-
ven off, terminated in, that is to say, are blended with, the arterial
coats.   If, in  fact, the only object had been always to pass these
nerves on with the arteries into the capillary tissues,  large  cords
would have  been   given which would have proceeded on without
disappearing until the  point  on which the vessels  had reached
their  place of  destination,  or which would have left them in the
middle of their course.  This  last is the mode adopted, when the
arteries are made use of as conductors to pass on  the nerves into the
viscera and cephalo-splanchnic muscles; but it is not with this view,
that so very many small twigs are blended with the arterial coats. We
may,  I think,  conclude from  this,  that a great number of splanch-
nic nerves are destined  for the coats of the splanchnic arteries; and
as, on the  other hand, we see their place supplied  in the muscular,
cutaneous, osseous, ligamentous, and other non-visceral tissues, by
cerebral nerves,  we are authorised in believing that the arteries of
the visceral  domain participate in  the mode  of sensibility of the
viscera, and  are associated with them sympathetically, in the same
way that the arteries of the cerebral system participate in the sen-
sibility and sympathies of the tissues to which  they are destined,
Still, however, the difference is very great; for  the arteries of the 
242
NERVES OF THL
 external parts  only receive very small nervous filaments,  whilst
 those of the viscera are enveloped in  large  cords  which seem to
 supply them with an additional coat.   This arrangement appears
 to me a very wise one;  for if the nerves  of the arteries, the lo-
 comotive apparatus, &c.  had been as considerable as those of the
 visceral arteries, they would have communicated to  them too much
 sensibility;  but as this property is very obscure in the nerves of
 the viscera, they may abound in the tunics of their arteries with-
 out rendering them too susceptible of lively sensations.
    Be this as it may, we see from  the above  observation, that the
 arteries cannot be entirely strangers to the sympathetic phenome-
 na, which may take place in the tissues to which they  carry
 blood.
    If,  on the other hand, we  reflect that the veins and  lymphatic
 vessels, in a word, the  entire centripetal vascular apparatus, does
 not receive any cords from the great sympathetic, we must admit,
 that the arterial or centrifugal vessels have a vital action  somewhat
 different.   But is it then impossible to explain this difference?  J
 do not know that this question has been  ever  deeply  examined,
 and it is that which induces me to engage in it.
   The middle  coat of the arteries, which  is composed  of circular
 yellow elastic  fibre,  is one  of the strongest  tissues in  the  body.
 Vested with the office of resisting the impetus of the  column ol
 blood which the heart at each instant propels into the vessels, and
 of reacting against this fluid, it has, I should think, need of a con-
 siderable nervous influx; for I cannot believe that it only owes its
 resistance and power of reaction to a purely physical elasticity. I
 imagine, that, analogous to the muscles by its structure and compo-
 sition, it ought  like them to participate in innervation, and  that
 such is the  end for which nature  has placed it in communication
 with the  torrent of nervous influx, or, if you will, of vital electri-
 city, which  incessantly circulates in the  living  body.   I propose
 this explanation until a better be found.   Experimenters may per-
 haps confirm or refute it, by destroying the nerves which envelop
 the arteries.  No doubt that, deprived of their plexus, they would
 undergo some changes, were it only by the loss of a physical sup-
port so powerful as this kind of nervous sheath.   But who knows
 what would be  observed? We ought at the same time to destroy
the nerves of relation that go to the arteries of the limbs,  and
which, much less numerous than the visceral  ones,  cannot be re- 
ORGANIC FUNCTIONS
243
garded as fit to furnish  them with  a  coat for reinforcement; we
should then see whether both sets would inflame, dilate, or contract.
I am not aware that such experiments  have been attempted; if any
arc on  record, the learned will not fail to make us acquainted  with
them, and perhaps science will thereby gain  something.
  Whence comes it that the arteries placed in a part inflamed are
enlarged, acquire more  thickness  and force in their tunics, and
give more energetic pulsations, during the  whole period of the
phlegmasia,  and resume their ordinary movements when it is dis-
sipated?  Does not this fact which cannot be attributed to the im-
pulsion of the heart, seem to prove that the  arteries participate in
all the  irritations of the organs in which they are situated, and that
consequently they receive their,share of the innervation?  And can
we conceive their having  such  relations, without admitting the
nerves to be the means? Do not we also see the arteries of a  part,
which  receives  the  sympathetic influence of a phlogosed tissue,
more or less remote, become developed under the irritation of this
latter?  Does not this sympathy, which I call organic, seem to prove
that the arteries communicate irritation reciprocally to each other?
And ought we to  seek  for  the cause of this reciprocal  influence
elsewhere,  than  in  the  nerves that,  penetrate   and form  around
them an uninterrupted chain from  the  heart to the point where
these vessels are lost in the animal matter which is not vascular?
  The great sympathetic nerve continues through the ganglions.
Do these small reddish  parenchyma; secrete a fluid destined to
traverse  the nervous cords, as means of sensation and movement,
or as nutritive matter? Have they rather the office of interrupting
and altering  the  innervation coming  from  the  brain,  or directed
towards it? Are they centres in which first converge, for the purpose
of being afterwards reflected from one viscus to another indepen-
dently of the brain, the  irritations which traverse the splanchnic
nerves? These questions are not resolvable  by  direct experiment;
they are only more or less probable.   Still, however, their obscuri-
ty does not seem to me to interdict all general explanations of the
functions of the great sympathetic.  I believe that we  may suc-
ceed by the way of reasoning, especially in employing the method
of exclusion,  to assign  to it an order  of relations which cannot
depend on the  cerebral nerves.   I will endeavour to  do this, in
taking as a basis what has  been said of the  different cords of the
splanchnic. 
244
NERVES OF  THE
  The great sympathetic or trisplanchnic nerve, is, as these terms
indicate, charged with the office of associating the viscera of the
three great cavities with each other.  It has been said that it presides
over nutrition: this proposition merits an explanation.   It is not by
giving to the tissues the faculty of assimilating, of transforming the
mobile animal matter in the secretors, of  applying it to the tissues
in solidifying it, nor by  expelling  the  molecules which can no
longer constitute a part of them, that it presides over the internal
life.   These operations are of another order; they belong to the
primitive vital  power, and form a part  of that vital  chemistry,
which is not this power  but its  first sign and effect   So true is
what I now advance, that it  is  this power itself which forms and
supports the great sympathetic: now it would be absurd to attribute
to this  nerve,  that  by which itself exists;  besides, comparative
anatomy proves that this power has no need of its ministry, since
life is evident  in its phenomena of composition,  decomposition
&c.  in  the zoophytes which  are destitute  of nerves; and since
the parts of animals furnished with-nerves, which  do not receive
cords cf the great  sympathetic,  such as the limbs, do not the less
enjoy life.   It  is then as regulator of the  movements  destined to
send the mobile animal matter to the tissues which are to make use
of it, that the.great sympathetic  presides over nutrition; and this
function is  participated in by the cerebral nerves.  Let  us  give
more development to this last proposition.
  The encephalic nerves establish relations  with external bodies,
and preside over the grander movements, as those of the muscular
masses for locomotion.  The great sympathetic establishes, in the
interior of the body, relations between the  viscera, and regulate*
their particular movements.  For the exercise of  this function, it
borrows stimulation from the  encephalon, and transmits some to it
at need.  Let us prove this by some details.
  The great sympathetic  receives  stimulation from the cerebral
nerves, which are themselves indebted for it to the action of exter-
nal bodies, and makes use of it to bring into play the cephalo-
splanchnic  and  splanchnic muscles, and the coats of the arteries.
A  it is not subject to intermission of action, it does not allow it in
these two  last  orders of tissues,  in which  it is predominant.  It
tolerates it in the cephalo-splanchnic muscles,  because the cerebral
nerves are there in union with it; but it forces them to action when 
                     ORGANIC FUNCTIONS.                  245

the wants of the viscera, of which it is the prime minister, impe-
riously require it  The muscles that do not receive cords from the
trisplanchnic are the only ones which can enjoy a complete repose;
and  during this state they, together with the other tissues that
surround them, have no other movements,—-except those of circula-
tion, which comes from the heart, and  consequently of the great
sympathetic; they have, I  say, no  other movements but those of
exhalation, absorption, composition, and decomposition, which de-
pend either on contractility or vital chemistry, and by no means on
the nerve of which we are now treating.  It is then always the
action  of the muscles,  including the heart,  that it renders per-
manent in  the viscera.  If  it suffered them to  rest, life could not
subsist, notwithstanding  the continuance of contractility and vital
chemistry, because the materials could  no longer be subjected to
this latter.
   On the other hand, the great sympathetic  receives the stimula-
tion of the tissues  in which it is found,  and transmits it to the
encephalon, by the cerebral  nerves, with which it is in contact.
For example, there supervenes, in a point of these tissues, vital erec-
tions,  such as exaltation of  muscular movement, or  a local exagge-
ration of capillary circulation, of the transformation of free matter,
of calorification, &c. Well, the great sympathetic gives rise in  the
encephalon to  another stimulation, tending to provoke the move-
ments necessary for the restoration of the deranged equilibrium.
More frequently these local irritations of the tissues placed in  the
domain of the great sympathetic, are not accompanied by pain; but
that does not prevent the nerve from obtaining from the brain  the
necessary acts.  At other times pain or pleasure is experienced;
then the great sympathetic acts with still more energy on the brain,
and more efficaciously forces the will.
   It will be seen,  that I here  indicate  the phenomena of instinct
It is thus that the wants, which all depend on  an  irritation of a
viscus with vital erection, and that local irritations, when becoming
causes of hysteric and epileptic fits, &c. act on the encephalon; and
assuredly,  if the irritated tissues had no other means of communi-
cation than the nerves of relation to make themselves obeyed by
this apparatus, they  would  not succeed in a constant manner,  the
will preserving the  power of resisting them:  consequently, each
time that nature desires to  oblige the encephalon to  make the loco-
motive apparatus  act, it must avail of the agency of these same 
246
NERVES OP THE
 splanchnic nerves, which are never at rest, and which thereby be-
 come the preservers of life..
   Not only can the nerves of the great sympathetic make the brain
 execute certain muscular movements, but they likewise determine
 a mode of action which produces a determined series of ideas, and
 thus make the judgment as well as the will  incline favourably to
 the exercise of the functions.   It is  by this influence that they
 cause a liking or hatred for external objects, and even the same acts
 alternately, according to the  mode of irritation prevailing  in the
 tissues in which they predominate, at the moment when the cere-
 bral nerves transmit to them the impressions which these objects
 have made on the surfaces of relation.   I expressed this fact in a
 general manner, when, in the  history of the phenomena of relation,
 I said that the centre of perception did not judge of the impressions
 of external bodies until after having obtained  the advice of the vis-
 cera.   As to the causes  of the difference of these  advices,  they
 are nothing more  than  the  eternal relations established in nature
 among the bodies which compose it; relations which, as I have said?
 take place long before man, the only being that can perceive them,
 has any consciousness of their existence.
   When the organic irritations of the viscera  are intense and obsti-
 nate, the centre of perception  is  so modified by the splanchnic
 nerves which transmit them, that  reason is lost and the man be-
 comes insane.   I have given  examples enough of this to dispense  I
 with my recurring to them.   If it be objected that the brain is then
 always diseased, I reply, that it is only so by the irritation that it
 receives from the nerves; an irritation which, during a certain time,
 may yield together with that  of the visceral tissues that produced
 it, but which, at the expiration of this period, always difficult to
 fix, becomes idiopathic in the encephalon, and then  often  incura-
 ble.   These facts, though well  attested,  do not prevent insanity
 from depending on a primitive irritation  of this organ; for there
 is no tissue in the animal economy which  may not be both primi-
 tively and secondarily irritated.
  The functions which we have hitherto assigned to the great sym-
pathetic,  are then, 1.  to  subtract irritation from the brain for the
use of the muscles which are in the  service of the viscera; 2. to
transmit to this organ the irritation of the viscera, in order to 9btain
the movements necessary for the  gratification of their wants; 3. to
render the muscular movements  of the viscera independent of the 
ORGANIC FUNCTIONS.
247
 will.   Let us next inquire whether sleep be a necessary conse-
 quence of this triple action.
   If the great sympathetic has the privilege  of  setting bounds to
 the exhaustion of vital powers or the means of action in the animal
 economy, whenever such exhaustions would compromise the integ-
 rity of the functions, it must be vested  with the office of bringing
 on sleep.  Now, have we not seen, 1. that this nerve obliges the
 will to leave the cephalo-splanchnic muscles at the disposal of the
 viscera? 2. that  it  forced the judgment to consider in a determi-
 nate manner the external objects necessary for the  performance of
 the visceral functions?  3. that it determined  as well the  cessation
 of the acts indispensable to the gratification of the wants, as the per-
 formance of these same  acts?   Since, then,  it can cause the indi-
 vidual to cease  from the  prehension of aliment when the appetite
 is satiated, and from exercise when fatigue is  produced, why may
 it not cause sleep?   It will, perhaps, be replied, that the feeling of
 fatigue which follows too long continued muscular action, is a phe-
 nomenon of relation;—granted: but fatigue is  followed by cerebral
 engorgement; and this latter I attribute to the great sympathetic,
 because it depends on a modification of the viscera.  In  fact, this
 modification acknowledges  as  a cause the painful  sensation of fa-
 tigue;  now,  this sensation is reflected, like all the others,  into the
 viscera; the great sympathetic is, of course, affected; it reacts then
 On the brain, and to its influence is owing the engorgement of this
 organ, which produces the impossibility of innervation of the loco-
 motive muscles, and finally sleep.
   What,  indeed, could  limit this extravagant exhaustion of the
 powers of life, if there did not supervene a modification of the brain,
 which  should render it impossible?  And how conceive this modi-
 fication to be different from that which obliges the brain to suspend
 muscular action, when so exacted by other wants; that  is to say,
 how conceive it independent of the great sympathetic?
   In the instances of excessive irritation of the encephalon, it will
 be objected, that the want of sleep is not felt; such as in arachni-
 tes, insanities, violent fits of passion, &c.   It  is because  the  great
 sympathetic has then lost its influence.   But  why has it lost it, it
 not because the encephalon has abstracted from it the degree of ac-
 tion whicli it ought  to have?   Here the natural order is manifestly
inverted;  but on reflection we shall find,  that this state of exaspe-
rated watching would be an habitual one, if there did not exist souir 
24S
NERVES OF THE
very potent power to prevent it.  What could,  without that dete*.
mine man to renounce the enjoyment of the waking state, which
the cerebral nerves,  much  more sensible than the great sympa.
thetic, render so lively and seducing?   Would it be reason?   This,
alas! is too powerless: he should always, then, have recourse to
the aid of education and reasoning to determine him to take repose.
Nature could not place reliance on  such means:  besides, animals
which are deprived of reason are still under the dominion of sleep.
I think, then, that in placeof weakening our proposition, the wake-
fulness of which I spoke only serves to corroborate it, and proves,
manifestly,  that a great power is required to circumscribe vital ac-
tion in  limits necessary to its  preservation: this power,  in mj
opinion, can only be confided to the nervous apparatus, that is to
say, the  great sympathetic, which, in other circumstances, is mani-
festly entrusted with regulating the action of the viscera.
  I have reasserted, that the immobility necessary for sleep, was
the product of cerebral engorgement: would it be going too far to
attribute it to the cords of the  great sympathetic, which penetrate
the cerebral substance with the arteries?  It seems to me, that these
nerves, taking on at this time excess of action, must draw the blood
towards  the capillaries of the brain; and from  this  congestion re-
sults at the  same time the repose of the  locomotive muscles, and
the augmented action of the orbicularis of the eyelids, the office of
which is to withdraw the eye from the stimulating impression of
the light.   One would be at first tempted to believe, that  all the
other cephalo-splanchnic muscles undergo at the same time  a dimi-
nution of energy; but, when we reflect that the lungs are engorged
together with the encephalon, we are inclined to admit that all the
visceral  arteries which  are furnished with ganglionic cords might
very well participate in  the modification of those of the brain; in
which case we must explain  the great  efforts of the  inspiratory
muscles, manifest in the first moments of sleep, by the compression
of  the bronchial  vessels, produced  by sanguineous congestion.
which diminishes the respiratory surface,  and necessitates an in-
crease of innervation on the part of the brain of the muscles. Not-
withstanding this observation, I still continue in the  belief, that
the assimilating power is not augmented in sleep, because experi-
ence does not seem to me to warrant it. The partisans of the oppo-
site opinion may say, that, if the blood abounds  in the  viscera
during sleep, it ought toaid the vital chemistry; but I would reply 
ORGANIC FUNCTIONS.
249
to them, that assimilation being always in a direct ratio to the waste,
it cannot but lose its energy in a state  which, like that of sleep,
singularly diminishes the loss of the substance of the animal econo-
my. Be this as it may, I examine facts with the intention of throw-
ing light on the obscure points in physiology; and whatever be the
opinion which  my readers may adopt, I shall always be flattered
at having furnished them with the means of arriving at the truth,
even though their conclusions should be at variance with my own.
We must ever distinguish the probable from the demonstrated; but
I still think that the study of the former ought  not to be neglected,
since it may lead, and has led, in fact, frequently to the latter.
   I have also said, in the study of the  functions of relation, that
the kind of engorgement or turgescence of the  brain and  other
viscera, which brings on sleep, was accompanied by a sensation of
languor, the pleasure  of which is not well appreciated  until the
want of sleep has been opposed. It is referred to the muscles, and
to the locomotive apparatus; but I  think that it is sympathetic, and
that it has its true seat in the engorged viscera,  and above all in the
encephalon and sub-diaphragmatic region, in which are found the
most voluminous plexuses and ganglions of the great sympathetic.
   Here, then, are the functions of the three orders of cords of this
important nerve, explained at the same time with those of the entire
nerve: 1. the cords  of the  cephalo-splanchnic muscles withdraw
these latter from the will, to make them obedient to the viscera; 2.
the visceral cords regulate  the movements of the heart, and the
muscular parietes of the hollow viscera; 3. the vascular cords give
power to the arteries, and invite more or less blood into their rami-
fications, according as the functions require it.  By their presence
in all the visceral arteries, they explain the redness of  the tongue,
eyes, &c. consecutive on gastritis; the injection  and  heat of the
skin of the trunk which  covers the inflamed viscera; the augmen-
tation of the secretion of bile, and of saliva, in gastritis and inflamma-
tion of the gums, &c: and by them we have accounted for sleep.  In
fine, the union or entire series of these nerves, as a result from what
has been advanced,  1. establishes the independence of the internal
movements as regards the will; 2.  forces the brain to lend its action
to the viscera; 3. to receive from  these  latter the excess of irrita-
tion which torments them; and 4. to suspend the exhaustion of vital
powers, so soon as it is converted to the detriment of the individual
                              32 
250
RESPIRATION.
  The nerves of relation perform in the tissues to which they alone
are distributed, as in the limbs, the same functions with  the great
sympathetic in the viscera.   I mean to say, that they associate the
muscles with each other, and with  the brain, and establish sympa-
thies among the arteries, considered in their reciprocal relations,
and in those that unite them  to the  tissues into  which  they enter.
But these nerves are different from the splanchnic in being able to
bring the muscles into action only  by the consent of the  will; and
whenever they establish sympathies between the arteries and the
tissues, the brain is apprized of it by pain.  Finally, when irrita-
tion is raised in these parts,  to the extent of forcing the will, it is
on account of its being very  painful; and then, as it is reflected by
the brain  into  the viscera, we must needs believe that the great
sympathetic lends its influence to obtain this result.
                       CHAPTER III.

                       Op respiration.

  This is one of the principal functions of the living body; its object
is to furnish  the animal with the oxygen of the air, of which it is
continually in want.  In the lowest order of animals, the exterior
of the body is sufficient for this vital process; it is perforated with
numerous openings which are the mouths of so many canals called
tracheae,  by which the air is introduced down to the interior of the
vessels.  Fishes are provided with  a membranous apparatus, sup-
ported by cartilages having a parallel arrangement,  and which are
ealled gills.   It is situated at the basis of the cranium, and is co-
vered with moveable opercula which the fish raise at will, in order
to place the water in apposition with their gills, and especially with
their mucous membrane, by which the air  contained in the water
is absorbed, or the oxygen  gas extracted by the  decomposition of
this  fluid.  But all these are cold-blooded animals.  When nature
designs the blood to be warm, she first places the circulatory appa-
ratus in the interior of the body.   But even that is not sufficient;
for some of the reptiles, as the  batracians,  the lungs of which are
internal,  are likewise cold-blooded;  this comes from their respira- 
RESPIRATION.
251
 tory surface, though internal, having but little extent, being limited
 to some vesicles, and receiving few sanguineous vessels.   It is not
 so with warm-blooded animals; their respiratory surface is not only
 placed in the centre of the  body, but is also of such  great  extent
 as perhaps to  surpass that  of  all the other membranes, and  it is,
 moreover, traversed by the entire mass of the blood.   It was then
 necessary that it should be folded on itself, as we find in  the mem-
 brane  of the digestive tube, and in  the  cerebral expansions which
 are folded and reflected on the same plan. Let us see how the Author
 of nature has proceeded in his supreme wisdom, to make the extent
 of the respiratory  membrane consistent with its circumscribed vo-
 lume in the human species.

 Section I.—A summary Description  of the Respiratory Appa*
                            ratus.

   The lungs, which constitute the  principal portion of this appa-
 ratus,  fill almost the entire cavity of the thorax, the form of which
 necessarily determines theirs; they appear to us  as two irregular
 cones, the  summit of which is placed  beneath  the clavicles and
 scapula, and the base, rounded off at the  expense of its inferior
 surface,  rests upon the diaphragm.    A  space  is contrived on
 the right side to make room for the heart; hence the lobe on this
 side  is divided into two lobuli, whilst  that on the right presents
 three.   These lobuli are separated by transverse fissures,  which do
 not penetrate to such a depth as to  interrupt the  continuity of the
 organ.
   To have a physiological idea of the structure of the lungs,  our
 attention must first be fixed on the trachea, to the inferior extremity
 of which they are attached like two berries on one stem.
  The trachea,  which forms  the scaffolding of the  lungs, may, with
 its bronchia;, and their expansions, be considered as a hollow tree,
 the trunk of which, beginning at the  larynx, terminates at the
 lower part  of the  neck,  to  be divided into two branches called
 bronchia;.  Each of these passes into one of the two thoracic cavi-
 ties,  and divides soon into branches, which are themselves subdi-
vided into twigs, that are spread in  every direction, and form very
delicate canals,  which are terminated by small membranous cavities
called bronchial vesicles.  Such, if I may  so  express myself, i«
the skeleton of the lungs;  let us examine their structure. 
255
RESPIRATION.
  The trachea is formed at its upper part, called larynx, of carttli- , |
ginous pieces, moveable on each other by means of small articular
surfaces, and set in motion by a certain number of muscles; its upper   i
opening, called glottis,  corresponds to the posterior nares, and is *#
capped by a cartilaginous piece, called epiglottis, which is always
raised to give passage to the air,  when a superior power does not
determine its descent.  In the remainder of its  extent, the trachea
is composed of cartilaginous circles, interrupted at the posterior
part.   A fibrous tissue  furnished  with muscular fibres, observed
by  the  anatomist  Reissessen,  unites  these  cartilages that  keep
the trachea always open, and fills the interval which they leave on
the posterior portion of this canal; it is this tissue which gives
them mobility;  it alone forms the bronchia;, in which it becomes
more elastic in order to keep the  cavity always open,  and  supply
the want  of cartilaginous rings.   This fibrous  membrane  is con-
tinued into the bronchial vesicles, where it still enjoys elasticity,
and even contractility; but it would not be sufficient to keep them
open, if  the air  that filled them  were  wanting, or if  the  surfacp
of the lungs could forsake the parietes of the thorax.                Jj
  The interior of the tracheo-bronchial tree is lined by a membrane j
of relation of the mucous  kind;  it is continuous with  that of the  |
mouth; for the latter, after having lined the internal ear, the nasal 7 J
fossae, the canal of this  name,  and  the oculo-palpebral  surfac^vS
passes into the trunk to clothe the interior of the parietes of the -jm
respiratory and digestive organs.                                  J
  It is around this hollow and complex tree that are  grouped and
distributed all the other tissues which  constitute the lungs.  The ■
principal is the sanguineous vascular, which is double; for the bron-
chial tree receives  for  its nourishment, and the secretion of its
mucus, arteries, that convey to  it red blood; then come  the pul-
monary arteries, which, immediately after their leaving the base of
the right ventricle,  penetrate into the parenchyma of the lungs, ac-
company the ramifications of the  air cells, and, having become ca- • ^
pillary, are so divided as to form  a net-work around the bronchial
vesicles.   These capillary arteries then  change into capillary veins,
according to the opinion of some  anatomists,  and these again into
veins of an always increasing calibre, ending at  last in the trunks of
the pulmonary veins, which deposit the blood that had, during this
course, become red, in the left auricle, in order for it to penetrate into 
RESPIRATION.
253
th« ventricle of the same side, and to enter into the current of the
aortic circulation.
  To the vascular tissue is affixed, as an appendix, the lymphatic.
It is composed of ganglions, situated chiefly around the bronchial
ramifications, and of lymphatic vessels,  which, after  having ab-
sorbed the  fluids from all the surfaces, as also from the interior of
the tissues of the lungs, go to the ganglions, traverse them, reunite,
anastomose, become larger and less numerous, and finally termi-
nate in the  left subclavian vein.
  The nervous tissue of the lungs is of two kinds in them, as in all
the other viscera.  The eighth pair,  which descends from the
cranium, furnishes first to the larynx of each side a branch,  called
recurrent; it then accompanies the trachea  and the bronchiae, to
the membrane of both of which it is principally destined,  but it
gives branches to the cardiac  pulmonic plexuses,  which  are  in a
great measure formed by the great sympathetic.   This latter espe-
cially abounds round the pulmonary arteries, as well of dark as of
red blood,  and thus forms the  second order of the nervous appa-
ratus of the lungs.
  All these tissues are united and joined together, and, it may be
said, separated from each other, by the cellular, which fills up all
the interstices between them.   This tissue, the areola; of which
are moistened  by a lymphatic dew or vapour of the greatest tenui-
ty,  facilitates the movements of expansion and condensation, which
are very considerable in the parenchyma of  the lungs; and  never
does it contain fat; which proves, as thought by professor Beclard,
that the  cells  secreting this fluid, have not  the same organization
with those destined for the lymphatic exhalation.
  This complex apparatus is enclosed in a diaphranous membrane,
of the class called serous by Bichat;  it is, like the  lobes of the
lungs, double.   We may represent it to ourselves as two sacs with-
out openings,  which  are spread out on one  side over the external
surface of the lungs, penetrating into  the fissures, and on the other
over the internal side  of the thoracic cavity, comprising a portion
of the diaphragm and  of the pericardium.   The apposition of each
pleura to the root of the lungs, above and beneath these organs,
leaves a space called the mediastinum,  which contains cellular tis-
sue, the origin of the bronchiae, and a part of the large vessels of
the thorax.   The internal surface of these pleuras is throughout. 
254
RESPIRATION.
 continuous; and  the  lymphatic vapour  that it  exhales  facilitates
 the gliding of the lungs on the parietes in which they arc enclosed. #^
   Such are the lungs,  the principal organ of the respiratory appa*
 ratus.   The remainder of it is composed of bones, viz. the dorsal
 vertebrae, the ribs,  and the sternum; next the intercostal and ab-
 dominal muscles and  the diaphragm, the relations of which we
 have studied when designating them  under the title of cephalo-
 splanchnic.  Let us next examine the action of this complex ap-
 paratus, which plays so important a part  in the preservation of the
 life of the individual.

 Section II.—Action  of the Respiratory  Apparatus in gene-
                              ral.
   Three grand functions  are performed by the respiratory appara-
 tus; aeration of the blood, pulmonary exhalation, and production
 ©f sounds; this last, modified by the intellect,  produces in man  |
 speech, singing, laughing, &c.
   The aeration of  the blood, the first and most important of the
 three,  is common to all  animals furnished with a respiratory ap- 'Jtf
 paratus.  Exhalation  seems to be inseparable  from it,  and may 9
 be studied  in a two-fold  point of view; as a means of  depuration,  A
 and as a channel  for the  elimination of  the  superfluous serosity.
 Aeration and pulmonary  exhalation belong to the internal functions.
 I shall here only examine the  first, withholding the other to the ■■''
 history  of the excretions  which shall be compared with each other.
 Voice  and speech  belong to the functions of relation:  they must
 then be the first treated of in this chapter, as being a continuation
 of the functions of relation, of which I have before spoken, and as
 modifications of  the mechanism that presides over the aeration
 of the blood.  Each of these functions may,  by its lesion, become
 a cause of disease; but I shall  restrict myself to speaking of the de-
 rangements of aeration and of the productions  of sounds,  for it
 seems to me, that the disorders of the  pulmonary exhalation require
 to be treated of in connexion  with those of the other excretions.

   Section III.—Of the Aeration of the Blood in the Lungs.
  If we  desire to proceed methodically in this study, we must first
fix our attention on the internal sense in which resides the demand
for respiration; now this  sense is placed  in the  tracheo-bronchial
mucous membrane, and all the rest of the respiratory apparatus only 
RESPIRATION.
255
act* in virtue of the impulsions coming from it.   Let us develope
this proposition.
  Vainly would we refuse a determinate seat to the want to breathe,
or vaguely locate it in the nervous apparatus or in the brain.   It is
the   mucous  surface  which  receives  the air,  decomposes,  and
absorbs it in whole or in part; it  is it then which must  apprize
the  centre of perception of the existence of the want,  must ex-
cite  the  necessary  movements to gratify it, in a manner similar
to that in which the mucous  surface of the stomach causes us to
feel the want of aliment,  the  same surface of the large  intestines
the  desire for defecation, that of the bladder the want of  urinary
excretion, that of the genital  organs the want of coition,  parturi-
tion, &c.  A peculiar pain  known by the term uneasiness, is the
first signal of the want of air.   This uneasiness is not slow in pro-
ducing a general irritation of the viscera; and, as the nerves presi-
ding over their action are most abundant in the epigastric region,
in it does this irritation always acquire most intensity.   Whatever
be the reason of  this fact, it is incontestable, for all persons who
are  tormented by dyspnoea refer their anguish to the epigastrium,
as if the numerous ganglions there  met with were the rendezvous
of the painful sensations that assail it.

Section IV.—Mechanism  of Respiration, or the Aeration  of
                           the Blood.

  The desire to breathe produces an appeal to the brain by mean.-*
of the eighth pair of nerves*or the pneumo-gastric,  and the  brain
calls  into action the inspiratory muscles destined to enlarge the
cavity of the chest.  We  are told that the section of the nerves of
the  eighth pair, practised in  the neck, does not prevent the dilata-
tion  of the chest; but it is well to  remember that this nerve com-
municates with other cerebral ones.  These communications take
place, in the first instance, in the cervical region; moreover there
are   found, in the  pulmonic plexus, cords  of the  great  sympa-
thetic, and these are continuous with others that  have connexion
with the spinal marrow.   It is then impossible to prevent the irri-
tations developed in the sensitive expansions of the pneumo-gastric
from reaching the brain.
  The principal inspiratory  muscles are the intercostals and ser-
rati, which elevate the ribs,  and the diaphragm which, by contract- 
.256
RESPIRATION.
 ing,  pushes down the abdominal viscera; hence  the expansion of
 the pectoral cavity.   Whilst  this is going on, the abdominal muv
 cles are in a state of inaction, in order that they may not be opposed
 to the depression of the viscera in their cavity.   It  is sufficient
 that one of the two movements above indicated takes place, to pro-
 duce this enlargement;  and instinct chooses one  or the other, or
 avails of both, according to  the state  of the muscles which are to
 act, or the viscera which are to  undergo functions during inspira-
 tion.  Thus, if the intercostals, or the lungs of one side,  are  pain-
 ful, instinct leaves them at rest, and is content to act on the oppo-
 site side.  If both are in a state of suffering, instinctonly calls into
 play the diaphragm.   If this muscle, and the pleura and the perito-
 neum which line it, the stomach, liver, &c. cannot be moved with«
 out causing pain, instinct forcibly raises the superior ribs;  finally,
 if inflammation has excited the sensibility of all  these  parts,  at
 well as of the abdominal muscles, the dilatation of the chest is in* 1
 perfect,  and accompanied with the greatest anguish, both  on ac- J
 count of the pain of the affected parts, and of the incompletenejp M
 of the aeration.                                               *■■
   The expansion  of the thoracic cavity leads to the supposition,
 that  a fluid  may penetrate into the bronchiae and  bronchial cells;
 this fluid is ordinarily the air.   If the body were plunged into a  1
 liquid of greater density, such as water, this would be introduced  I
 to the respiratory surfaces,  as happens in submersion; but aeration  I
 would not take place.
   The larynx,  trachea, bronchia;,  and their vesicles,  are  then
 purely passive in  inspiration; they allow themselves to  be pene-
 trated or distended  by air, which thus enlarges the parenchyma;
 of  the lungs, and  obliges  it to  follow the  osseous and  muscular
 case in its  recession.   So  soon  as the  inspiratory muscles have
 acted, they are relaxed, and the abdominal ones, which  are their
 antagonists, and consequently expiratory, depress the costal appara-
 tus, and thrust up the viscera of the abdomen under the diaphragm,
 which, in its turn, is relaxed and rises into the cavity of the chest:
after this, all the respiratory muscles are at rest, until a new sensa-
tion of the want of air determines the encephalon to put them into  \
action.   But let us examine into what takes place in the pulmonary
parenchyma during inspiration.   At the same time that the thora-
cic cavity is diminished, the lungs are necessarily  condensed;  and
this must be accomplished in a regular and uniform  manner;—we 
RESPIRATION.
257
are then obliged to admit that all the bronchial vesicles are endowed
with a contractile power, in virtue of which  each of them retires
on itself, expelling at the same time a part of its contained air: I
say a part, for they cannot be entirely emptied.   The retraction of
the thoracic parietes is, in fact, limited by the  bones which  form
its  basis.   So soon as this  has reached its limits, the  pulmonary
vesicles cease to contract, for the very simple reason that the paren-
chyma cannot leave the parietes of the chest; this is the only cause
of the limited condensation of the vesicles.  If, consequently, there
be little blood in the lungs, the vesicles  are much distended after
expiration; whilst, on the other hand, they would contract to the
extent of being almost  entirely emptied,  if the  lungs were in a de-
cidedly plethoric state,  as happens when this viscus is inflamed, or
whenever, by an  obstacle to the course  of the blood, this  fluid is
retained in abundance in their tissue.   On such occasions, the de-
sire to breathe will be renewed, and we shall find instinct multiply
the efforts of the  common  inspiratory muscles, and  associate with
tliem those  of the muscles of the arm,  scapula, neck,  and head,
which have a point of insertion on the cavity of the  thorax.   We
see then that the quantity of air found in the pulmonary parenchy-
ma is always in an inverse  ratio to that of the blood  traversing it,
or of the  fluids effused in  the two cavities of the pleura.

Section V.—Modifications of the Mechanism of Respiration)

  These consist invoice and speech, singing, sighs and sobs, laugh-
ing, coughing, and sneezing.  The time to treat of  these  pheno-
mena is when we have  before us the regular movements of respira-
tion, or normal respiration.
  Voice, speech,  singing, and  hissing, are modifications of expira-
tion.  In place of the air issuing out freely, we retain it in the
larynx, compress  it, force it to vibrate the different pieces  com-
posing the larynx, which are  then  more or less tense, constricted
or enlarged, by the divers actions of the muscles of this small appa-
ratus: in the mouth, the expired air by means of volition undergoes
like modifications, and  we  cause it to be driven out  in varying
volume, with more or less slowness or  rapidity, in  order to pro-
nounce  letters, and  syllables: this is the product of  education.
Physiologists have at present nearly a complete knowledge of the
                              33 
!i&                      respiration.

mechanism of the production of sounds.   It has been  proved th.d
the voice  is formed  in  the space comprised  between  the  thyro-
arytenoid  ligaments and the glottis.   If we make an opening in the
trachea, or in the  crico-thyroidean membrane, the voice  is lost,
and, if this  opening be  obliterated, it is restored.  An incision
made between the thyroid and the os hyoideus does not destroy it.
The section of the summits of the arytenoids  allows it to remain,   i
while a more profound  lesion of them abolishes  it   It  equally
ceases after a longitudinal opening is made.  Finally, if we blow
with force into the trachea of a dead subject, and  contract at the
same time the opening of the glottis, a sound similar to that of an
animal is produced. It has also been shown that the larynx cannot be
exactly compared either to a stringed or to a wind instrument, with
or without reeds.  The experiments of M. Magendie have proved
that grave sounds are produced by vibrations through  the  whole
extent of the thyro-arytenoid ligaments, and acute by the vibrations
of their posterior part alone.   It is also ascertained that the widen-
ing or narrowing of the larynx, its  elongation or  its  shortening,
contributes to render the voice either acute or grave.   For  farther   '
details,  I  must refer to the works of Bichat and of Magendie, and
to the articles Voix et Parole, in the Dictionnaire des Sciences
MSdicales, where the reader will find  a summary of  all that has
been written on this subject.                                     ..
   Laughing, sighing, and sobbing, have been studied in the history  ;,
of the functions of relation,  as means of expressing the passions by
which we are affected.   It is  here sufficient to  say that they ara
either inspirations or expirations, more or less profound, quick or
slow, regular or interrupted, and always depending on the sensations
that may be  experienced  in  the different viscera, and which more
or less influence respiration.
   Coughing, and sneezing, are always caused by a primary or sym-
pathetic irritation of the mucous surfaces traversed by the air in the
act of respiration.   The first  is solicited by an  irritation which
has its seat in the  tracheo-bronchial membrane.   Instinct, which
takes perception of  it, causes  the abdominal muscles to contract;
then  the  air expressed from the pulmonary vesicles swells the
bronchia?,  and trachea; the opening of the larynx  is relaxed; the im-
prisoned air escapes with noise in making the entire tracheo-bronchial
tree to vibrate, and  brings with it  mucosities and other foreign
bodies, which by  their presence incommoded the surface of the 
RESPIRATION.                      259
respiratory sense.   Such is the usual object of coughing; but, as
any irritation of this surface  may produce it, it often takes place
without expulsion.   The cough being a stronger expiration than
ordinary, tends to produce a void in the vesicles of the parenchyma;
hence, when it is violent and  frequent, the person thus affected
hastens to renew the supply of air to the lungs, by means of a hur-
ried and  very deep inspiration, accompanied by a peculiar noise.—
This is what we  observe in hooping cough, a  kind of bronchitis
accompanied by a very lively irritation, that solicits multiplied fits
of coughing, without giving the patient an opportunity of exercising
inspiration,  which only takes place when the  abdominal muscles
have thrust  up as high  as  possible the diaphragm   into the chest,
and when the lungs are almost entirely exhausted of air.  We may
conceive that the want of this fluid being then sensibly felt, instinct
must hasten to perform inspiration;  and this fact tends to confirm
the opinion which we announced, that the movements of inspiration
are the effect of a want that has its seat in the mucous membrane of
the pulmonary apparatus.
   Sneezing  differs  from coughing,  in  the  irritation that  solicits
the convulsive  expiration  being in  the nasal fossa;.  In order to
its ceasing,   and  for the expulsion  of  the foreign bodies  which
provoke it,  instinct begins  by filling the lungs  with air,  by
means of a  deep inspiration;  then  the abdominal muscles  con-
tract, the viscera which they raise up press the diaphragm into the
chest,  and the air is accumulated in  the bronchiae and trachea:  but
in place of  issuing out by the mouth as in coughing, it escapes by
the nasal fossa?; because, at the moment of its arrival in the pharynx,
the lower jaw is pressed against the upper, the contraction of the
pillars of the velum palati raises the tongue, presses it against the
palatine  arch, and  excludes the  passage of the air through  the
mouth.  If this last part of the process  does not take place,  the air
escapes by the mouth, and  in place  of  sneezing there is a  cough;
but this latter being more violent than common,  there ensues  a
more considerable void in  the lungs, which is always followed by
a  very painful sensation.   We observe, that the mechanism of
sneezing concurs with  that of coughing in exhibiting the seat and
nature of the want which presides over the movements of respiration.
   As instinct has for its object always to ward off suffering, if any
of the muscles which ought to  contract, or if any point of the sur-
faces which are to undergo friction, are painful, coughing and snee/- 
260
RESPIRATION
ing, though solicited by the irritation of the bronchial mucous mem-
brane, are incompletely performed, or even not at all. We observe
this in pleurisy, pericarditis, peritonitis, and even  in the highest
grade of gastritis.  The patient, at such times, is in a state of painful
agitation or anguish; and, in the opinion of the vulgar, he has not
strength enough to expectorate. Extreme emaciation also is opposed
to the action of coughing and sneezing, because the mass of the ab-
dominal viscera is too small to push up the diaphragm and produce
fits of expectoration. Hence, we often see the phthisical, in the last
degree of marasmus, lose the power of expectorating, and suffocated
by the accumulation of pus and mucus in  the pulmonary cavities.
We may from this judge, how dangerous it is for a man reduced by
a disease to contract a cough, and to be under the necessity of ex-
pectorating or performing deglutition so imperfectly as to introduce
drinks into the trachea.   We ought, in consequence, scrupulously
to abstain from making the asphyxied and  the moribund drink, as
they have no longer  the power of  performing deglutition  with
regularity.

           Section VI.—Of Aeration in particular.

   The atmospherical air, being introduced into the bronchial vesi-
cles by means of the muscles, the performers of all the grand move-
ments, is decomposed by a vital  operation, which can only be re-
ferred to vital chemistry.   Before its introduction, it was composed
of nearly 21 parts of  oxygen and 79 of azote in a hundred, with a
small quantity, an atom in a measure, of carbonic acid-   After its
expulsion, it presents of oxygen 18  to 19 per cent, and carbonic acid
2 or 3 per cent.   It has then lost as much oxygen as it has acquired
carbonic acid, while traversing the pulmonary cavities. It is, thence,
with reason inferred, that the oxygen of which the air has been de-
prived combines with  the dark blood returned by the vena  cava;
and this loss of  oxygen takes place without any disengagement of
caloric capable of  injuring the integrity of the tissues.   The car-
bonic acid which the air gained after its coming out from the vesi-
cles, could only have been furnished at the expense of the carbon
which abounds in the blood of the pulmonary veins, and from which
it derives  its dark colour.   This carbon is exhaled  by expiration,
and the blood immediately resumes the vermillion colour which it
had lost in the aortic circulation; this is,  indeed, a true depuration. 
respiration.                      261
It remains for us to know to what extent the inspired air, after  its
entrance, contributes to this,—a point upon which chemists are not
agreed: some will have it that the carbonic acid is formed in the act
of respiration; others, that the oxygen is absorbed by the pulmo-
nary veins, and only joined to the carbon in the course of the cir-
eulation; for, say they, the sudden formation of carbonic acid at the
moment of respiration would produce too great a disengagement of
caloric.  Besides, it is not proved that the air expired is always that     *
which  was just before inspired, since there remains between each
breathing, in  the  vesicles, during a space of  time much  longer
than that required for a  respiratory movement, a certain quantity
that could by absorption have been deprived of its oxygen, and be
emitted to give place to that which has just entered.
   As to the vaporised serosity which escapes  with the expired air,
there is no need of supposing  that the water, which is its  base, is
formed of the oxygen of the air suddenly united to the hydrogen
of the blood in the act of respiration, since the same exhalation is
observed on all the surfaces of the human body.  Such a combus-
tion would,  moreover, most probably disengage more caloric than
could be tolerated, without danger, by the delicate tissues in which
is performed the aeration of venous blood, and there would result
an expense of oxygen much greater than what actually takes place
in respiration.  After all, nature has, for all these combinations,  pe-
culiar procedures,  impossible to be imitated by us.
   The aeration of the blood, while  it  renders it  of a vermillion
colour, more coagulable, less serous, and less carbonised, confers on
it also a more irritating property, and makes it fit for the exercise
of the  various functions.  It is thus  that this fluid  acquires  the
faculty of disengaging caloric,  while furnishing the materials for all
the combinations that are performed in the interior of the tissues,
during the  round of the circulation,—combinations to which we
must add the  formation  of carbonic acid, if it takes place in  the
circulation at  the expense of the oxygen absorbed in the lungs.
   These facts arc generally admitted as so many deductions, drawn
by analogy from what takes place in the  chemical  changes  in inor-
ganic, bodies.  In fact  we see caloric  disengaged whenever conden-
sations or crystallizations take place, and even when new combina-
tions ot deviations arise, numerous in proportion to the differences
always met  with  in the mixture of many bodies united in the liquid
•and molecular state, under the influence of atmospheric air.  Now 
202
respiration.
the condensations and junctions of divers molecules  in  a liquid
state, take place in a constant and uninterrupted manner, in physio-
logical phenomena: it is not then astonishing, that caloric should
be continually disengaged by the  exercise of the functions; and
most reasonably are these phenomena referred to a chemical power
peculiar to living bodies.
  The vital principle which directs this living chemistry keeps the
temperature of the body within certain limits; if it employ solidi-
fication, and the changes of form in animal matter, to produce this
temperature, it also avails of  vaporization to prevent its rising to a
height, that would be hurtful to the integrity of the tissues, or de-
stroy that condition of the fluids necessary to the exercise of the
functions; and this again is an additional analogy to what we observe
in the  chemical changes in inert bodies.   Accordingly, if the at-
mosphere in which man is placed be below the temperature of his
body, his internal functions go on  with redoubled energy; and as
more combinations  are necessary, more aliments are required, and
nutrition becomes more active. If, on the contrary, the air be found
warmer than the body, the skin supplies a greater evaporation, the
fluids which would have yielded to combinations of too multiplied
a character, are exhaled, the body is dried, and loses of its volume.
   We may, I  think, admit, as a thing well proved from  all these
circumstances, that one  of the chief purposes of respiration is to
furnish the animal  with the  means of creating for itself a fitting
temperature; we see, in consequence, that animals with lungs in the
interior of their bodies,  and well developed,  are the only ortes
not torpid  during the winter;  and  in this they  are distinguished
from the  inferior  classes, which perish or  fall into a languid
state during that season.   The first are called warm-blooded, the
latter cold-blooded  animals. Some with lungs in their interior, sleep
during the winter;  they form an intermediate class; and their sleep
can  only be attributed  to diminished energy  of the  respiratory
function.   I am aware, that  the experiments of Brodie  seem  to
throw a doubt over the  calorifying effects of respiration, for  he
found  that though this process was  kept up artificially,  and the air
blown in lost as much oxygen, and gained as much carbonic acid, in
decapitated animalsas in natural respiration, yet their bodies continued
losing their heat. He has even observed, that the dead body became
cold in a shorter time than another animal dead at the  same time,
but on which  artificial respiration had not been practised; and he 
respiration.
263
hence concludes, that respiration had rather for its object the cool-
ing than the heating of the animal economy: but I am of opinion,
with Thompson, that  a comparison of the different animals com-
pletely  destroys the force of this assertion, since we know thereby,
that the innate temperature augments  constantly with the increase
in the size of the lungs, and I believe that we may treat this ques-
tion in the following manner.
   The embryo obtains its temperature from its mother, and during
gestation  nature is occupied in creating  for  it the organs which
are to preserve it after its birth.   So soon as it sees the light, its
organs enter into action; but as they are yet weak, and as the skin
has not the necessary degree of vigour and firmness for resisting
the influence of too cold an air, which might  subtract too much
caloric  from the young being, the mother is still  required to furnish
it with  a part of her own.  Finally, when the  body has acquired
more vigour, and the skin more firmness,  the animal is enabled to
take care  of itself; its lungs supply  it with an abundant source of
heat, of which its circulation disengages a sufficient supply in all the
organs; and the skin is in possession of the necessary vigour, either
to prevent an excessive waste of caloric, or to deny passage to that
 from without, which  might be  capable of disturbing the equili-
 brium required for the preservation of existence.  After all, how-
 ever, limits are placed  to  the exercise of this double faculty, for
 the excess of heat destroys us as well as the excess of cold; but we
only sink under  them after  all possible reaction of the animal
economy has been  manifested, in which respect  there  are very
 great differences.
   Muscular contractility seems to be in a direct ratio to the fulness
 of respiration; but it is more especially the nervous system, which
 gains most in activity by the increase of temperature; and we find
 augmented in the same proportion  the ability to bear violent  and
 continued exercises. This is observable in birds, the muscular power
 of which is greater than  in  other  animals,  for they  can indulge
 in rapid and singularly prolonged movements,  without their expe-
 riencing fatigue.  We likewise remark, that they require for renew-
 ing their strength but a very light sleep, even during which they
 are subjected to very considerable  muscular efforts.
   We  may, I think, deduce from  all  these  facts, that the brain  ol
 man must be supplied with warm and oxygenated blood, for the en-
 joyment  of energy requisite to the  exercise of his intellectual func- 
204
respiration.
 tions.  As to the passions,  it seems to us demonstrated  that they
 are always in  direct ratio to the heat of the blood, on which also
 depends the degree of necessary action in  the different viscera, so
 that they may respond to the impressions communicated to them
 by the encephalon, when it is engaged  in ideas suitable  to origi-
 nating emotions.  It is likewise very evident, that viscera animated
 by warm blood, will send to the centre of perception  stimulations
 more acute, and more capable of influencing the turn of thought,
 than viscera chilled with a lymphatic and  imperfectly oxygenated
 blood: all the  phlegmasia; attest  this truth.   It is not  long since I
 saw a patient, who felt his ideas disturbed, and anger always on the
 point of breaking out, when his stomach was heated by stimulating
 drugs, and who regained his calmness and freedom  of judgment so
 soon as he made use of cooling articles.   Pythagoras made a simi-
 lar observation, when he recommended  to his disciples abstinence
 from animal food,  in order that  they might be freed from brutal
 passions, and give themselves up without obstacle  to the study of
 wisdom and the practice of virtue.
   We learn now what a number of physiological  phenomena are
 connected with respiration.   The aeration of the blood is the first
 and most important of the internal functions; that, the interruption
 of which can be the least tolerated,  and on which so many evils
 follow; hence the pulmonary phlegmasia; are the most formidable
 of all inflammations.   I now propose inquiring into the manner in
 which the various actions of  the respiratory apparatus may become
 the cause of diseases, as also into the other lesions of which it if
 susceptible.


 Section VII.—In what manner the Mechanism of Respiralim,
             may become the Cause of Diseases.

  So long as inspiration and expiration  are regular, they cannot
 give rise to  any pathological condition.   There are then but  the
 modifications of these movements, which are capable of producing
 it: now these are to be found, as we have  seen, in the voice, speech,
singing, laughing, sighs, sobs, coughing, and sneezing.  Voice and
speech irritate the trachea and  the larynx, by causing  them to vi-
brate  too frequently, whence results at times inflammation of these,
parts.  This morbid state may take place in the mucous membrane.
which becomes parched by the frequent passage of the air in  too dense 
                         RESPIRATION.                     265

column; but the muscles of the pharynx, the small articulations of
the cartilages, and the fibrous tissue of the tracheo-bronchial canal,
may also take on  inflammation.  There is  nothing easier of re-
moval  than  these diseases in their incipient state; but too fre-
quently attention is not paid, they are allowed to  make progress,
and then become the cause of fatal disorganizations; hence laryn-
geal phthises, which are converted into pulmonary.
  Speaking and  singing also fatigue the  larynx and the velum pa-
lati, and thus  become frequently causes of angina, when there  is an
inflammatory action present
  Laughing and sobbing are less irritating to the air passages,  than
to the substance  of the lungs themselves; they retain the blood in
them, as do also forced  cries and  efforts of singing, and lay the
foundation  for pulmonary congestions  and haemorrhages.  These
modifications of  the respiratory process act likewise on the heart,
irritate, and may consecutively phlogose and dilate it.   The  con-
vulsions of laughing and of sobbing, may become excessive and ha-
bitual, and be converted  into diseases; they drive the blood towards
the head, which  may hence  suffer  from congestions, phlegmasia;,
ruptures of the vessels, and sanguineous exhalations.
  Coughing and  sneezing jar very much the trachea, and render it
painful; but  their most remarkable effect is, by creating a vacuum
in the pulmonary vesicles, to cause an afflux of mucus and even of
blood, and  engorge and inflame them, so as to require new efforts,
by which  the tickling that provokes these convulsive expirations
is still  more increased: hence we cannot too  frequently counsel
patients affected  with pulmonary catarrh to restrain the inclination
to cough,  and only  to  yield to it when they feel distinctly the
necessity of  expelling the mucus accumulated in the bronchial
cavities, and  that the  expectoration will be easy.    The  con-
gestive  and phlogosing  effects of coughing,  are shown in  a  very
evident manner in certain gastrites, which provoke sympathetically
the  desire to cough, without there existing any bronchial inflamma-
tion or the  least  mucus to be expectorated.   We see only at  first
short fits of  coughing without excretions, corresponding  to the
epochs in which  the stomach is stimulated by ingesta, and removed
at will by taking some demulcent   But if this precaution be ne-
glected, the cough, by dint of being repeated, produces an inflamma-
tory fluxion in the bronchial vesicles; chronic pneumonia comes
on,  and  soon predorninates over the gastritis.  It is now more than
                            34 
266
RESPIRATION.
eight years since  I  pointed out, both in my lectures and clinic,
this kind of phthisis consecutive to gastritis; which, unhappily, is
but too frequent               '
  We have said that sneezing expels a larger quantity of air from
the lungs  than coughing.   We believe that the afflux of blood and
mucosities to the bronchial cavities and the vesicles, which it pro-
duces, is the principal cause of the propagation of catarrh from the
nasal fossae into the  lungs.  Sneezing is  not less  irritating to the
nasal fossae; the more it is yielded to, the more  is the feeling which
provokes  it exasperated, and the greater the fulness of the fossa?;
cerebral cqngestion is also a consequence of it, and more than one
apoplexy  may be referred to this origin.  One of my pupils has
lately acquired a sudden reputation,  in his part of the country, for
the cure of a sneezing, which was very harassing to the head, nasal
fossae, and lungs, and which, untractable to all  the antispasmodics,
was cured by an application of leeches round the  nose.
  Cough also irritates the  diaphragm and the  abdominal muscles.
I have often seen, in cold weather, when pulmonary catarrhs were
epidemic  among the soldiers, the  recti muscles of the  abdomen
(sterno-pubien) become excessively painful  at their superior ex-
tremities, inflamed,  and presenting, after death, collections of pus
in their fibrous tissues.  I have even seen the inflammation extend
in some  subjects to the peritoneum; so true is it, that  the cough
may, from a symptom, as it was in the  beginning, become a very
dangerous malady.   Every practitioner knows that it may be also
rendered  convulsive,  and kept up by the mere  force of imagina-
tion,  so soon as the patients think of it, or if those who are present
recall it to their minds.   I have had under my care a person, who,
after having coughed in an extraordinary manner,  was freed from
this inconvenience  by strictly attending to  himself, agreeable  to
my express recommendation.  But the fear  of being again seized
by it was so great, that so soon as I inquired of him  after his cough,
he replied to me by coughing, though he  had  not done so during the
whole day previous.  This inclination gained such an ascendancy,
that whenever he was apprised of my arrival, or recognised the
noise  of my gig at his door, he  had fits of coughing.   He was
cured by the administration of narcotics.
  It is needless to add, that coughing and sneezing may  be a cause
of hernia, and cause  the rupture of aneurisms of the larger vessels. 
RESPIRATION.
267
Section VIII.—Diseases resulting from Derangements in the
             Aeration of the Blood in the Lungs.
  The air that serves  for respiration, may  be the bearer of hurt-
ful particles or of irritating  vapours,  which will give origin to in-
flammation in the air cells and  cavities.  Mineral vapours, chlo-
rine, ammonia, acids in a state of expansion, such as the sulphurous,
irritating powders, as those arising in the pulverization of tobacco,
euphorbium, squills, &e. frequently produce coryzasand pulmona-
ry catarrhs.  I have  seen  pericarditis evidently produced  by the
powder, on a man  who worked in a manufactory of tobacco.  Dif-
ferent  smokes act  also on the mucous membrane of the bronchiae;
and finally/the mildest odours, such as those of flowers, are at
times sufficient to occasion  coryzas and  bronchitis.   I  have  seen
the emanations from cherries, exposed for drying, produce  during
the night such a constriction in the bronchial apparatus, that a violent
fit of asthma was the consequence, which, at first, came on  during
sleep, like a night-mare, and terminated in a catarrh  of some days
duration.
   All foreign bodies, of which  atmospherical air is often the vehi-
cle, may, by irritating and  filling the air cells, impede the aeration
of the blood, and bring on  asphyxias, succeeded by inflammations
of the tracheo-bronchial surface, which are sometimes very difficult
to remove.  When the inspired air is deprived of its oxygen, the
aeration  of the blood does not take place.   At this time a gas
more or less inimical to life,  and  not atmospherical air, is introduced
into the lungs.  Among these gases there are some  which are in-
jurious only by the want of oxygen; such are azote, and its protox-
ide, pure hydrogen, oxide of carbon, and carbonic acid without mix-
ture.   There only results from them an asphyxia without  inflam-
mation; but there are many others, which, by their poisonous nature,
strike  directly at the nervous  system,  and thus produce real poi-
soning.  Of this number are, sulphuretted,  phosphuretted,  and ar-
seniated hydrogen; the vapours of the hydrocyanic (prussic)  acid,
and the miasmata which arise from animal and vegetable matters in a
state  of putrefaction.  These  gases are endowod with activity so
great, as to be capable of producing instant death,—only explain-
ed  by the rapidity with which they penetrate  through  the whole
extent of  the  nervous  system, by the aid of the caloric  that
holds them in solution.  When they  do not produce this effect, 
268
RESjIMRATION.
they exhibit at least that of suspending respiration and circulation,
and destroy  all signs of life.  Those  sufferers, whom the speedy
application of oxygen  has restored to existence,  experience for a
length of time weakness and uneasiness,  and often retain, for a
longer or shorter period, a phlegmasia of the mucous membrane of
the respiratory passages.  In all gaseous asphyxias,  the decarboni-
zation of the blood is interrupted; this fluid remains  black, watery,
and not coagulable; the transformations by vital chemistry do not
take place; caloric ceases  to be disengaged in the viscera; nervous
irritability no longer gives any evidence of its existence, and mus-
cular contractility seems abolished.  Then  is all thrown into a fa-
tal repose.   The  aptitude  of animal matter, to resume the vital
condition, may sometimes still persist  for a certain period, and it
is for art to avail of it by applying oxygen gas, and rousing nervous
excitability;  but if this  period, always so short, be not turned to ac-
count, the repose of asphyxia is  only interrupted by the internal
movements  of putrid  decomposition,  which soon furnish the cer- 4
tainty of death.           '
  Are  the   aerial influences that cause these phenomena purely
sedative?  We are allowed to doubt it; for, whenever the agents
of which I am now treating act on the body in smaller doses, the
phenomena  of life  are exalted  and doubled, in the tissues which
they have modified, and some of the numerous shades of inflamma-
tion are manifested.*
  It is thus that the system of warm-blooded animals resists  cold,
or the subtraction of organic heat; which would seem to show that
irritation  is the fundamental phenomenon of pathology, at least of
those animals the  study of which enters into the present subject
  Oxygen,  that aliment indispensable to life,  may  in its  turn be-
come a poison.  If this gas be in excess in the  air in which we
breathe, it irritates the  vesicles and the entire pulmonary apparatus;
it accelerates, excessively, the circulation; inflames the tissues, and
  • We cannot, I think, otherwise explain the oetiology of malignant pustules,
carbuncles, and even of typhus by infection, of which gastro-enteritis exhibits
the essential characters, notwithstanding all that to this day has been said to
to the contrary.  I have long suspected that this phlegmasia, by reacting on the
mucous membrane of the pulmonary apparatus, impedes to a certain extent the
aeration of the blood, and that this is the chief cause of the lividness observed
in the worst grade of those diseases.  I would call the attention of inquirers t»
this important point of pathology. 
RESPIRATION.
269
 gives  rise to fever.   Hence,  the  pure and cold air of elevated
 places, which we know to be abundantly charged with  this prin-
 ciple,  hurries  the progress of chronic inflammations that tend to
 disorganization of the lungs.  With still more certainty is the pure
 oxygen gas, prepared by artificial means, fatal to persons attacked
 with these phlegmasia;.  When the lungs act with too much fre-
 quency and energy, the blood is deteriorated by an excess of de-
 carbonization.  That which is drawn  from  the veins is then  al-
 most as  vermillion  as that  furnished by the  arteries;  hence
 depraved secretions, and the  body  rapidly  runs  into marasmus.
 Pathologists  ought to try and  distinguish, in the diseases  of the
 lungs,  those which diminish the decarbonization from others which
 render it more  active  than  natural.   Such a discovery  would
 doubtless enrich the therapeutical treatment of  these diseases, and
 might  throw light on the means of preventing them, as well as on
 the treatment of some others. I have remarked that very extended
 bronchitis, occupying all the ramifications of the bronchiae in the
 two lungs, and  furnishing a puriform secretion  (such as bronchitis
 in measles), keeps up constantly a livid colour, analogous to that
 of typhus, and gives a dark blood on venesection;  whilst pneumo-
 nia, circumscribed in a small point, and, above all,  at the summit
 of one of the lobes, as also incipient pleurisies, produce  a roseate
 colour, and give a vermillion blood by phlebotomy.   On this ac-
 count blood-letting ought to be cautiously used  in the former case,
 especially when it is of some days duration, if we do not wish  to
 expose the patient to the risk of sudden death.  In fact, though the
 emission of blood  be still necessary at this epoch, it ought only  to
 be local and drawn in small quantities. But in pleurisies, and in pneu-
 monias of limited extent, which leave intact the greater portion  of
 the bronchial tree, bleeding, to be useful, must be copious, and oft
 repeated,—for we find that the strength of the patient  augments  in
 proportion to the  blood which he thus loses.
  These facts, though anticipating pathology, do not seem by any
 means foreign to our subject, since they may  aid in throwing some
 light on the first and most important of the internal functions, and
 on the  oetiology of the most common and depopulating diseases,  at
least in climates  where the  temperature  is subject to   frequent
 changes from heat to cold, and from cold to heat. 
370
                       CHAPTER IV.

APPBNDIX—ON THE FUNCTIONS OF THE  CEREnRHM AND « EREI1KI.
  LUM, AS TENDING  TO THROW LIGHT ON THE ACTION OF THE
  RESPIRATORY MUSCLES.

  I had concluded the article on respiration before perusing the
memoir  of M. Coster, a physician of Turin,  inserted in the first
volume of the Archives Gin&rales de Mbdicine, page 359, on the
experiments of M. Rolando his countryman, having for object the
clearer understanding  of the functions of the cerebrum and cerebel-
lum.   M. Coster finds the closest resemblance between these expe-
riments which were published in Piedmont in 1809, and those which
were performed in France by M. Flourens in 1822.  The inferences
from both are, that wounds of the cerebral hemispheres,  in  many
warm-blooded animals, cause drowsiness, coma, loss of memory and
attention, in a word of intelligence, without paralysing the locomo-
tive muscles: the animal  is as it were stupid; but if forced, it walks,
and evidently wants but volition to put its muscles in  action.  But
if the cerebellum be wounded, convulsions supervene in the volun-
tary muscles of the opposite side; and if it be disorganized, or one of
its  lobes removed, this side is paralytic.  The animal sees, hears,
and so well understands the meaning of the menaces used towards
it, that it wishes  to retreat when afraid of  being  struck; but the
muscles are disobedient  to the order of volition.   Still, however,
in  both cases respiration  continues, ceasing only  with  life, and
when the alteration has extended to the medulla oblongata.
  The conclusions  to be drawn from these  facts are  very evident
and valuable  to the physiological physician.  They show that the
hemispheres  of the brain preside over thought, memory, will, and
intellect; that the cerebellum is endowed with the function of call-
ing into action the locomotive muscles, but  that it  cannot cause
them to act in a regular  manner, unless it receive the impulsion of
the will, which in its turn exacts the integrity of the cerebrum.
   But  since  respiration is not interrupted  either  by the lesion of
the hemispheres of the brain, or by that of the lobes of the cerebel-
lum,  it seems to me that its  persistence must depend on the gnat
sympathetic.  I  would view the question in this manner. 
            ACTION OF THE RESPIRATORY  MUSCLES.         £71

  The centre of perception, residing, as I have said, at the summit
of the medulla oblongata, is the point to which tend stimulations, in
which  reside perceptions, and whence emanate volitions.  But we
must distinguish  volitions determined by the will from those go-
verned by instinct; for the first suppose  the integrity of structure
and plenitude of vital action in the cerebral hemispheres, whilst the
second only suppose them at times, not always.   In fact, instinct
is manifested by a great number of acts of various degrees of com-
plexity.   Those which are most so, such as the selection of  food,
and of the opposite sex, and the construction of the  nest, the care
of the  young,  &e.,  require that the hemispheres of the cerebrum,
the seat of the intellectual faculties, and director of voluntary mo-
tion, should be  susceptible of strong  action, because here instinct
cannot make itself obeyed without the intervention of these facul-
ties.   This is not the case with the acts of instinct of a more simple
or at least less complex kind; such are respiration and the convul-
sive movements of the cephalo-splanchnic  muscles.   To execute
these acts, does not at all demand the direction of intelligence or
volition,  nor is the  entireness of the hemispheres of the cerebrum
necessary for this purpose.  It is sufficient that the centre of per-
ception exists,  and that it can communicate with the muscles which
are to be called into action:  but this last is an essential condition;
for if the  medulla oblongata were separated from the spinal mar-
row by a section, there would no longer be any possible muscular
movements of a  general kind, but only partial  convulsions,  pro-
duced  by  the stimulation of  each point of the cerebro-spinal appa-
ratus,  on  which end the muscular nerves, either above  or below
the section, or by the stimulation of the nervous trunk of a limb.
Let us next inquire how all this is verified in the experiments of
Rolando and Flourens.
  When they  had destroyed the hemispheres of the cerebrum, the
centre  of perception ceased to be in communication with the external
senses, because these latter cannot operate on it without the concur-
rence of the action of the cerebral hemispheres, which are, as I have
said, consulted by the intellectual part. The faculties of intelligence
are therefore wanting,  and stupor supervenes.
  During all this time, however, respiration continues; because the
impressions which  come from the internal  pulmonary sense, and
which require the co-operation of the  inspiratory muscles, arrive
directly at the centre of volition, and have,  to be obeyed, no need 
272
ACTION OF THE
 whatever of the concurrence of the cerebral hemispheres, the scat of
 intelligence.  But from the instant when the instrument which dis.
 organized the hemispheres, penetrates to the summit of the medulla
 oblongata, respiration and life cease, because the centre of percep-
 tion and of volition has been destroyed.  The same thing happens
 if the animal be abandoned to itself after the mutilation of its brain,
 because the inflammatory irritation will at the expiration of a cer-
 tain time have penetrated to  this same centre of  perception and
 volition.
   When the gentlemen experimenting wounded the  cerebellum, the
 cerebrum being spared, they excited convulsive movements without
 injuring the intellectual functions; because they so contrived it, that
 a lively stimulation should be transmitted to the centre of percep- ]
 tion, and act on it in an instinctive manner; but if, before any of the
 lobes of the cerebellum were interested, they had taken care to de-
 stroy its communications with the medulla oblongata, by dividing
 the pedunculi which pass to the pons varolii, I am  persuaded that
 the cerebellar lobe might have been pricked and slashed withoat 1
 convulsion  ensuing;  what proves this, is the fact, that, when they
 entirely removed one of these lobes, paralysis of the  voluntary mus-
 cles of the opposite side took place.
   But whence comes it, that, during these two experiments, re-
 spiration still  continued.  Had not,  then, the internal pulmonary
 sense any need of the cerebellum, to  obtain the co-operation  of the
 muscles dilating the chest, though they  are in  connexion with vo-
 lition, and,  as such, seem to owe their principle of action  to the ce-
 rebellum?   I think this new difficulty may be thus  resolved.
   The dilating muscles of the chest, or the cephalo-splanchnic ones,
 are called into action by  the  centre of volition; but  this centre .
 makes them act under two different influences; at one time in obe-
 dience to  the  viscera, and at another under the subjection of the
 will.   In  the  first case, it is stimulated from the internal visceral
 senses,  and  in the second it is  the cerebrum and  cerebellum which
 transmit the stimulation to it  In other words, the-centre of per-
 ception can  only make these muscles act in obedience to the will,
 which is derived from the cerebrum, when the cerebellum furnishes
 it with the means; but it may, without the  concurrence of either,
put them  in action, in order to  their obeying the internal  sense
whence proceeds the want of respiration. 
RESPIRATORY MUSCLES.
273
   It it be demanded how I can know that the centre of perception,
 situated at the head of the medulla oblongata, is charged with such
 .« function under this double influence, I reply, by bringing together
 the experiments of Legallois and those of Rolando and Flourens.
 According to Legallois, the  destruction of all that part above the
 point of insertion of the eighth pair, still allows respiration to go
 on; this act, then,  has no occasion either  for  the cerebrum or cere-
 bellum.  On the same authority, the section  of this medulla below
 the point mentioned, puts a  stop  to respiration; this  point, then,
 must of necessity communicate with the dilating muscles, for the
 performance of respiration; and, in consequence,  there are but two
 things required to support this function:  1. the  communication of
 the centre of perception with  the respiratory sense; 2.  the com-
 munication of this point with the dilating muscles of the chest.  If,
 now, we would reduce things to their true meaning, we shall find,
 that the experiments of Rolando and Flourens are fully comfirma-
 tory of those of Legallois; or rather, that they are the same in refe-
 rence to respiration, since they prove what he had proved; 1. that
 the destruction of the cerebrum and cerebellum does not prevent re-
 spiration, provided the medulla oblongata be  intact;  2.  that  the
 cerebrum and cerebellum cannot-keep it up,  if the  medulla  oblon-
 gata be destroyed.  After all, these  same dilating muscles wrhich
 ran contract without the abovementioned parts of the encephalon,
 to produce respiration, cannot move without these latter for the pro-
 cesses of speaking, crying out, that is to say, of obedience  to  the
 will.   The medulla oblongata, then,  their necessary motor,  causes
 them to act under two influences which may be independent of
 each other.
   It results, moreover,  from  this,  if I be not  deceived, that the in-
 tellectual faculties  cannot produce voice and speech without the in-
 struments of instinct, and that these latter may suffice  for the in-
 stinct of respiration without the concurrence  of  the encephalic ce-
 rebral matter, destined to  the phenomena of intellect   But  we
have seen above that this is not the case with all the instinctive acts,
since many of them demand for their execution  the encephalic in-
struments of mind.   There exists, then, a series of instinctive acts,
of which some require the co-operation of intellect, while others
may dispense with it.   But were I to  enter into the development
of this series, I should only repeat what I have already said  of the
instinctive wants which  the will can restrain,  of those which it can 
274
ACTION  i'K Till"
 only suspend, and of those, finally, over which it exerts no kind of
 control.   I shall  content myself, then, with referring to the first
 part of this work, still observing, that sufficient reasons for these
 differences are constantly found in the organization of anim ils.
   I am  next to consider the  second proposition,  which  I have
 placed at the  head of this appendix;  to wit,  that the influence of
 the great sympathetic sufficiently explains how the  respiratory
 movements still persist, even after the destruction of the cerebrum
 and cerebellum.  The great sympathetic does not reach the me-
 dulla oblongata; it is not then it which obliges the medullary point
 to support respiration,  after  the destruction of the  cerebellum; it
 only communicates with  the eighth  pair, and,  consequently, on
 this latter does  it act.  Again, the great sympathetic  communicates
 with all the nerves of the inspiratory muscles. It  acts therefore, in
 one direction, on the  nerve in which resides the internal sense of res-
 piration;  in the other, on the nerves of the muscles whicli the cen-
 tre of perception causes to contract for the performance of this func-
 tion.  It has  been imagined, that, communicating with the spinal
 marrow,  it might derive from this latter the contractile impulsion
 for each of the  inspiratory muscles.  This  proposition  is inadmis-
 sible, because the section of the medulla oblongata,  and even that
 of the spinal marrow, equally suspend respiration.   In  fact, if this
 communication  had for its object the obtaining of contraction for
 the  respiratory muscles  in  the entire  extent of the  trunk,  we
 should find, after the section of the spinal-marrow, the respiratory
 muscles, situated below the point divided,  continue their action,
 notwithstanding the paralysis of the upper ones.  Now this  never
 takes place, and we  thus obtain proof that  the respiratory move-
 ments are called for  by the respiratory sense  at the  upper portion
 of the medulla oblongata.
  It is then very certain,  and  well attested, that the communica-
 tions of the great sympathetic with the eighth pair,  and  the mus-
 cles which perform respiration, are destined to transmit to the cen-
 tre of perception  the desire to  breathe,  and  to make the viscera
 participate in the innervation that the centre throws into the muscles,
 at the moment in which it acts for the gratification of the desire.
  From this association it h .ppcns, that the  respiratory  muscles
may act independently of the influence of the'cerebrum and  cere-
 bellum.    Now there does not exist the like between  the voluntary
 muscles and the great sympathetic;  this latter does  not make any 
                    RESPIRATORY  MUSCLES.                 275

■ppeal to the centre in their favour; and,  on this account, these
muscles  cannot  enter  into contraction  when the  communication
with  the  encephalon is cut  off.   Since  the experiments  of the
vivisectors show that the destruction of the  cerebellum produces a
paralvsis of these muscles, whilst it does not  occasion that of the
respiratory ones, we are bound to admit that this difference depends
on these latter being maintained in action, by means of the union
naturally established between their nerves and the cords of the
great  sympathetic.   Thus  the great  sympathetic will have  a
double.function; first, that of soliciting the centre of perception to
bring into  action the respiratory muscles; secondly, that of ren-
dering them su.sceptible of obedience, notwithstanding the absolute
deficiency of the influence of the cerebellum;  finally, there would
remain  to this latter the power of calling these muscles into play
to satisfy the intellectual faculties,  that is to say, the cerebrum or
brain  proper, whenever their  action is not importunately solicited
by the  great sympathetic.
  For the still better comprehension of this question, I will sup-
pose that the great sympathetic is put in communication with the
common voluntary muscles;  these would be,  like  the respiratory
ones,  obliged to gratify the wants of instinct; and  reciprocally,  if
it were  necessary that a visceral muscle should become the agent of
volition, nature would  force it to this by distributing to it cerebral
or spinal cords.   I do not know whether comparative anatomy has
realized the former of these suppositions;  but I know that it is in
favour of the second, since the ruminating animals have the faculty
of bringing up the aliment at will into their mouth, to make it un-
dergo a second mastication.
   How deny, after having meditated on these facts, that the great
sympathetic is the organ destined to render the movements indis-
pensable to life  independent of the caprices of the  will,  and  act,
at the  same time, as  intermedial  between the wants of vital
chemistry  and the organs charged with  obtaining  from without
the agents  necessary to the gratification of these wants?
   Dr. Gall had invested the cerebellum  with the function of repro-
duction. This assumption always seemed to me vagueand unsatisfac-
tory;  I shall discuss it when treating of generation. For the present
I will merely remark,  after the learned professor  Chaussier, to
whom I recently communicated my doubts on this head, that one
of the principal effect < of the venereal  orgasm is to determine a 
276
ACTION  OF THE
Strong innervation on the locomotive muscular apparatus, and thug
to produce an exhaustion which robust subjects bear better than
feeble ones.   If then it were proved, that the volume of the cere-
bellum is found in proportion to the muscular energy, what ought
next to be ascertained, it would follow that, since athletic men arc
commonly most powerful in the generative act, the development
of the occipital protuberances  should generally correspond to tho
excess of energy  in the virile powers.
  It must be an erroneous opinion, that the cerebellum  is des-
tined to preside  over the movements  of  the heart, an* other
splanchnic viscera, as had been advanced by Willis.  This function
is devolved to the great  sympathetic, which transmits to them, as
we have shown, the stimulation of the  encephalic apparatus,  and
which returns to the nerves of this  latter  the  exuberant  nervous
irritation of these muscles, and that of the capillary system of the
viscera seized with inflammation.
  Science advances uninterruptedly, and makes immense strides:
two laborious experimenters,  M. M. Foville, and  Pinel  Grand-
Champ, have just published an essay on the special seat of the dif-
ferent functions of the nervous system.  Th'e  inferences from the
pathological observations which they have collected, and the experi-
ments which  they  have performed, are, 1. that the brain is the
seat of intellect  and of motion;  2. that the corpus striatum
and medullary fibres corresponding to this nervous mass, pre-
side over  the movements of the leg; 3. that  the optic bed, and
the medullary fibres to ivhich  it corresponds, that is to say,
those of  the posterior  lobe,  keep  under  their dependance the
movements of the  arm; 4. that complete hemiplegia follows an
injury simultaneously and equally affecting the parts  presid-
ing over the movements of the arm and of the  leg; and that
partial hemiplegia, or that which  affects unequally the arm
and the leg, depends on the alteration not being carried to  the
same extent in the optic bed and corpus striatum; 5. that  the
cerebellum is the source of sensibility, and not, as M. Flourens
supposes, the regulator of irritation.  These authors dwell also
on the  support  given by the observations of La Peyronnie, who
has seen  affections of the cerebellum produce convulsions and a
general exaltation of sensibility, and also by the ideas of Petit de
Namur. 
RESPIRATORY MUSCLES.
277
  M. M. Foville, and Pinel  Grand-Champ, have verified the ex-
periments of M. Magendie, showing that the posterior roots of the
spinal marrow preside over sensibility, and the anterior ones over
muscular motion.  They, in consequence, make the posterior medul-
lary fibres descend from the restiform eminences which come from
the cerebellum, and the anterior from the  pyramidal and olivary
bodies, which, in passing behind the pons varolii, are  continuous
with the white fibres of the optic beds, and the corpora striata.
  Our experimenters have moreover thought they could  remark,
that in diseases of a  purely mental character the alteration was
limited to the superficial gray substance  of the hemispheres of the
cerebrum.
  Here then we have the seats  of the intellectual faculties, of the
motion of the limbs, and of sensibility, apparently determined: the
cerebellum will therefore only act on the muscles as the exciter of
pain. But there  remain yet many facts  to be established, and I
cannot forbear proposing to the gentlemen  vivisectors the following
questions.
  If it be true  that  the superficial gray  substance of the hemi-
spheres of the cerebrum, presides over the intellectual operations,
how is it in correspondence with the nerves  of the external and
internal senses, by which are transmitted  the  impressions that call
the intellect into action,  since this gray substance is not continuous
with the nerves?  The impressions which feed the intellect being
founded on the exercise of sensibility that resides in the cerebellum,
how are they transmitted by  this latter to the surface  of  the cere-
brum?  Would the white, which is adherent to the gray  matter of
the  cerebral  hemispheres,  be alien to muscular motion, and serve
Tather as a means of communication between  the cerebellum and
cerebrum?  Would the  fibres of this white substance  of  the peri-
phery of  the cerebrum, thus form, with the gray substance ad-
herent  to  them, the theatre  of the intellectual  operations  and
faculties—which would corroborate the  system of Dr. Gall, who
assigns to each of these faculties  an organ susceptible of forming a
prominence externally?  Have these same white fibres of the peri-
phery, which on this supposition would be destined to  the intellec-
tual operations, and those of  the  corpora striata  and optic thalami,
that regulate muscular  motion,  a point of union?  And  does this
 point exist in the medulla oblongata? What purpose is served by the
 gray matter placed between white fibres in the corpora striata, the 
278
ACTION OF THE
 beds of the optic nerves and the medulla oblongata?  What is UV
 office of that observed in the cerebellum and spinal marrow?  Arc
 there in those places mental or instinctive faculties, and, if not has
 the  gray substance any other appreciable function?  What is the
 portion of the encephalic apparatus, which presides over the move-
 ments of the respiratory muscles?
   The writers of whom I am now speaking consider the spinal mar-
 row as only a fasciculus of nerves, establishing communications be-
 tween the cerebrum or cerebellum, and the differentparts of the body:
 by this hypothesis, how are we to explain the presence of  the gray
 matter in this fasciculus, whilst we find none  in the peduncles of
 the cerebrum, or in those of the cerebellum?  and why  is not the
 whole dorsal medulla  arranged like the lumbar, which is  in fact
 but a fasciculus of nerves?
   It had  been before  proposed to consider the gray substance as,
 above all others, the active part of the encephalic apparatus;  which
 is equivalent, in my mind, to calling it the seat of sensations and
 the point of departure for volitions.   This opinion pleases me the ^
 more, as then the white fibres would be but the conductors of these
 phenomena.   I  had even compared,  and the idea was  frequently
 expressed in my lectures, the sensitive nervous expansions to this
 gray substance.   I was tempted  to regard these  two vasculo-ner-
 vous forms of animal matter as the seats of sensations and volitions,  '
 and  white fibres interposed  between them as the means  of commu-
 nication  from one to  the  other.   I view  this mechanism thus:
 the  impressions would be  made  on the vasculo-nervous matter,
 forming the sensitive surfaces of the  external  senses, and of the
 mucous membranes; they would be transmitted by the  white ner-
 vous fibres in the central vasculo-nervous matter, that is to say, in
 the gray substance of the medulla oblongata; and  thence the voli-   "
 tions or innervations would set out, and, traversing the nerves in an
 inverse direction, would produce the phenomena of muscular move-
 ment   If this mechanism be admitted, it would  be in  perfect ac-
 cordance with the experiments of our authors;  for the stimulations
 received by the sensitive  nerves, and  thence passed to the gray
 substance  of the medulla oblongata,  might be sent, some to that
 of the cerebellum, where they would  produce sensations of  a cer-
 tain  kind;  others to that of the hemispheres, where they would
elicit thought,  and whence they would be reflected  into that of
 the corpor;*  striata and -thalami of the  optic nerves,  from which 
RESPIRATORY MUSCLES.
279
must emanate the movements  for the voluntary muscles; some, in
tine, would enter into the gray substance of the medulla oblongata
only, in which would spring the volition  to make the inspiratory
muscles act, and  perhaps many instinctive determinations.   This
mechanism would seem  the more  probable, because at  this same
point,  that is  to  say,  at  this portion of  the gray matter, the
eighth pair, which brings to the encephalon all the stimulations of
the viscera, abuts,—stimulations which are, as I have shown, the
determining causes of the movements attributed to instinct.
   Hut  agreeable  to this view  of the subject, it would be indispen-
sable for this said portion of the gray matter equally to receive vo-
litions coming from all other analogous portions, comprising  those
of the spinal marrow; for the cerebellum would in vain tend to pro-
duce pain,  the hemispheres thought, the corpora  striata and  optic
beds motion of the limbs; they could not succeed in accomplishing
these things without the influence of the gray matter  of the medul-
la oblongata.   In this manner  one might explain how it is the cen-
tre of perception, and  the motor  of  all the volitions; how it is
brought to  act,  at one time, by the aid of the gray  matter of the
hemispheres, which  would preside over the intellect; at another,
by that of the cerebellum in obedience  to pain or  pleasure; and
again,  by the stimulation of the viscera,  which perhaps obtains a
new degree of power while passing through the gray matter of
this last mentioned organ.  We might, on this showing, admit the
opinion of the ancients, who thought that the cerebellum presided
over the movements of the principal viscera, and that of Dr.  Gall,
who places the  seat of concupiscence in this organ; since the vene-
real appetite forms an essential part of the phenomena of instinct.
We also explain, how the will  can arrest the effects of venereal de-
sires, and  those of pain  and many  other instinctive impulsions,
owing  to the gray matter of the centre of perception being  influ-
enced by that which presides over the intellectual operations.  Fi-
nally, the impossibility of long resisting the desire of respiration,
vomiting, defecation, and discharge of the foetus, may be attributed
to the peculiar kind of stimulation which  the eighth pair receive-
from the great sympathetic, and which it transmits  to the central
point that now  engages our attention.
  As it is impossible to believe that stimulations produced  ou
any  sensitive surface whatever, should be directed  by a peculiar
affinity, at one time,  towards a certain portion of grav  matter, and 
280
VCTION Ot  THE
again towards  another portion, I proposed,  as has been  seen, to
admit, that, after having reached the central point of the medulla
oblongata,  they are all reflected  and disseminated  throughout thr
entire extent  of the  encephalic apparatus, and  even  the  sensi-
tive surfaces, internal as well as  external; for I see no reason why
these stimulations, these electric commotions, should  stop at one
point, but perceive many to induce a  belief that they are  general.
It will then be conceived how they assume different hues on re-
turning to the central point of perception, after  having traversed
the divers departments of vasculo-nervous matter, as well intra as
extra-cephalic,  and how they determine volitions in the sense re-
quired by the intellectual or instinctive wants of the animal.
   The intra-cephalic vasculo-nervous matter, or the gray substance
of the encephalo-spinal apparatus, the extra-cephalic vasculo-ner-
vous  matter of the sensitive  expansions,  the intermedial white
fibres  to transmit the stimulations from all parts of the body to-
wards the brain, and vice versa; such are the conditions which to me
seem indispensable, for the exercise of the functions of the nervoua
system; and hence the reason why I have asserted that the brain can
never act alone in the most simple intellectual process, and even in
the slightest sensation.   All the morbid phenomena seem to me
♦0 corroborate this idea,  the reasons for which will be  more fully
developed in my treatise on Pathology.
   There arises, in this place, a very powerful objection against the
opinion of those who assign separate nerves for sensation and mo-
tion.   No doubt but the  nerves which go to the sensitive surfaces,
such as the skin, are more sensible than those which are distributed
to the muscles, and other tissues not fulfilling sensitive functions in
the natural state; but, in  numerous other cases, these latter become
very much so; it. is sufficient for this purpose that they be modified
by inflammation.  It is thus that rheumatism renders muscular ac-
tion very painful; we  know  to what extent it becomes so  in the
phlegmasia; of the spinal marrow; and I have seen tremors and
pains of the muscles occasioned by arachnitis.   What is there more
insensible than  an articular surface in a state of health?  What more
sensible than the same surface in gout?  Where is the sensibility of
the pleura,  of the peritoneum, of the arachnoid, in a person who i*
well? Does  there exist more atrocious  pains than those which are
caused by inflammation of these  membranes?  How are we to be-
lieve that the nerves that preside over the functions of these tissues, 
RESPIRATORY  MUSCLES.
281
 in the normal or natural state, are not those which acquire this de-
 gree of perturbating sensibility?  If the great sympathetic, the most
 obtuse of all the nerves, can acquire this property, is it possible to
 suppose that a single branch of the encephalo-spinal domain can be
 entirely alien to pain or pleasure?
   There is then but a difference in degree in the sensibility of the
 nervous tissues;  they are all conductors of stimulations, and these
 latter are more or less felt, according to the necessities of the func-
 tions over which the nerves traversing them preside.   All these
 isolations of vital properties are chimeras;  there exists but one, the
 shades of which vary, though in  their nature essentially identical;
 and I challenge any other conception of physiology.
   The  brain  cannot then be devoid of sensibility.  That it has
 little in  a  normal  state I concede; but what are we to think of
 those violent  cepalalgias which correspond so precisely to certain
 abscesses of the  brain?  Is it intended to make  the  cerebellum
 the  seat  of  cephalalgias  from  gastric  irritation?   It  will be
 found, we are told, in the arachnoid; granted:  but why do not
 the nerves of this membrane make us feel  any thing in the natural
 state? And are we to suppose the pains so deep and lancinating, with
 heaviness, fulness, and dizziness, felt in the hemispheres,  to be in
 the cerebellum? The cerebrum is on the same  footing with many
 other tissues;  suddenly  injured,  it evidences no pain; but give it
 time to be inflamed, and you will see that  it has likewise its sensi-
 bility.  Is not the same remark made in reference to the liver, the
 substance of the  lungs,  and the globe of the eye? And if it be al-
 leged that the brain  has been seen inflamed and suppurated in con-
 sequence of wounds without  causing pains, we would reply that
 this observation  may be made of the  other viscera.   Sensibility
 exists every where in nervous and irritable constitutions;  in  sub-
jects of  an opposite nature it is obtuse  in  the parenchyma; of the
 viscera; in all it  is exquisite on the  sensitive surfaces.  It is de-
 veloped in  the commencement of phlegmasia;, but it is deadened
 often by the persistence of irritation; and  this is one of the causes
 which have so long rendered  inflammatory  diseases misunder-
 stood.
   But whence comes it, shall we be  asked, that wounds of the
 cerebellum so  promptly excite pain and convulsions? This can re-
 sult from no other cause than from its being destined to reflect ir-
                                30 

action or hie
ritation vividly into the nervous apparatus; that is to say, from its
being a very active promoter of sympathies, and preeminently the
exciter of the important  movements: this is what  we  learn  from
the experiments of M. M. Foville and Pinel-Grand-Champ.  It is
a great deal, I concede with the liveliest pleasure; but we must not
thence  conclude that it is the reservoir of sensibility, or that it
alone  presides over  its  evolution.   I  would  prefer  saying  with
Rolando and Flourens, that it is only the inciter to muscular move-
ment; but both assertions are equally incorrect.   The cause of sen-
sibility is every where diffused, since  contractility resides in  all
the tissues; but there are some of them, the function of which con-
sists  in  collecting stimulations (which are nothing else but the
putting this property into action), transmitting and reflecting them
from one organ to another; and  if, while these phenomena are
going on, the self (moi) be attentive, there is sensibility; if it
be absent, that is to say,  if the centre of perception  be not suscepti-
ble of acting, there is only a transmission of stimulations.   Sensi-
bility can  then have no other seat but  the  central point of the  -,
brain, where the  stimulations  terminate,  nor any other condition
than  the possession of consciousness.   The self (moi) perceives
with more or less readiness pain  in different organs, according to
the state of their  nerves;  in the  healthy condition, it refers it to
the internal and external senses,  because they are normal or stan-
dard centres for the reflexion of stimulations, which the animal
must necessarily receive, and because  the  vasculo-nervous matter
is there  found  in a fitting state for this  reflexion; but if inflamma-
tion has prevailed some time in a tissue  until then  insensible, it
will create a new vasculo-nervous matter, a true accidental sense,
to which the stimulations will tend, and in which pain will some-
times be more acutely felt than in the ordinary senses.  A puncture
of the cerebrum will not,  we are  told,  cause either pain or convul-
sions, whilst that of the cerebellum largely produces such an effect
I do not doubt it,  since it  has been observed: but expose the  cere-
brum and spinal marrow of an animal affected with a violent arach-
nitis;  exercise stimulation on them, and see if pain will not take
place, and if the muscular apparatus will remain immobile during the
operation.  On the other hand, destroy the summit of the medulla
oblongata;  stimulate the  cerebellum,  and you  can  then judge
whether this organ be the receptacle of sensibility.   A magazine 
RESPIRATORY MUSCLES.
283
of sensibility, independent of the centre of perception and the ex-
istence of consciousness,  seems to me  chimerical.  I may be de-
ceived, but I require, in order to be freed from error, experiments
other than those hitherto  published on this point  of  physiology.
To feel is to think, and sensibility is the soul.
                       CHAPTER  V.

                  FUNCTION OF ASSIMILATION.

   The  assimilation of alible  matters  devolves on an apparatus of
organs of great complexity, extending  from the mouth to the anus.
But as, when studying the sense of taste, we spoke of mastication,
an I ins.div.ition, we shall now only treat of deglutition and diges-
tion.  Deglutition is performed by the oesophagus: digestion takes
place in  the stomach and intestines, by the  aid of certain fluids sup-
plied from the glands annexed to these organs.

Section I.—A summary Description of the Digestive Appa*
                            ratus.

   The oesophagus, which forms the superior portion, establishes a
communication between the mouth and stomach: it is a hollow cy-
linder, composed of a muscular  tunic, which chiefly makes up
its structure,  since the principal  function  of  the oesophagus is to
carry along the alimentary mass; and of  an  internal membrane,
which is restricted to supplying a mucous liquid, fit to facilitate this
progression.  There  is very little to be said respecting this canal,
the sensibility of which is very obtuse  in a  normal state.   Its supe-
rior part, called pharynx, presents,  however, some  interest to the
physiologist:  it  is funnel shaped; its  upper  portion, which is the
widest, corresponds to the base of the cranium, and forms the fauces j
and the  inferior portion, which is narrowed, is continuous with the
resophagus.   The pharynx is formed of muscular bands, lined inter-
nally by a mucous membrane having papillae  communicating with
the cerebral nerv^,  and in which to a certain extent is continued 
284
DIGESTIVE APPARATUS.
the sense of taste: the muscles of this funnel are in part voluntary.
This region of the oesophageal canal is  the only one which evinces
any sympathy,—being closely united to the stomach by cords of
the great sympathetic.  We find consequently in it the phenomena
of relation and nutrition, as we shall see when examining its phy-
siological action.
   The  digestive canal, properly so called,  begins at the  superior
orifice of  the stomach, and terminates  at the anus.   It may be di-
vided into three regions; the stomach, the small intestine, and the
large intestine: these three regions have many characters in com-
mon; but each of them has peculiar connexions and uses, which
concur to the grand general function of digestion.
   The  entire digestive canal has a common character in being
formed of three membranes; one internal, of  a  mucous  nature^
which  plays  the  principal functional part; one  middle,  which
belongs to the series of  splanchnic  muscles; both  of them are
peculiar to the digestive tube; the third, which is external,  is a
portion of the peritoneum, that is to  say,  that it is common to
all the viscera and  sides of the abdominal cavity.   The mucous
tissue  of  the  digestive canal  is not in my opinion  purely gela-
tinous; for we find in it nervous expansions, which, though blended
with the capillary,  sanguineous, and mucous apparatus, must  pre-
sent albuminous matter similar to that of which the cerebral sub-
stance consists.   The dissection of this membrane  is impracticable;
we only know that it is vasculo-nervous, and that it exhibits folli-
cles or glands, placed between it and  the muscular coat, and  des-
tined to secrete the mucus,  which penetrates through the mem-
brane by means of small excretory ducts, and continually lubricates
the interior of the digestive canal.  Are there any other secretory
organs in this  tissue? This we shall inquire into when treating of
that part constituting the gastric surface. The general mucous mem-
brane which now engages our attention, evinces contractility, but
in a very limited manner; it forms numerous folds and plaits, which
are more or less completely effaced when the canal  is distended.
These  are called valvulae conniventes.  The muscular  plane is
formed of fibrine, and its bands are separated by an  areolar tissue,
easily distinguishable in certain portions of the digestive canal.  The
fibres which compose it affect  different directions,  longitudinal and
transverse; they are eminently contractile, and play a very im-
portant part in the functions of the alimentary canal.  The mus-
/ 
DIGESTIVE  APPARATT*.                 285
rnlar  is closely united  to  the  mucous membrane, by an areolar
tissue, which never contains fat.
  The serous  membrane, which is external, is the only one of a
homogeneous structure.   We find in it gelatine alone; for the san-
guiferous and lymphatic vessels  which are seen in it, are themselves
furnished by this substance.
  The peritoneum supplying this membrane is detached from the
abdominal parietes, in order to embrace the digestive canal by a fold
that forms two laminae,  between which the canal  is placed.  It
is strongly adherent  to  this latter through the greatest part of it,
that is to sa)", at the anterior and posterior surfaces of the  stomach,
and at the  anterior face only of  the intestines; but in some parts it
recedes, and then its only connexion is by means of a cellular tissue,
in which may be deposited some  fat. This arrangement is observable
at the two curvatures of the stomach, and at the internal curvature
only of the small intestines.   The object of this is to facilitate the
dilatation of the digestive canal, by permitting it to glide between
the two lamina; of the peritoneum, and  afterwards  to resume'its
former dimensions.
  It is between the duplicatures of the peritoneum that are placed
the  vessels and  nerves which establish the communication between
the digestive tube and the other organs, by conveying the materials of
nutrition, and enabling it in its turn to transmit them to  the body
generally.  The  arteries come from the abdominal aorta, and assume
different names in their course,  according to the region of the canal
to which they are destined.  The veins come from the  capillary
tissues, and all meet in a common trunk, usually called vena portae,
or, more correctly, sub-hepatic, which thence goes to the liver to
deposit in it the blood collected  in the intestinal canal.  Two orders
of lymphatics are found in the digestive apparatus;  one constitutes
a part of the general lymphatic system; the other which  comes
from the intestines has the name of  lacteal vessels: all meet in a
common trunk of which we shall speak hereafter.
  The nerves are of  two orders: one, coming from the eighth pair
or pneumogastrie, is of  the encephalic domain; the other  is de-
rived  from the great sympathetic,  a description of which has been
already given.  Each region of the digestive apparatus now requires
a particular examination.
  The stomach, which forms the most important portion, is placed
1:1  the epigastric  region, above the other two, and  beneath the 
2»0
DIGESTIVE APPARATUS.
 diaphragm.  It appears as a considerable expansion, constituting a
 kind of bag, with two  openings, one of which corresponds to the
 oesophagus, and the other to the first of the small intestines. I shall
 be careful not to spin out the  chapter  by a deiaileil description of
 this organ, but content myself with pointing out what is important
 to be known, in order to have a just idea of its functions.  1 would
 mention then, that it is situated transversely, and curved on itself,
 forming an arch of a circle, directed  from left to right and  from
 above downwards, to again rise, so that its two orifices are higher
 than its fundus: it is compared to a bag-pipe.  It follows as a conse-
 quence ironi this, that the substances which it holus do not tend to
 escape  by their  own weight, though  the right or pyloric orifice,
 which communicates with  the intestines, be situated a little lower
 than the left or  oesophageal opening.  We must aiso note, that its
 smaller curvature, which is the upper one, and the greater, which
 is the lower, are abandoned by the peritoneum in such a manner
 as to leave a double triangular space occupied by a very lax adipose
 tissue, in which  the stomach retreats when  it is distended  with 1
 food.  We have already observed, that the small intestines only
 presented this disposition at their internal curvature, consequently
 the stomach has much more room than all the rest of the digestive
 canal to enlarge itself. We must, moreover, observe, that the mus-
 cular fibres of the stomach are stronger than those of the small in-
 testines, and  less so  than those of the large ones; that they are most
 powerful at its two orifices; that in these parts the internal mem-
 brane is  thicker, more sanguineous,  and better  furnished with
 mucous  follicles; and that, much richer in vasculo-nervous expan-
 sions than that  of the  intestines, it is so in a much more  positive
 manner  at these orifices than in the  rest of  the organ.   If then
 this  membrane  constitutes an internal  sense,  as we think  we
 have proved, it must be conceded that it is more exquisite at the
 above orifices than elsewhere.  Finally, I would remark,  that the
 predominance of the sensibility of the stomach over the other re-
 gions of the digestive canal is due less  to the great  sympathetic,
 which, however, is met with  in  considerable  proportion, than to
the eighth pair,  which furnishes to this  viscus several branches,
called stomachic cords,  the like of which are notfodnd in the intes-
tines.  It remains for us to know whether the  portion of mucous
membrane, belonging to the stomach, contains secretory organs,
the office of which is to furnish a fluid fit to produce the assimila- 
DIGESTIVE  APPARATUS.
287
uon of nutritive substances. The existence of this liquid has been
admitted by some under the name of gastric juice.   Others have
denied it in the most formal manner, asserting that the serous saline
limpid and frothy fluid, which the human subject sometimes ejects
by vomiting in the interval between the digestive efforts, can only
be saliva, the deglutition of which went on in an insensible manner;
or of  pancreatic juice, which,  by irritation of  the stomach,  has
been drawn into its cavity.  They also rely on the absence of every
kind of glandular tissue, fit to furnish such a fluid.  The question
is as yet undecided; though, if we are to judge by analogy, we shall
observe that many animals are provided with gastric glands, supply-
ing a digestive liquid.  We meet such in the succenturius of birds;
the lumantin of the north (Manatus.  Cuv.) presents, in the coats of
its stomach, a gland of very considerable size, devoted to this pur-
pose.   I would demand, in my turn, if it be not possible that the
gastric fluid, which we consider as mucus, is a true digestive juice;
and if, consequently, the glands that secrete it  would not be diffe-
rent from those destined for genuine  mucus?
  The second region  of the digestive canal has been  divided into
three sections:  the duodenum, the  jejunum, and the  ileon.   1
believe there are but two recognizable portions; the duodenum will
form the first;  all the remainder of the  small  intestines on to the
ileo-coecal valve, will constitute, in my mind, the second.   In fact,
the duodenal portion  preserves something of the properties of the
stomach: it is  wider,  thicker,  more muscular, nervous, and sensi-
ble, than all the remaining part.  We see in it a curve analogous
to that of the stomach, but directed from right to  left, and, conse-
quently, fitted somewhat  to retard the  passage  of the alimentary
substance; hence it has, from  some anatomists, received the name
of small stomach-   It doubtless represents the  second stomach
of the non-ruminating herbivorous animals; but what  particularly
distinguishes it is the  common orifice of the canals  for bile and pan-
creatic juice, the secretors of which are placed  near  it, and with*
which it is associated  by nervous cords and vessels.
  Immediately at the termination of the duodenum, which is ad-
herent throughout, thereby facilitating the  temporary  delay of the
chyme, the small intestine becomes free and floating,  in the midst
of the grand central fold of the peritoneum, called  mesentery: it i?
moveable, and much more narrow in its  diameter than  all the other
regions of the  alimentary canal.   In this portion the mucous mem 
288
DIGESTIVE APPARATUS.
 brane has but a small supply of nerves, and little sensibility; it is
 porous, and absorbs, like a sponge, the chyle that it deposits in the
 numerous lacteal vessels of the mesentery, with which it commu-
 nicates.   The muscular coat is thinner, the intestinal cavity is here
 always empty, and numerous  lacteal ganglions are placed between
 the laminae of the corresponding portion of the mesentery. Thevcrv
 important remark may here be made,  that the cords of the eighth
 pair do not seem to be prolonged into  this region, which is, conse-
 quently, under the influence of the great sympathetic.   The blood-
 vessels  by which it is penetrated are  numerous, though we meet
 with no other secretions but that of a mucus, which, to a certain ex-
 lent, possesses, perhaps, an assimilating property.   These charac-
 ters, to us,  seem sufficient to  distinguish the small  intestine from j
 the others.   After having  described  a number of convolutions^™
 placed one above another, it terminates at the ileo-coecal valve, a '
 fresh  narrowing, which offers great interest to the physiological
 physician, as we shall  see when  giving an account of the physio-
 logical action of these organs.
   The large intestine is separated from the inferior portion of the
 small one,  called ileon,  by  this  valve, which  is simply  a con-  ,
 siderable  fold of  the  internal   membrane,   the free border  of
 which corresponds to  the cozcum, a kind of enlargement or sac,
 whence begins the colon.   The mucous membrane that forms the  i
 coecal valve, is strengthened by a cellular tissue, numerous vessels,
 and a greater number of mucous follicles than arc found in the parts
 adjacent.  We are also at liberty to suppose, that the nervoso-vas-
 cular expansions are more considerable in it,  since its sensibility is
 developed to a remarkable degree in the pathological state.   It is
 equally a matter of observation, that the small lacteal glands or gan-
 glions are very abundant in that portion of the mesentery, corres-
 ponding to  the part in which the intestinal canal undergoes the
 transformation that now engages our  attention.   These remarks
Vill be  turned to  a useful account in  the  pathology of intestinal
 phlegmasia'.
   The colon constitutes the major part of the large  intestine.  It
 begins in the right iliac region at the pouch  called ewenm, is di-
 rected upwards, passes  before  the kidney,  is seen under the con-
 cave surface of the  liver, traverses the epigastric region from right
 to left, before the  duodenum and  pancreas, and beneath the great
 curvature of the stomach, to which it is attached  by a double fold 
DIGESTIVE  APPARATUS
239
of the peritoneum, that is  subsequently extended  to all the other
intestines, and is the great omentum; thence the colon turns down-
wards, to be directed, while it passes by the side of the spleen and
before the left  kidney, to  the  iliac region of that  side.   At  this
place it forms a considerable fold in a curved form, which traverses
the hypogastric region to return to the point where it set out.  But
whether  it runs this course  or not, it dips into the pelvis, and de-
scribes a  straight line, assuming then the name of rectum, to finally
terminate at the anus.
   The  form  and structure of the  large intestine differ from
those of  the small ones; its  mucous coat is thicker; the muscular of
that portion of it called colon, is composed of longitudinal fibres
which make up the major part of it, and of bands, some transverse,
others longitudinal, which cross each other at right angles, with the
effect of narrowing the diameter of this intestine, and of leaving in
their intervals, and on its free surface, cells of various sizes. These
are always most  considerable at the middle  or epigastric  region,
which bears the name of arch of the  colon; they disappear in the
lumbar regions, where the intestine is, as it were, plunged into the
cellular tissue,  behind the  peritoneum, which is only here adhe-
rent to  its anterior surface.   This epigastric portion is then the
most dilatable,  as it is not rigidly embraced by the peritoneum;
the fold of this membrane, or the omentum which contains the
intestine, as well as the stomach,,abandons it at its superior and in-
ferior surfaces, having the same relation to it as to this last mention-
ed viscus.  Vessels and nerves placed in the cellular tissue of the
omentum,  are common to the stomach and transverse portion or
arch of the colon.   It  is important to bear in mind this arrange-
ment, for the just  appreciation of the  connexions too little  noticed
by pathologists, which associate the stomach and middle  region of
the large intestine together.   The lateral portions of the colon
have communications, by nerves,  with the  kidneys, spleen, and
spermatic vessels.  The rectum is in the same manner connected,
in man with the bladder, and in woman with the vagina.
   We learn  that   the  large intestine, partaking of  the  cerebral,
spinal, and ganglial nerves of the duodenum,  stomach,  kidneys,
bladder,  and  vagina, must be endowed with more sensibility than
the  floating portion of the small intestine, which only communi-
cates with the brain by the  small cords that connect the great sym-
pathetic with that  organ.   This is what experience proves; as the
                               37 
290                 DIGESTIVE APPARATUS.
kind of pain called colic, has almost always its scat in  the colon,
whence is derived the name.
  It is observed, that the muscular fibres of the rectum are  very
powerful; they communicate with those of the anus, which is more
abundantly supplied with cerebral nerves; hence, in this point, the
presence of faeces causes the irritation  which is transmitted to the
whole rectum in order to produce defecation.
  We have yet to speak of the  subsidiaries to  the digestive tube;
but as I must treat of them in the history of the secretions, I shall
content myself with remarking,  here, their relations to  the gastro-
intestinal mucous surface, on  which their excretory ducts open.   ■>

Section II.—Of the  Functions of the Digestive  Apparatus;
                       Hunger—Thirst.                        1

  We must again set out with the functions of relation,  since hun-  -.
ger and thirst, the natural preludes to digestion, suppose a concur-
rence of action between the assimilating apparatus and the brain.
  Natural  hunger is founded  on the want of nutritive materials:   |
the exercise of the functions decomposes and  dissipates the free   [
and  mobile animal matter; the  fixed  portion has no aliment for
its  reparation;  there  is no  longer a  sufficiency of  stimulations
appropriated to vital chemistry in the fluids; this process is deteri-
orated, and hence the source of the want   It is then  that the por-
tion of fixed matter, that is, the nervous form of this matter, which   >
is destined to  the functions of relation, undergoes a peculiar stimu-
lation: in whatever manner this last may arise, it is not  the less
certain, that  by the centre of  perception  it is always referred  to
the stomach.  This viscus seems then to be the point to which
converge all  the famelic stimulations resulting from the deficiency
of nutritive materials in the different parts of the body.   It is in a
state which the centre of perception regards as  painful,  and which * j
causes the desire of alimentation  to be felt.  Hence it is from the
organ destined for the assimilation of the nutritive materials, that
the sensation  emanates,  to determine  the animal to seek them.
Nothing is more certain;  for if the stomach be diseased, the neces-   ,
sity of nutrition, though carried  to a very great degree, and well
understood by the intellect, would not produce an instinctive want.
In fact, this one, like all others  of the same order, is founded  on 
                      HINGER,--THIRST.                   291

a peculiar visceral sensation.   Now, when the stomach is inflamed,
it is not the feeling of hunger which is felt, but others, which oc-
casion sometimes thirst, sometimes a dread of all kinds of ingesta,—
very often anger,  almost  always  sadness; or else  these sensations
give rise to stupor, delirium, convulsions, and even at times abolish
the mental faculties,  according to  the mode and intensity of the
irritation of the  great sympathetic; for we have shown elsewhere
that to it alone  belongs the power of overcoming the intellect and
forcing the will.
  We see that it is impossible not to attribute to this nerveHhe fa-
melic  stimulation of the stomach.    It must bring it to this latter
by means of its  prolongations in  the coats of the visceral arteries;
and when this stimulation has reached  its tissue,  it is diffused
through all the plexuses of the abdomen, where it is taken up by
the extremities of  the eighth  pair, to  be transmitted  to the cere-
bral centre; but this latter speedily reflects it into the nerves of its
domain, and the  intellect repels all other ideas, in order to be exclu-
sively occupied with those relative to alimentation, whilst at  the
same time the entire muscular apparatus becomes painful, and loses
a part of its energy.
  These  modifications in  the phenomena of relation are soon ac-
companied by many others, observable in the play of the organic
functions.  The  stomach being preeminently the  stimulator of the
whole economy,  since it calls the brain into action for the seeking
or avoiding of nutritive matters, the heart, and all the secretors in
aid of assimilation, depuration, &c.  must  all fall into languor when
it is no  longer irritated by the presence of aliments.   Hence we
find that the inertia of the heart is soon added to that of the brain
and muscles, from which, as a necessary consequence, results slow-
er respiration, coldness of the entire body,  and  especially of the
skin,  diminution of all the secretions, a sensation of emptiness and
lightness in the body, proceeding  from the circumstance of absorp-
tion not being proportionate to the exhalation.
  Such is the  first period of hunger;  but, if it be not appeased,
another series of phenomena is not long in occurring.   The painful
sensation of the  stomach is increased,  and becomes a very power-
ful stimulus to those very  organs  which it had  previously thrown
into a state of languor; sadness is changed into anger,  and the ce-
rebral centre, tormented  by  the  constantly increasing stimulation
of the great sympathetic,  repels every idea alien  to the want,  and 
 292                   HUNGER,—THIRST.
 reserves all the powers of the economy to  execute  the acts neces-
 sary for alimentation.   As muscular action is  its principal instru-
ment,  the muscles  receive  an abundant  innervation; agility and
 force are displayed in  the highest degree, especially in the carnivo-
 rous animals, of which often much exertion is required  to procure
 their nourishment;  the action of the heart and  lungs is revived,
 the circulation accelerated in order to aid the locomotive apparatus,
 and the anger exasperated by the continually increasing pain in the
 epigastrium, serve as a constant support to the general exaltation.
 What  most struck an  observer on the raft of the frigate Medusa
 after her shipwreck, was the scenes of fury and rage renewed every
 minute among unfortunate creatures abandoned in the midst of the
 ocean.
    The sensation of  thirst is not less terrible in its effects;  it does
 not necessarily  produce,  like  hunger, an  inertia of the different
 functions, because it may be experienced by persons satiated with
 solid food.   As it is more irritating, it occasions from the  first an
 exaltation.  Thirst, which is felt in the fauces and pharynx, consists
 in a sensation of dryness and heat, with a desire to drink; for its cause
 consists in a deficiency of fluid destined  to moisten  those parts.
 It soon extends to the oesophagus, seems to traverse the chest, which
 is represented as all on fire, and in fact the tracheo-bronchial mucous
 surface is parched and burning: this sensation of heat seems to be
 lost in the stomach.  The portion of mucous  membrane which is
 the seat of the feeling, is  injected with blood, and deprived of sero-
 sity; it becomes burning and  inflamed.   The desire for fluids is
 exhibited with rqnewed force,  and all the wishes of the sufferer are
 directed towards cold  water.
    When hunger lasts  too  long, it is necessarily joined with thirst,
 and this latter often becomes in the  end predominant.   These two
 wants  combined are the torment of the unfortunate famished; but
 it is more especially the  latter, which  seems to us  that which in-
 spires  the most  ardent desires, and most excites to anger.
    Hunger and thirst may be suspended by sleep; for so soon as
 consciousness disappears,  sensibility is no longer manifested, though
 the irritations which give qrigin to it still  persist.   This fact in
 conjunction with a thousand others,  proves that sensibility is by no
 means  a vital property of the  same order with contractility, and
 that it  is only the consequence of the latter being  called into ac-
 tion.   I have elsewhere said that this result was not a phenomenon 
                         HUNGER,—THIRST.                     293y
of matter,  and is incomprehensible, for in my mind it is blended
with thought.   Yes, let us dare to repeat it, to feel is to think.-  I
will even say expressly, what I had  already indirectly advanced,
to feel  is to judge; and it is as ridiculous to make of sensibility an
organic function,  as  to  consider  it  a  property inseparable from
living animal matter.    I repeat it  once more, there is no other pro-
perty but contractility dependent  on organization, or if you will on
the chemical composition of animal matter, and which varies ac-
cording to  this  composition.   The  exaltation of  this property,
which is revived under the influence  of stimuli, and which by the
nerves  is transmitted  from  one  tissue to another,  constitutes that
stimulation which never ceases in  the living body.   Finally, when
consciousness exists, and we are aware of this stimulation, there is
sensibility, but this phenomenon is necessarily intermittent*  Any
  • An objection has been made to this assertion, which it is important to meet.
It has been alleged in favour of an uninterrupted state of sensibility, that, since
the foetus moves in the uterus, it must necessarily have felt stimulations, which
came from the viscera to its brain; only, it is added, its sensibility is more obtuse,
and we  are told that the person asleep is in the same condition.   To this we
may, it seems to me, thus reply.  If you refer to sensibility all  the movements
that result from the stimulation of organized matter, you ought  equally to attri-
bute to the same cause, the motion  of the leaves of the sensitive plant, since
they also contract under the influence of a stimulation;  then the movements of
the stamina which stoop to embrace the pistils, the  closing of the petals of the
marygold during the night, the expansion of those of night-shade in the cool of
the evening, will be likewise  effects of sensibility, and this property will be found
diffused through the whole vegetable kingdom.   The name will even be confer-
red on the contraction of muscles  separated from the  living body, and on the
movements of the excretory ducts in exciting their fluids.  Sensibility not being
appreciable, except by contractility, we should then be  justifiable in laying aside
this property, and in admitting but the first, or to attribute  them both to each
particle of animal matter.  In fact we should say, every fibre -which moves by the
kontact of a stimulus, has-felt,- every fibre is then sensible: it would afterwards re-
main for us to divide, as Bichat has done, sensibility, into animal or perceived, and
organic or not perceived.  But who does not see that there is here an abuse oi
the word sensibility?
  The word organic sensibility analysed, expresses the following fact: the fibre of
an organized being has contracted by having been  touched by a foreign body. The
word animal sensibility expresses this other fact: the  animal has experienced plea
sure or pain.  Now tell me, I beseech you, what is there in common in these two
facts ? The first is a phenomenon entirely material; the  second is purely intellec-
tual.  For the  first we require but a piece of organized matter; for the second,
we want an auimal full of hfr, having a cerebral centre, and being  in a waking
state.  If you place sensibility in the nerves, why not say that this property still 
SO 4
HUNGER,— THIRST.
   other hypothesis is beyond my comprehension.  We see, by what
   has been said, that if the necessity for aliments and  drinks persists
«'#during sleep, the instinctive want does  not exist, that is to say, is
   not known  without consciousness.   Even though  aliments and
   drinks be necessary to the sustenance of a man sleeping profoundly,
   their deficiency is not attended with so much disturbance as in the
   waking state.  The reason of  this difference is, that the stimula-
   tions of the animal economy are greatly augmented in energy, when
   they are perceived by the sentient /.  It moreover follows, that he
   who can sleep in spite of the wants by which he is agitated, suffers
   less than him who is deprived  of this advantage.   This fact con-
   firms also another  assertion which I  advanced in the first part of
   this work, viz. that the state of sensibility is a violent one, which
   becomes a perturbator, and would tend to exhaust the powers of life
   if it were not interrupted by sleep, which for a time carries us back
   to the foetal state.
     We may now  judge how important it is for the  pathologist to
   be well acquainted with the functions of  this digestive apparatus,
   which, as the principal exciter of the animal economy, exerts such
   an influence both in the sleeping and waking states.
     Abnormal hunger and thirst will be treated of in the pathologi-
   cal part of the digestive function.

   Section III.—Action of the  Digestive Apparatus.—First As-
                              similation.
     The aliments having been cut by  the  incisor teeth, torn by the
   canine, and ground by the molars, to which they are presented in re-

   exists in those of a limb separated from the trunk? It is sufficient that the nerves
   no longer communicate with the brain for it to disappear ;  that is to say, for the
   man having it no longer in his power to say, I suffer in this amputated limb
   when, you prick it.*   If you require this avowal, in order  to the recognition of
   sensibility in an arm or in a leg, which you irritate, why will you admit its exist-
   ence in the brain of a recent embryo,  and in that of a dying apoplectic, whom you
   may prick and slash without their complaining?  It is time for  us to understand
   each other in physiology.  Apply the term contractility to the movements of
   organized matter, and reserve that of sensibility for the phenomena of conscious-
  ness ; the property entirely intellectual, will become the attribute and the proof
  of mind, and we shall no longer hear the ridiculous question proposed: Art
  plants sensible?
    *  If a man tell you, / suffer in thr. limb -which I no longer hove, it is because he experiences
  irritation in the extremities of the divided nt rvc, which are a part of his body; but this depends on
  a fact foreign to the question now under rii.cussion, and which I shall treat of in another place. 
deglutition.
295
gular succession by the combined action of the tongue and buccal
muscles; having been, at the same time, penetrated by saliva and
mucus, the aliments, we say, are united into a mass, called the ali-
mentary bolus, which is carried into the  pharynx in the manner
already indicated when treating of  the  sense of taste.  The mu-
cous membrane of the pharyngeal funnel is no sooner sensible  of
the presence of this bolus, than it determines the contraction of the
muscular bands which are affixed to  it.  The action of these latter,
which contract from above downwards, and from the circumference
to the centre, agreeably to the direction of their fibres, engages the
bolus in the oesophagus; and this latter, continuing to contract  in
the same manner,  soon carries it into the cavity of the  stomach.
Let us cast a glance  over the  relations  between  these successive
acts, and we shall find the manifest transition from the  external
life to that called organic.
   The masticatory movements are determined by the will, in con-
formity with the impression made on the sense of taste, and trans-
mitted by it to the cerebral centre.    They  may  be suspended at
will; but so soon as the bolus has passed the isthmus of the fauces,
the portion of mucous membrane which then receives  it has  no
longer need of the concurrence of volition to make the muscles of
the pharynx act. This membrane calls on the brain for contraction;
and this latter obeys, because invited to do so by the cords of the
great sympathetic.  Still, however, as cerebral  nerves are met
with in the pharynx, if the alimentary bolus excite pain, or if it
pleases the will to refuse it a passage, the pharyngeal fibres contract
from below upwards, and the bolus is repelled towards the cavity
of the  mouth.   These muscles are to be placed then in the series
of the  cephalo-splanchnic ones.
   The  process is of a different nature so soon as it has passed below
the pharyngeal funnel, and has reached the oesophagus properly so
 called;  as  in  this place  the sympathetic  nerves predominate,  the
 mucous membrane  makes  itself obeyed without  any  opposition
 from the will, and the bolus can no longer be  arrested in its pro
 stress to the stomach.
   If, however,  its presence was inconvenient:  if il was  not suffi-
ciently moistened by mucus; if it was stopped by asperities, as iti
 the case of its containing a bone or cartilage, a pin, &c. instinct
 will be stimulated for its expulsion  by the oesophageal sense, which
 is of the number of the internal ones; it will excite hiccup, or even 
296
DEGLUTITION.
 vomiting, and wc shall then see the respiratory muscles,  whicli
 are also cephalo-splanchnic ones, forced to suspend  respiration in
 order to second the efforts of the splanchnic muscles of the stomach
 for the  purpose of producing the ejection.   Thus then, by  this
 mechanism, the  will will be forced,  whilst in the mouth it cannot
 be so, however disagreeable the impression  produced  by aliments
 on the sense of taste. Thus, suppose that the will persists in having
 the unpleasant aliment masticated and  swallowed, the sensation
 thence resulting may,  when the substance reaches tke base of the
 tongue  and  touches the velum palati, provoke efforts to vomit;
 but if the will persists  the aliment will still be swallowed, unless
 vomiting be actually  excited; for, as this movement resists voli-
 tion, it will  expel the aliment,  together with the  other substances
 rejected  by the  stomach.   In these cases it is very evident  that /
 instinct has not forced the  masticatory  muscles to reject the ali-
 ment, but only obliged them to suspend their action,  and to open
 the cavity of the  mouth in order to  facilitate vomiting.  Thej&
 muscles have then obeyed the visceral sensations, which draw after
 them the will, but were not at all subservient to the impression I
 made on the  sense of  taste:  this impression tends  to solicit the
 will to reject the aliment, but  it has not the power  to force it;
 there must, for this purpose, always intervene a visceral irritation.
 The only local phenomena,  which can be produced by the sensa-
 tion of taste  independent of the will, are the secretion of saliva,
 and that of mucus from the tonsils, as I have  shown, when treating
 expressly on mastication.   These views would seem to be in anti-
 cipation of the pathology of deglutition,  but they were necessary
 for the understanding of the mechanism of this process.
   The aliments and drinks having reached the stomach, remain in
 it a certain time in order to be submitted to assimilation.  The lat-
 ter process belongs to vital chemistry; but while this power acts on
 them, it manifests phenomena of relation, the study of which is
 very important to the physiological physician.  We will now take
 up the consideration of them.
   The transformation of alimentary matter into chyme, is a process
 of vital chemistry, which is known, but not explained; whilst it is
sin our power to account for the  phenomena of relation,  that accom-
 pany it, by referring them to irritation.   This latter remains inex-
 plicable; but this is not now the question that engages us. 
FIRST ASSIMILATION.
297
  Is assimilation produced by the action of the mucous membrane,
aided by  fluids peculiar to the person in whom the process  takes
place, and the molecules of which are put in apposition with those
of the ingesta?   Is it  accomplished by means of water, heat, and
atmospherical gas?  The  reply to these questions can only be af-
firmative.   The presence  of air, the aid of heat and water, are by
no means doubtful.  The  mixture of the ingesta with the humours
of the  subject is not any more  equivocal, since  they only  reach
the stomach after being impregnated with saliva and mucus.   But
one is desirous of knowing whether the stomach furnish a peculiar
fluid.  We have expressed our opinion on this subject; but whether
the gastric fluids possess an assimilating property, which, for our-
selves,  we admit, without pretending to demonstrate its actual
presence, or whether it does not possess it, it is still certain that
the alimentary mass  is mixed with a great quantity of fluids  pecu-
liar to the subject.  These conditions being fulfilled, assimilation is
performed.   Neither contractility nor sensibility are its immediate
agents; they only concur as instruments of relation.   But we must
distinguish organic relations which  do not interest the encephalon,
from those relations in which it participates.  Let us begin with
the first, which have the closest connexion with assimilation.
  The gastric surface is irritable:  stimulated by aliments, it fur-
nishes them with fluids from its own tissue.   It invites, also, those
of the salivary glands, and of  the liver; for the bile is not confined
to a union with the  chyme which  traverses the  duodenum;  it is
forced up into the gastric cavity, perhaps not for the digestion of
all kinds of aliments, but certainly for that of some,  as of fatty and
oily substances.   It comes in during the first period of digestion,
and  then imparts a bitter taste to the alimentary mass.  We may
even call to mind the circumstance of there being animals  in which
the biliary canal opens into the stomach.   If the bile arrives at this
viscus,  it  would  seem to  me probable, that the pancreatic fluid is
likewise directed into it,  and this  without the  necessity of any
effort at vomiting, or even nausea.
   The first part, then, performed by contractility in digestion is,
to oblige the auxiliaries of this process to furnish their fluids.  The
relations by which this afflux is  determined are, as we know, per-
formed at a short distance.
   The second office of contractility is also very limited, and, like
the  first, is gone through without  the aid  of the encephalon.  It
                               38 
298                   HKST ASSIMILATION.

consists in placing the muscular coat of the stomach at the disposal
of the mucous* membrane,  at  first,  for  the retention of the ali-
mentary mass, and afterwards to communicate to it very slow oscil-
latory movements, which tend  to direct it from the cardia towards
the pylorus, and from the pylorus towards the cardia.   These move-
ments are the consequences of  the different direction  of the  fibres
of the muscular coat,  and are  always in correspondence with the
manner in  which the gastric sense  is affected.  We  here regard
them as in a natural state, because we are studying natural or nor-
mal digestion, in which the gastric sense is stimulated  in a manner
conformable to the wants of the economy.   The contractions which
we now describe,  keep up, then, a movement of the alimentary
mass, and present  it successively to the different regions of the gas-
tric cavity,  by which its assimilation must  be facilitated.
   When the food  has  remained some time in the stomach, it is
transformed into chyme; its bitterness has  disappeared; it is acid,
and of a peculiar acidity, and at length becomes  fit to pass the pylo-
rus; and then begins what is called  second  digestion.  We  will
follow this process, before speaking  of the relations in which the
cerebral centre participates.
   The ingesta do not all  pass  the pylorus at  the same moment;
those which require the le;>st assimilation pass  the first.  Magendie
has observed, that water and alcohol are promptly disposed of; he
thinks that the veins of the mucous  coat of the stomach absorb it
This assertion does  not seem  to me  sufficiently substantiated, at
least in all cases; for in pyloric irritations,  which cause a distention
of the stomach, water, together with the food, is accumulated in
the cavity of this  viscus until vomiting comes  on, and the urine is
almost nothing. I  have had several opportunities of assuring myself
of this fact; and I am inclined  to think, that if the  water  disap-
pears so promptly from the stomach, it is rather because the pylorus
lets it pass  the first, than because  it is entirely absorbed by the
mucous membrane.  It would be, however,  hazardous  to deny, that
this absorption cannot take place to a certain extent;  for I am per-
suaded, that there is no part of the  living body which does not
possess more or less an absorbing power.
   Be this as it may, what we are very sure of  is,  that alimentary
matters of a certain density,  and  which  require a long digestive
labour,  are  not absorbed by the gastric membranes, but are forced
to remain in them for a certain time.  When this period has expired, 
FIRST ASSIMILATION.
299
the pylorus, to which they had been many times presented, allows
the in a passage, even  though the assimilation of them should be
incomplete,  or should  not have taken place.   Experience proves
this  every day, since pieces of tendons, and of bones, and coins,
finally pass into the intestines.  I believe that these foreign bodies
clear the pyloric strait by the aid of substances in a more advanced
Btate of assimilation: at times, however, they are inevitably thrown
back, as we shall see in the pathological part.  We find, from this,
that  the natural or normal evacuation of the stomach is command-
ed by the internal sense, which forces the muscular coat to be con-
tracted in such a manner as to expel its contents, after having at first
obliged it to  retain them during a certain time. This difference in
the commands made on the muscular coat can only depend on the
manner in which the sense is affected; and here we may distinguish
two  degrees of this affection; the first, which  is the effect of the
impression of aliments not  assimilated, tends to retain them; the
second, which results from the impression of aliments  converted
into  chyme, tends to expel them through the pylorus.  There is a
third, which  we shall find in the pathological part
   It was formerly thought that the alimentary matters approaching
the nearest to the nature of the individual, were the most promptly
assimilated, and absorbed  the first.  Experience has  not exactly
responded to this theory.  Doctor Sarlandiere has ascertained, at the
Hotel Dieu, on three persons having artificial anus, that food the least
nutritive, such as the roots,  stems,  and leaves of vegetables,  and
fruits, arrived more speedily at the opening than farinaceous articles,
milk, and meat: the difference is even considerable; for in the space
of an hour to an hour and a half or two hours, the first came away
by the wound, without even  presenting any great alteration; whilst
the second appeared only at the expiration  of three or four hours,
under the  appearance of chymous matter already perfectly elabo-
rated.  These experiments  prove,  that the internal gastric sense
repels the  aliments which offer the least assimilative matter, and
retains,  with a kind of complaisance, those from which it can de-
rive  better aid for nutrition.  The physician whom I have just cited
observes,  that milk and fecula  pass more promptly  than meat,
without their being, however, less assimilated, which gives to this
kind of food  a great advantage over any other, when it is required
to nourish a person whose stomach is very irritable: still, however,
idiosyncrasy may furnish exceptions to this rule. 
yoo
flKST ASSIMILATION.
  Though the bile be directed, when required, into the stomach,
it is not the less certain, that it is furnished with more abundance
to the chymous  matters during their short stay in the duodenum.
All physiologists believe, that  there then  takes place a process by
which the  excrementitial matters are precipitated, and the chyle
destined to be absorbed is separated from them: it is evident, that,
at the expiration of natural digestion, the acidity disappears in the
contents of the small intestines.  The chyle, presenting the appear-
ance of a milky liquor, is carried to the circumference of the mass
moving through the intestines,  and is directed towards the  mucous
membrane, to which it seems to adhere.  This membrane absorbs it
like a kind of sponge, and  causes  it to  reach the chylous veins,
commonly called lacteal vessels, in which we shall take it up, when
treating of secondary assimilation.
  After having  traversed the long  channel of the  intestines, the
product of  digestion approaches the ileo-ccecal valve; this point of
narrowing retards somewhat its passage, and gives time for  absorp-
tion to deprive it of the major  part of the chyle which it retained.
The transit is therefore slowly performed here, and, when effected,
the matter  has  obtained  the characters  of excrement.  Still it is
tolerably fluid in the coecum, and the ascending and transverse por-
tions of the colon; it is much more  dense   in the sigmoid  flexure,
and, when accumulated in the rectum to solicit the act of defeca-
tion, it presents the consistence which we see in it after its issue.
  These changes suppose that the absorption of chyle is continued
to a certain  degree, in the course of the large intestine. It seems
to  me  probable, also,  that the assimilation  is not limited to the
stomach and duodenum. The small intestines are moistened during
the passage  of aliments, with a fluid, which cannot be regarded as
foreign to this process, especially in their first portion, which bears
the name of jejunum.  This  term comes from its being always
empty, which  has  been  referred to the more rapid absorption in
the ileon.    For  myself, I hold it incontestable, that the  obstacle
which is met with at the end of this intestine, by the narrowing at
the valve, is the principal cause of the fulness which it offers; and,
as  it is equally certain, that absorption is very active in this region,
since we find in the  corresponding  portion of mesentery an im-
mense number of lacteal glands, and even the more the nearer we
approach the coecum, I should be induced to believe that assimila- 
FIRST ASSIMILATION.                   301
tion is still considerable in the ileon, and that it diminishes at the
same time that the absorption augments, in proportion to the near-
ness to the large intestine.   I shall return to this question in the
pathology of the assimilating function.
   If we examine the organic  relations which take place during the
progress of the alimentary matters from the stomach to the coecum,
we shall  find them analogous  to those which we have remarked in
the first digestion, but they are evidently less delicately graduated.
We see  indeed a stimulation of the mucous surface, by virtue of
which the secretion of bile, that of pancreatic juice, and of mucus,
more or less an assiinilator, are solicited.  The call made on the bile
is very considerable in the duodenum, but it is not limited to this
intestine.  Pathological anatomy apprizes us that, if there  be a
portion of inflamed jejunum, the bile, as well as an albuminous fluid
which may be attributed to the pancreas, is always found in it in
abundance.  We are far from discovering so large a quantity in the
phlogosed parts of the ileon; which proves, in my opinion, that this
portion of the small intestine  has less connexion with the two grand
secretory organs annexed to digestion, and that  consequently  it
possesses less of an assimilating function.
   The second organic  relation of the internal sense, and which is
exercised between it and the muscular coat, seems to me less deli-
cate than that of the stomach, since the small intestines do not re-
tain their contents for so long a time as this viscus, and do not move
them about with the same regularity.   Still, however, the  same
phenomena are met with here, in certain substances being longer re-
tained, and arriving sooner at  the large intestines, than many others,
and sometimes these matters  take a retrograde direction in the in-
testinal cavity; but as these differences are especially notable in the
pathological state, we shall reserve them for the last section of this
chapter.
   The excrementitial matters contained in the cavity of the  large
intestine, are there submitted  to a very slow progression.  This or-
gan is ope of deposit, and must consequently be much less moveable
than the superior regir n, which is but a place of transit.  The cells of
the colon aid in the retention of its contents.  Here  the organic relar
tions are  infinitely more limited; the appeal made to the grand se-
cretors is null in the  normal state; that exercised on  the mucous
follicles is very limited, and  reduced to the secretion of a sufficien-
cy of mucus to avoid dryness and constriction,—phenomena which 
302                  FIRST ASSIMILATION.
are as yet but too common.   It is clear, that if this relation h;ul
much activity, the matters would be always liquid, and  could not
remain there.  It is not less evident that,  if the colon possessed a
sense of a delicacy similar to that enjoyed by the stomach, or even
the small intestines, it would act too powerfully on the  muscular
coat, and thereby render defecation much too frequent:  pathology
proves these two positions.  A certain  degree of torpor, a state of
almost permanent tonicity, constitute then the most ordinary mode
of vitality of the  mucous membrane of this intestine, and of the mus-
cular coat annexed to  it.
   Still, however, this torpor is susceptible of an interruption, which
constitutes a part of the normal state; for at  the end of a certain
time, the faeces do not fail to revive the irritability of the mucous
membrane.   The sense with which it is endowed, is awakened; it
acts with force on the secretors of mucus, and on the muscular pa-
rietes.   The large intestine at this time  enjoys a degree of activity
equal to that of the superior region of the canal, and it retains it »
long as is necessary for the excretion of faeces; as we shall soon be
well assured after examining the relations of the digestive canal,
that suppose the intervention of the cerebral centre.
   These relations, like the preceding ones, take place by a modifi-
cation of the stimulus of the gastric sense, over which  presides a
vasculo-nervous matter, which is continuous with the nerves of the
eighth pair.   When the surface in which this sense resides is sti-
mulated by aliments, its action is not limited to the effect on the
adjoining secretors, and the muscular coat to which it is adherent;
it gives notice by means of the  eighth pair  to the centre  of percep-
tion, of the kind of stimulation it receives.   If this is to the well
being of the animal economy, the individual experiences a sensation
of joy; the brain reacts on all  the senses, which become more ac-
tive; on the muscular apparatus, which acquires more energy; in q
word, there takes place an agreeable innervation,  that solicits the
percipient centre to continue and hasten mastication and deglutition.
The heart receives its share of  this stimulation, and doubtless the
great sympathetic contributes to influence it;  but the brain plays an
important part in this, because  pleasure is felt, and pleasure never
fails to act, at the moment in which it is  felt, on the principal organ
of the circulation.
   From this increase of innervation exercised on the entire muscu-,
lar apparatus, and on the heart,  results the acceleration of the circu- 
FIRST ASSIMILATION.
303
latory movement; a greater quantity of blood is thrown into  the
viscera; those of digestion profit by it to furnish the secretions, and
the muscular contractions required of them; the lungs are found to
display a  new degree of activity; they  command  more extensive
movements of the dilating muscles of the chest; respiration becomes
more accelerated  and full.  The brain, stimulated  by a more con-
siderable afflux of blood, continues to  act more powerfully on all
the muscles; and  a kind of febrile condition is established.   We
may even  remark, that,  in  the first period of digestion, when the
blood is precipitated towards the viscera, this fluid is lessened in
the external tissues; and,  if  the atmospherical temperature be re-
duced, there supervenes a chill of some minutes, followed very
promptly  by a reaction which gives warmth and colour to the skin
on all parts of the body.
  Such are the first phenomena that announce the  influence of the
gastric sense over the nervous matter of the encephalon.  We find
that, setting out from the  internal surface of the stomach, the sti-
mulation is diffused by means of the encephalon through all the re-
gions of the body.  Were it, in fact, limited to the muscular coat,
and the secretors auxiliary to digestion, the intellect and the entire
muscular  apparatus would  be strangers to it; we should not expe-
rience that feeling of content and strength, which produces gaiety,
and promptly restores vigour to the limbs.   The heart might have
been without doubt excited, but never to the extent to which it be-
comes by cerebral innervation.   Observe also,  that the other
internal senses, and especially the pulmonary,  acquiring more ac-
tivity by the sympathy which unites them to the stomach, are
placed in  union with this latter, for the purpose of appealing to the
brain, and redoubling the action of the  cephalo-splanchnic muscles.
I have already said, that the afflux of  blood  to the  lungs  at  this
time is another very powerful  cause of the augmentation of action
in the respiratory muscles; and this arises from the respiratory sur-
face, diminished  by the sudden engorgement of the parenchyma,
receiving a smaller volume of air than before,  which obliges  it to
solicit more frequent inspirations.  It is thus, that we find mani-
fested the reciprocal influence of the internal functions on those of
relation,  and of these  latter on the former; but we must fix for a
moment our  attention  on the different sensations,  which the intel-
lect refers to the stomach during the chemical operation of diges- 
304
FIRST ASSIMILATION.
 tion, because each of them developes sympathies somewhat differ-
 ent.
   The first, and most remarkable, is that which pertains to gastric
 digestion: all the regions of the stomach are perhaps susceptible of
 it: I have not the proof, but it seems to me evident, that the cardi-
 ac region is its principal seat.  The following is what occurs.  So
 soon as a mouthful of aliment and one of wine are swallowed, we
 experience,  if the stomach is healthy, that is if it is not too much
 irritated, a feeling of comfort  and, strength, referred to the entire
 locomotive apparatus,  and which seems to be the effect of a mild
 warmth felt in the  stomach.  The pleasure which engages us to
 continue the alimentation may, perhaps, be felt in the entire extent
 of this viscus, since this latter is contracted, and the alimentary
 mass touches it in all  points; but towards the end of  the repast,
 when the stomach is distended by food, which is followed  by sa-
 tiety and distaste for solid substances, the mouthful of wine which
 we swallow, is at the moment of its descent in contact only with the
 cardiac region,  and yet the same  pleasure is  felt at the very mo-
 ment, and it depends then  on the stimulation of this part.   This
 portion of the gastric sense plays,  of course, a very important part,
 as a stimulator of the centre of perception, during the whole period
•of ingestion.
   When satiety has reached  its  maximum,  the cardiac sense no
 longer responds in an agreeable manner to the stimulation of spiri-
 tuous liquors; the mucous tissue in which it resides, has become hot,
 and even burning,  and to the desire for stimulating has succeeded
 that for cold drinks, the contact of which with the cardia revives the
 vigour exanimate by excessive stimulation, as had been done before
 by the contact of wine and alcohol, when the stomach, relaxed and
 chilled,  required  irritants.  We  would even go too far in the in-
 gestion of watery drinks, were we not arrested by the sensation of
 fulness which depends on  the general distention of the viscus.
 This sensation, joined to that which results from refrigeration, soon
 restores to the  cardia the property of being agreeably  affected by
 spirituous drinks;  and if we recur to the use of these  latter, the
 stomach  being  filled with water, they hasten digestion, and the
 desire for solid food is soon  renewed.
   Thus then, in my opinion, the  pleasure of alimentation specially
 depends on the  agreeable stimulation of the cardia; and satiety on
 the distention of the stomach.  But we must distinguish two kinds 
FIRST ASSIMILATION.
305
 of satiety;  that  for solid  aliments, which allows the desire for
 drink to remain; that for drinks, which only withdraws for a mo-
 ment the desire for solid food.   These two satieties arise,  without
 doubt,  from the modification of the totality of the stomach;  but
 the cardia is the point in which they are manifested at the moment
 in which  it  is brought into contact with the ingesta.   We learn
 from these remarks the degree of delicacy in the gastric sense, and
 how it becomes the faithful  interpreter  of  the wants of vital  che-
 mistry for the centre of perception.
  The want of aliments and of drinks being gratified, the feeling
 of comfort and strength, which the ingestion had produced, gradu-
 ally  diminishes, and  is finally no  longer  felt,  because it is not
 kept up by  new aliments, and because the remembrance of the fa-
 melic weakness is diminished and insensibly weakened.   The in-
 dividual now feels himself fit for every kind of muscular exertion;
 but no longer experiences that state which invites  him to  display
 his strength, unless he be  excited thereto  by another instinctive
 want, or by the calls of intellect. But if these causes of stimulation
 are wanting, and if the repast has been copious,  a fresh  instinc-
 tive  want  is manifested, especially if the body was fatigued before
 the ingestion; it is that of repose and sleep.  It seems  to me to be
 produced by the cerebral  congestion, the  necessary consequence
 of the digestion of a large quantity of aliment: this want is incom-
 parably more pronounced if the food have been mixed  with a cer-
 tain quantity of fermented drinks.
  If a man attends to his feelings during digestion, for the purpose of
distinguishing the sensations corresponding to the different  periods
of this chemico-vital operation, he discovers, that to the very lively
pleasure of ingestion soon succeeds a confused feeling of comfort in
 the whole  trunk;  but he perceives nothing very distinct in the sto-
 mach, until this viscus frees itself from the chyme formed from solid
food; for the absorption of water, useless in the  digestion of solid
aliment, is performed without causing any remarkable sensation.
During this  time  the  alimentary  mass is driven towards  the left
hypochoridrium, and is contained in the great arch or fundus of the
stomach; but after the third or the fourth hour, a mild heat is felt
in the sub-umbilical region, and accompanied by a feeling of emp-
tiness and relaxation in the  stomach.  Gas often escapes;  the
lower belly  is raised at the same time that the  epigastrium  sinks,
and the desire to urinate is  felt anew.   We  may also make the in-
                            39 
306
FiR^r
ASSIMILATION
teresting observation,  that the breathing, which during the firs'
hours was pectoral,  becomes now manifestly more abdominal, and
much less frequent and  expansive.   These signs  indicate the pas-
Sage of the chymous mass through the pylorus and duodenum into
the small intestine.   Commonly the heat of the skin and perspira-
tion are augmented;  many desires, such as those for  muscular ex-
ercise, thought, and generation, which had  been, as it were, sus-
pended  during the process of the digestion of substantial food, are
now felt sometimes with more energy than immediately after the
repast.  This is the period in which  man is best fitted for every
kind of corporeal and intellectual labour, because he is less excited,
has more power of resistance,  and  more breath.   He  is not dis-
tracted then by any disagreeable sensation;  and  this is what is so
important to be well apprized of in order to distinguish the slightest
shades of irritation of the digestive apparatus.
   This  state, which constitutes what  we call second digestion, va-
ries in its duration,  according to the quantity of aliments taken. If
they were in small quantity, it is completed in one or two  hours:
if the meal have been an abundant one, the second digestion is pro-
longed much more, and sometimes even lasts from fifteen to twenty
hours.  During this time the alimentary matter is found  both in
the  stomach and  intestines,  for the stomach  only gradually frees
itself, by directing  in successive waves towards  the pylorus,  the
matters which ought to pass the first, according to the order of their
digestibility,  of which  we have already given an account   It may
be observed,  that under these circumstances, that is to say after
heavy meals, the chyme which  last  remains in  the stomach be-
comes always very concentrated, and exercises on the mucous coat
a stimulation which is productive of thirst.    It is then that a small
quantity of water hastens the passage of this residue, and more
promptly recals the sensation of hunger.   Still, however, this lat-
ter, which  is very gradually felt,  only becomes urgent when the
small intestines have definitively  transmitted to the colon the en-
tire chymous  mass which had been so long in  traversing them.
This fact seems to prove  that digestion is continued in the small
intestines. 
DEFECATION.
307
Section V.—Of Defecation.  Encephalic Relations of the Large
                          Intestine.

  We may have observed, at the different epochs of digestion, an
action,  simultaneous and conformable with the actual state of the
viscera, in  the cephalo-splanchnic muscles  belonging  to each re-
gion of the trunk.  Thus, during the first period, when the stomach
was full and the lungs engorged with blood, the intercostal mus-
cles acted with  much energy in raising the ribs; the  diaphragm
and the  upper fibres of the abdominal muscles allow themselves to
be distended by the stomach; finally, the inferior portion of  these
same muscles, which corresponds  to the sub-umbilical intestines,
and the hypogastrium,  persist in a notable degree of  contraction.
When, again, the chyme, allowing the turgescence of the epigas-
trium to subside, has spread  itself in a sinuous stream in the small
intestines, we see the pectoral muscles diminished in size, the dia-
phragm depressed,  the upper sections of the sterno-pubien muscles
and the  upper fibres of the transverse and oblique to be contracted,
whilst the expansion of the chest is performed by the development
of the umbilical  and hypogastric  regions, the intestines in which
have just acquired  an increase of action.   We have witnessed all
this in the clearest  manner;  now we have to observe not  less evi-
dently this  same cephalo-splanchnic motor apparatus  obedient to
the modification  of the large intestine alone.
  At first  the accumulation of feces  in  the  cavity of this  organ
provokes no other noticeable sympathy except  a slight relaxation
of the muscular fibres of the  corresponding parietes, accommodated
to its enlargement, which increases somewhat the abdominal sur-
face; but so soon as the peristaltic movement, until then very slow,
has accumulated a certain quantity of excrementitious matter in
the rectum, the irritation which they produce on the anus  gives
rise to a quadruple series of sympathetic movements.  First, the
fibres of the rectum and colon begin to contract through the whole
extent of these  intestines; and immediately after, the abdominal
muscles and the  diaphragm imitate them, and exert on the abdomen
a mild pressure  which is not yet commanded  by the  will.   Then
the insufficiency of this effort causes a certain degree  of  pain,
which produces an appeal to the brain, and thenceforward the will
is forced to yield  to  the muscles above  mentioned, an impulsion
which instinct alone could not communicate to them.  But all thr* 
303
DEFECATION.
does not yet suffice;  we require an attitude for faecal discharge, a
point of support for the inspiratory muscles, to keep the chest im-
moveable, in order to direct all their action to the abdomen: now
this point of support can only be  found in the  limbs;  the will is
then  obliged  to let  the  muscles that are under  its dependence
concur with  those which are  primitively obedient to the viscera;
and it is by this  admirable union  of synergetic efforts that  defe-
cation is accomplished.
   If we study digestion in the different ages of life, the sensations
will not always be found as above described.   The child does not
know how to give an account of the irritations of its viscera; the
adolescent does not pay attention  to them unless  he  be sick; the
adult begins to observe them;  but the man who is in the decline of
life lets nothing escape him,  in the exercise of  the internal func-
tions.
   Education and the  kind of life, also have great influence on the
manner  in which  men are made sensible of the  state of their vis-
cera.  Persons practised in muscular efforts, and whose intellect is not
cultivated, only experience confused sensations  in the gastric pas-
sages, except in a very decided pathological state; whereas, these
organs  make  themselves felt in a very distinct manner in those
who continually and  from an early age exercise their intellectual
faculties.  It is worthy of remark,  that sensibility, so far from being     J
blunted, becomes more delicate in proportion as we advance in life; at    i
fifty years of  age  a man is more sensitive  than he was at twenty:
nor can this be attributed to any other cause, but the habit gradually
acquired of analysing the sensations resulting from the stimulation
of the different  sensitive surfaces, external as  well as  internal; it
is the education of the part of the brain destined for intellect, or,
in other words, of that faculty which the philosophers have called
consciousness.  It has been observed that warm climates contribute
to perfect this faculty; for men inhabiting  them are more sensitive
than those  of the  north; hence they give  their physicians a much  .
clearer idea of internal irritations, and above all of those of digestion.
This last remark,  however, having been made  by all physiologists,
I do  not deem  it necessary to dwell on it any longer. 
ABNORMAL ASSIMILATION.
30 <J
Section VI.—In what manner the  Exercise of the Organs of
            Digestion becomes the cause of Disease.

  To elucidate this question, we must study the  digestive organs
in their relations with the external agents capable of modifying
them.   What at first  meet our notice,  are the pathological phe-
nomena from the absence of these agents, that is to say, the morbid
effects of hunger and thirst.
  If there be facts which prove that the source of our wants is in
the  exercise of our functions, they are assuredly those of which I
am  now to treat; they  both show that the deficiency of stimuli pro-
duces in some of our organs an excess  of excitation.  In fact, when
the  stomach does not  any longer receive the aliments to which it
was accustomed,  it begins to  be chilled; which announces a languid
circulation in  its capillary tissues.   The same languor, the same
chilliness, are manifested in all the  other apparatuses, because they
are  no longer excited by the  stomach, and especially because the
heart, being less  stimulated,  sends to  them  a smaller quantity of
blood.  The first shade of a pathological state which results from a
defect of aliments, is therefore weakness: but the stomach is a sin-
gular organ; its destiny is to be always irritated, and therapeutists
ought never to lose  sight of this important fact.   If then it be not
so by the presence of  aliments and drinks, it becomes so in their
absence; it is contracted and irritated, it invites blood, and draws
towards it the fluids secreted by its annexed  organs.
  Must we have recourse as an explanation to the deterioration of
vital chemistry, which superanimalizes,  to make use of an expres-
sion of  the chemists, the free  and circulating matter? Does there
result from this modification a  super-irritation of the solids or fixed
matter,  which can only be now renewed by materials inadequate to
its wants? This super-irritation being perceived  by the sensitive
centre, does it produce the pains of hunger and thirst?  I believe that
the actual state of our knowledge justifies our replying  affirmatively
to these questions.  Is  it a law that this super-excitation which I call
famelic, should be stronger in the stomach than any where else, and
be at first referred to this viscus?*  I believe it;  that seems to me
  •  We see here the chain which connects vital chemistry with, intellect.  Are
we not indeed led to believe that the nervous radicles collect the stimulation
produced in the tissues by the degeneration of living matter; that these radicles
convey this stimulation into the splanchnic nervous apparatus, since the stomach 
310
ABNORMAL ASSIMILATION.
quite natural, and analogy confirms me in this opinion.   Is not the
irritation which results from the defect of respirable air first referred
to the lungs?  Is not  the desire for coition first felt in the genital
organs? that of defecation in the large intestines? that of the ejection
of urine in the bladder?  It  will perhaps be objected that these last
mentioned wants have for cause the superabundance of the stimulus
fitted to  each  organ.  That  is incontestable.   It is  very certain
that the  semen when not ejected is concentrated by  absorption,
and issuper-animalized;thatthe urine and faeces undergo the same
alteration; but why should not there be a similar change in the sto-
mach?  May not the gastric fluid be  accumulated in the gastric
cavity, and become an inconvenient stimulus to it?   Many physi-
ologists have thought so.   Hunter believed that this juice became
acrid, and by its delay, in cases of long fasting, acquired such great
activity as to dissolve the internal membrane of the stomach, and
even to cause a perforation.   I do not admit that things take exactly
this course.   The  faculty of  the  gastric juice to  digest the organ
which furnishes it, cannot, in my opinion, be attributed to it, for
digestion supposes a concurrence  of the action of the mucous mem-
brane and assimilating juices.   But is it not  possible for this fluid,
when too concentrated, to  irritate the mucous coat and give rise to
an inflammation capable of producing these organic alterations?  It
Will, perhaps, be alleged in reply, that it is  too hasty to attribute
evident changes to a  humour, the very existence of which is hypo-
thetical.  Well, then, if we repel  the idea of a solvent fluid secreted
is irritated; that the nerves of the eighth pair transfer it to the centre of percep-
tion ; that this latter, while contemplating as it were this excitation, diffuses it
through the sensitive and motor nerves; finally, that the  painful stimulations
which it receives from the stomach, induce the thoughts of food, and force the
will to the actions necessary to procure it ? It is when  in this state, that the
centre of perception best recognises the impressions made on the external
senses, by alimentary substances, because these impressions  augment the famelic
irritation. Let, nevertheless, a profound sleep supervene;  all the desires are_
suspended, because the condition of the brain, which was dependent on the
waking state, no longer exist*: now it is this condition of things which  makes
the state of sensibility, that constitutes consciousness.  What  then becomes of
sensibility and consciousness during sleep ? Where are these faculties, the only
source of whatever is sublime in human conceptions ? Where  were  they in the
foetal state ? There is nothing more than an aptitude to their existence, depend-
ing on the state of life.  The stimulations, however, of these organs, and their
transmission to the brain, still take place, as is proved  in epilepsy.   So far the
facts:  let the psychologists explain them; if they cannot, let them do like us,—
be silent and admire. 
ABNORMAL ASSIMILATION.
Jll
by the stomach, we are forced to admit the presence of a mucus in
this viscus, which is peculiar to it, and that of saliva, which de-
scends continually into it.  These humours may be depraved,  and
the irritation to which they give rise  draw in the bile and pan-
creatic juice.  Now I believe it will be difficult not to admit that
these fluids must be concentrated, and aid in the super-irritation of
the organ.
  However this may be, it is very certain  that hunger does  not
fail to produce thirst;  that the stomach becomes over-excited,  and
finally inflamed, and ends by exhibiting all the sympathies of the
best defined gastritis.   It is then that the  pains become atrocious
in the stomach and parts  corresponding; and if we would  remedy
them, we must proceed by giving small  portions of cool water,
gradually increased in quantity.
  The thirst produced by the want alone of watery drinks, tends
to the same result; the  phlogosis is developed  in the pharynx  and
stomach, solid aliments cannot be tolerated, and death takes place
here as in other cases, always preceded by sadness, anger, and con-
vulsive movements.  It.seems to me probable, that the arachnoid
is often affected with phlegmasia, for I have almost always found it
opaque in those who perished from gastritis;  and Dr. Scoutetten,
who was for a long time  my clinical dissector, has given  this fact
in his inaugural dissertation.   It is  now many years since I  first
wrote, and still longer  since I announced  in my lectures,  that the
brain and stomach communicate  reciprocally irritation  to each
other.  Even in the Histoire des Phlegmasies, on the occasion of
the  death of young Beau, who is the subject of the first  obser-
vation in the second volume, first edition, I had held  out the idea,
that the brain, irritated by the sufferings of the viscera, could  in-
vite into its tissue a sanguineous congestion, and undergo an inflam-
matory modification.   [See, also, the propositions which are at the
beginning of the Examen des Doctrines Midicales.]   It  is, then,
well proved, that the deficiency alone of stimuli adapted to the sen-
sibility of the stomach, can give rise in  it to a super-stimulation;
with still more reason  can it be produced when this viscus is over
charged with excitants: but it will be remarked, that those which
arc adapted to its vitality will offend it much less than those which
are repugnant to it.  Let us next examine into whatever is appli-
cable in the lesions which it suffers from both of these sets of agents. 
31*
ABNORMAL ASSIMILATION.
  Whenever the stomach is engaged in the process of assimilation,
it is irritated, calls to it blood in abundance, contracts with energy,
is heated, and, reacting on all the sensitive tissues, it becomes a very
active centre of irritation to the animal economy.  Restrained within
just bounds, this excitation is favourable to the exercise of all the
functions; too exalted or too  often repeated,  it becomes a univer-
sal  disturber, and a source of organic disorder both in the viscus
itself and in those which sympathise with it.  Alible substances, of
the most healthy kind,  may then generate the same evils as would
follow from a deficiency of food.
  Among the numerous organs  that participate  sympathetically
in the excess of gastric irritation, there are two which seem to be
more frequently affected than  all the others: these are the liver and
the encephalon. The first because it is forced to an excess of secre-
tory action, by the over  digestive activity  of the  stomach; the
second because it is destined by nature to be obedient to  all the
gastric irritations, of whatever kind they may be.  In fact, in bun.
ger and thirst, must not the will be  drawn along by the influence
of the stomach, in order to  direct the actions  necessary for the
gratification of the want, even when reason would oppose obstacles
to it? Is it not necessary,  during alimentation, for the intellect to
be apprized by pleasure or by pain, of the useful or hurtful qualities
of the substances  which are presented to the mouth, or which reach
the gastric cavity,  in order that the individual may continue or
suspend the ingestion of them?  During gastric assimilation, is it
not indispensable for the centre of perception to be informed if it
be done  in  a manner injurious  to the well-being of  the animal
economy, in order that man be  directed  to seek instinctively a
remedy in the bodies which surround him, in drinks for example,
or to  ask it from those of his like, to whom observation, experience,
and reason have imparted it.
  We have already said, that all these phenomena are in the pro-
vince of instinct;  they prove to  demonstration, that the stomach
can never be over-irritated  without the liver and brain participating
in it.  It  will not then excite surprise to hear us say, that these or-
gans must be the first by their diseases to participate in the disorders
of nutrition.  We shall thus acquire evidence, that, if it be an over-
irritation which the stomach undergoes in consequence of its hav-
ing been forced for too long a time to digest the healthiest aliments
/ 
                   ABNORMAL ASSIMILATION.               313

in very large quantity, the diseases  that the liver and brain will
contract simultaneously  with this  viscus,  must be exactly of the
same nature.  Now this is what is attested every day by facts of the
most  positive  nature, and  this  is what I propose  developing,
in the most succinct manner possible.  I will first examine the mor-
bid alterations of the stomach, and then exhibit those of the liver
and brain depending on them.
  I have already spoken of the rising of the stomach, and even the
vomiting, which are  occasioned  by the disagreeable impression
caused by certain aliments in the act of mastication.  I have like-
wise pointed out the hiccup, which supervenes from an obstacle to
the passage of the alimentary mass, while traversing the oesophagus:
it is needless to dwell on the chemical lesions, more or less painful,
which may be produced in the mouth, pharynx, and oesophagus, by
certain substances, such as acids, alkalies, puncturing or lacerating
bodies.  Let us pass on then  to an examination of what happens in
the stomach, when it is engaged in the assimilation of the substan-
ces that have reached  its cavity.
  Two  phenomena, we  have said, necessarily take  place during
digestion; the assimilation of alible matters, and a notice transmit-
ted to the centre of  perception as to  the  manner  in which  this
assimilation is accomplished.  The  first is in the province of vital
chemistry, which calls to its aid contractility, in order to attract
the fluids, and excite  the  necessary movements of the splanchnic
muscles. Is all this performed in  a quiet manner, and conformable
to the good of the animal economy,  we experience  a feeling of
gaiety,  strength, and  hope; the  intellect  is pleasurably affected.
Is the afflux of fluids  too impetuous, are the local muscular move-
ments too exalted, there is inconvenient heat  of  the  epigastrium;
this is repeated on the skin of the trunk,  on  that of  the feet and
hands, on the face, and in  the interior of the cranium; the  feeling
of strength is diminished; the pulsations of the heart and arteries
are too sensibly felt  Is  the muscular parietes of the stomach too
readily  solicited to contraction, painful movements are felt in the
epigastrium,  gas, acid or alkaline, or of an alimentary odour, sent
towards the mouth with  impetuosity, a nausea, presentiment  and
fear of vomiting, uneasiness referred to the locomotive apparatus,
breaking down of strength,  tendency to drowsiness, accompanied
by pains, and feeling  of weight in the head, are among the accom-
                               40 
314
ABNORMAL ASSIMILATION.
panying symptoms; and in fine, the instinct is modified in a very
disagreeable manner for the centre of perception.
  Such are  the  first pathological  effects  of a  laborious digestion
with the excess of stimulation.  If alcoholic  liquors have been plen-
tifully used,  the exaltation is manifested still more  in the ence-
phalic functions than in the other viscera.   Thus, to heat and rapid
circulation are joined bursts of gaiety and afterwards ot fury, deliri-
um, excessive and even convulsive strength in the muscular appara-
tus,—the whole terminated by a sleep which sometimes approaches
to the apoplectic state.
  If,  on the contrary,  the drinks  and aliment  be of a nature not
sufficiently  stimulating,  the  two  orders  of phenomena, which
we have just pointed out, are manifested at  first in a quite different
manner.  In place of gastric, lingual,  ocular, and cutaneous injec-
tion and heat, we observe a sensation of cold in  the epigastric re-
gion,  and paleness  and coldness of the surface; instead of  a sensa-
tion of contraction and strength, there is that of weight, relaxation,
and fulness of the stomach.  This viscus is sometimes in so power-
less a condition  that there is not the least gas expelled from  the
mouth; the strength is then destroyed,and the pulse scarcely percep-
tible; speech and even thought become impossible;  convulsions su-
pervene, and we find persons sink in this state,  with the  stomach
full of aliments, which had not,  after the expiration of some hours,
undergone the slightest digestive  alteration.  Such  a death is the
effect of pain, which depends on the internal gastric  sense being dis-
agreeably affected by the ingesta and its not reacting on them for the
purpose of assimilation.   The kind of excitation which it experi-
enced, only acted on the centre of perception, so as to  cause convul-
sions, and the violence of these latter exhausted life.  In fact, death
cannot result in  such cases without convulsions; so true is it, that
this viscus is  so constituted that it can never remain any length of
time  without being excited; let it be in a  manner adverse to,  or
congenial with, the well-being of the animal economy, it can never
remain inactive.
  This kind  of death is,  however,  extremely rare; more  fre-
quently when the stomach refuses to assimilate aliments, they are
gradually decomposed  as  they would be in  an unorganized vessel,
having the same warmth  and moisture as the stomach.  The new
chemical  qualities which these ingesta acquire by their fermenta-
tion or putrefaction, the  gases more or  less opposed to  vitality 
                   ABNORMAL ASSIMILATION-                315

which are disengaged from them, exercise a stimulation on the sto-
mach which fills it with saliva, mucus, bile,  and pancreatic juice;
it becomes more and more swelled, its coats are red and engorged,
still, however, without assimilation being performed; but its muscu-
lar coat is solicited to contraction, and its fibres approach, either to
expel by vomiting, or to discharge through the pylorus, the foreign
bodies that oppressed it, or even to  bring about these  two modes
of action  at the same time.  The eructations  are more frequent;
borborygmi and colics announce  the revolt of the intestinal canal:
finally,  ingesta are evacuated in  two  ways, and as all the secretors
annexed to digestion are excited  by the rubefaction of the  mucous
membrane, which, we may remark en passant, does not take place
in the kind of death above  described, these  ingesta are expelled,
together with a great quantity of humours.
  We can well conceive, that such movements of the assimilating
apparatus  cannot  take  place  without a multitude of perceptions
more or less painful, and a concurrence of muscular movements of
every kind.   It is of  these which we are next to treat; for,  what-
ever be the cause of vomiting, which may,  as we too well know,
be brought on by the healthiest food  as well  as by various poisons,
its mechanism  is still the same.
  When the stomach is inclined to vomiting, it begins by slowly
contracting itself in an antiperistaltic  direction,  that is to say, from
its pyloric to its oesophageal extremity.  The  muscles  of  its sides
being forced to t>bey it, those of the abdomen are also thrown into
contraction; the depression of the diaphragm,  which is much  less
powerful  than they, becomes impossible: it contracts, notwithstand-
ing, by which  means a strong pressure is exerted on the stomach,
which is thus compressed between that muscle and  the abdominal
ones.   This viscus is then as it were carried upwards,  and we feel
it in fact exercising a kind of pressure under the base of the  chest
This latter cavity remains immoveable to serve as a point to  the
mass of abdominal viscera, and to speak  is  impossible.  The sto-
mach continues to  contract from below upwards; but the cesopha-
geal orifice resists.  When the  moment for vomiting has arrived,
instinct'suspends the effort of the stomach, in order to obtain a full
inspiration, which swells out the two pulmonary parenchyma;, fol-
lowed by a still greater pressure of the diaphragm on the contracted
viscus.   M. Magendie  thinks that with  this  inspiration there  is
likewise a deglutition of air, which renders  the stomach still more
compressed by the enlargement of its cavity.  Finally, the antipe- 
316
ABNORMAL ASS1MILA 1'IOJ..
ristaltic action of this viscus is propagated beyond the cardia, and
pervades the whole of the oesophagus; this membranous canal open-
ing receives the gastric contents, which it conveys into the mouth,
and, to diminish the obstacle to their exit, this cavity is obliged to
be opened: thenceforward the stomach continues to empty itself by
fits, always preceded by an ample  inspiration.  Each time that the
stomach thus frees itself, the air contained in the lungs, and retained
for an instant by the  constriction  of  the  larynx, escapes likewise
with a noise and general vibration of the bronchial tree: there results
from  this mechanism, that  each effort of vomiting is  accompanied
with  a fit of  coughing; and as the mucous membrane of the nasal
fossa? is in a state of congestion, resulting from the retention of blood
in  the  head, it undergoes a  titillation, whence results sneezing.
Thus cough and sneezing are associated with vomiting, which ex-
cites  very copious evacuations  of pulmonary, tracheal, and  nasal
mucus, to which arc added an abundant excretion of saliva, and the
humours from the amygdalae of the mouth; for the glands furnish-
ing the former are brought into simultaneous action.   We find even'
that their secretion augments from the  moment that nausea is felt;
whence comes salivation.   If to these  evacuations be added those
of  the gastric  juice, of bile  and pancreatic fluid conjoined  with
the forced sweat,  which the  .skin so abundantly supplies at this
time, the blood being propelled  with  great violence towards the
cutaneous surface  by the obstacle which it encounters in traversing
the chest,—we may have same idea of the prodigious vascular irrita-
tion which accompanies the perturbating act of vomiting.
   Nor is the irritation of the cephalo-splanchnic muscles less con-
siderable; it is  curious to observe  the successive contractions of the
abdominal muscles, and to see how they are embodied and directed
upwards in order  to raise the viscera, and press them under the arch
of the diaphragm: the voluntary muscles are  not strangers to this
general disorder; forced as they are by  instinct to furnish a favour-
able attitude for vomiting, and a point  of support for the trunk to
rest on adjoining  bodies, we find them all enter into action under
the influence of the will; there are even cases in  which the  irrita-
tion  of the viscera is carried to such a  degree,  that these  muscles
are thrown into the most violent convulsions.
   The derangement of the  circulation merits observation; the lungs,
condensed, retain  the blood which comes from  the head, and pre-
vent  the emptying of the vena cava; the blood  of the encephalon 
ABNORMAL ASSIMILATION.
317
undergoes a reflux towards the face, and the teguments of the thorax
and superior muscles; that of the abdomen, finding the viscera of
this cavity less permeable, is thrown into the superficial vessels of
the inferior part of  the trunk and of the lower extremities.   The
skin is then strongly injected; and as  it  participates at the same
time by sympathy in the irritation of the mucous visceral tissues,
it furnishes an  abundant perspirable excretion.   The organs en-
trusted with the deposit of the excrements being too much pressed
upon, are sometimes thrown into  simultaneous action, and we see
occasionally persons who  let their  faces and  urine  escape  in
vomiting.
  Such is vomiting considered in the adult, and when the locomo-
tive apparatus has acquired some development.  But in the  period
of infancy,  in which this apparatus  is  yet weak, vomiting  is,
not near so difficult.   Some physiologists, having observed this fact,
have attempted to explain the process  as taking place by a different
kind of mechanism in the two cases: they have attributed that  in
children to the stomach, and that of adults to the abdominal mus-
cles; but it is evident that there can  be but one method for this
kind of evacuation.   Hence we find that when a child vomits, the
muscles  of the abdominal parietes follow the stomach;  the only
difference met with, between children and adults, is that the former
have the stomach more irritable and more powerful  in relation  to
the respiratory muscles.   But in proportion as the  individual  ad-
vances in years, this predominance of the viscera over the rest of
the  body diminishes; and the muscles which move  it are less obe-
dient to  the viscera, when these latter require an evacuation of their
contents.  Do we not find in fact, that defecation and the excretion
of urine are very prompt, and by no means laborious, in the infant
at  breast; that they are often  painful  in adult age;  that finally, in
old  age, the difficulty with which they are "performed constitutes in
 many persons a very inconvenient pathological condition?  There
 is yet another circumstance which contributes  to render vomiting
 much more easy in children; it  is the greater volume  of their  ab-
 dominal viscera: but the same cause acts with equal power  on
 adults; in equal ages we find  more facility in provoking vomiting in
 fat than in lean persons, and in the extreme of marasmus it becomes
 absol u tely impossible to produce this discharge. The reason is thi s: the
 volumeof the organs contained in the abdomen being too inconsidera-
 ble to exert a pressure under the arch of the diaphragm, the abdominal 
318
ABNORMAL ASSIMILATION.
 muscles are required to supply their place: now this is impossible;
 and, as no viscus can cease to be  in contact with the parietes which
 enclose it, unless a  foreign  body be interposed, the stomach can
 never attain the degree of condensation necessary for  the  act of
 vomiting to take place:  in such cases, if this viscus continues to be
 excited in an antiperistaltic direction, the person is exhausted in
 vain efforts; it is as impossible for him to vomit, as for the con-
 sumptive, reduced to marasmus, to expectorate, and the anguish
 which they experience commonly ceases but with their life.
   It is from not having well understood this forced association of
 the cephalo-splanchnic muscles with the viscera, that some physio-
 logists have supposed vomiting to be  performed by the abdominal
 muscles.   The ancients had affirmed that this evacuation depended
 on the contraction of the stomach: experimenters, in order to ascer-
 tain the fact,  removed  the muscles of the abdomen after having
 given an emetic, and they found the stomach remain in a state of
 quiescence.  They allowed those muscles to remain, and they re-
 marked that they entered into contraction at the moment of vomit-
 ing.   In place then of concluding from these experiments that the
 stomach required the assistance of the abdominal muscles to empty
 itself,  and that they only followed because they could not  aban-
 don it, they concluded  that this viscus was entirely  passive in vo-
 miting; they would have had it abandon the abdominal parietes and
 mount alone under the arch of the diaphragm, before they acknow-
 ledged that it was an agent of vomiting:  but  no evacuation is per-
 formed in this manner.   Never does  a hollow viscus, except it be
the heart, empty itself when deprived  of the aid of the cephalo-
 splanchnic muscles: it has need of such aid to  overcome the con-
 striction of the  sphincters.   Besides, the removal of the muscles
 of the parietes totally deranges the action of the subjacent viscera.
 So soon as the abdomen is opened in a living animal, the intestines
 are inflated and tend to escape  outwardly,  in place of being con-
tracted  and emptying themselves.   It is the same thing with the
bladder and the lungs; and  I am persuaded from analogy, that if
the abdominal muscles were removed from a bitch in  labour, the
uterus would not expel  the foetus.   Who has ever  thought how-
ever, of attributing all these evacuations to the respiratory muscles
alone?   Let any one attempt to produce defecation when the ex-
pulsive movement is not developed in the muscular coat of the co-
lon and rectum,  and he will never accomplish it.  There  is no 
                   ABNORMAL ASSIMILATION.                319

effort, whether voluntary or convulsive, which can bring on vomit-
ing or  labour, unless the stomach or the uterus experience in its
tissue the contractions necessary for the expulsion of its contents.
  Stress has been laid on another experiment, to show that vomit-
ing depends on the muscles of the abdomen.   A hog's bladder hag
been substituted for the stomach, and made to communicate with
the oesophagus and duodenum; tartar emetic has then been injected
into the veins, and vomiting has in consequence taken place.   But
it was  not considered that any other substance which would have
excited convulsive contractions, would  have produced the same ef-
fect.   Simple  pressure of the hand could have  occasioned it, be-
cause this inert bladder has not, like the stomach,  the faculty  of
retaining its contents.  This kind of vomiting is then purely me-
chanical; and only shows that an emetic excites convulsions, but by
no means that  which was desired to be proved by it.  If this blad-
der be  examined  at the termination of the experiment, it will be
found  folded,  wrinkled,  and the intervals between the wrinkles
will contain a portion of the fluid  which had been introduced into
its cavity; this is because it is not contractile like the stomach. In
fact, if this viscus were as inert as the bladder,   the former would
also be wrinkled in vomiting, and would never be completely empty.
There  are, however, a host of cases in which it  expels all its con-
tents: it has contracted in all points, and, if it contracted, it was not
passive in vomiting.
  The partisans of the opinion which I combat do indeed grant that
the stomach  contracts, but they affirm  that, in doing so, it merely
imitates the  abdominal muscles.  But were it thus, why not imi-
tate them whenever they exert a violent pressure on it?
  Finally, if the  stomach be not the  primary agent in vomiting,
why does it expel  certain substances  while it retains and digests
many others?  In  children,  at the breast, it only rejects what is  in
excess, and turns  the remainder to a very good account.  This fact
is so common,  that nurses are in the practice of saying that the child
which  vomits, thrives.  In the  greater number of gastrites, which
have not become intense, the stomach rejects mucus and bile after
a meal, and retains the food.  This viscus acts in the same manner
in  reference  to the pyloric passage, as  we have already pointed out.
If  we wish for other experiments, pathology will supply them  to
us.  An account has been  published of a sick man who could no
longer digest, and who rejected nothing by the mouth. His stomach 
320
ABNORMAL
A>SIMIL \TION.
was always  ull, and  the dissection aforesaid showed that it had
no longer a muscular coat.   Its tissues had undergone  completely
the fatty degeneration.   Here we. have enough to convince us that
the stomach is the primary and necessary agent in vomiting; and I
should be ashamed to have been stopped  to refute the contrary
opinion, if those who sustained it, for it had been advanced before
the present time, did not enjoy on other grounds a well merited con-
sideration.
   What then is this function, in virtue of which  the stomach sepa-
rates the matters mixed and confounded together in  its cavity, so
as to retain some and discharge others?  It has doubtless aided, to-
gether with other phenomena not less singular, in the admission of
an archaeus in the epigastrium.  I shall not now discuss this opi-
nion, but the faculty of which I speak admits of a very plausible
explanation;  affinity may  to a certain extent account for it.  Thus,
when substances are presented to a pylorus too sensible, there be-
gins from this extremity a movement of antiperistaltic contraction,
which drives them towards the cardia.  This movement is propa-
gated to the  oesophagus, which opens to receive these  substances,
and, still farther prolonged to the pharynx, conducts them  into the
mouth, which rejects them as causing a disagreeable sensation to the
centre of perception, but which can, if the will requires  it, swallow
them again.  This is rumination; it is done without pain; only with
some dislike; a slight contraction of the superior region of the mus-
cles of the abdomen follows the stomach  in  its  ascension.  It is
thus that the viscus frees itself of its too great distention in a child,
and in persons who have taken too much aliment, and who  are pos-
sessed of an irritable stomach. In such cases there is no choice made
among  the substances contained in the stomach;  it only rejects
what is found near the cardia, at the moment in which the peristal-
tic contraction reaches this orifice; but the movement is not then
sufficiently violent to have all rejected, nor to force the mouth to
remain open, and render  it impossible for the portion of chymous
matter which had been returned to it, to be subjected to a fresh de-
glutition.
   It remains to be ascertained why  certain substances which are
disagreeable,  are alone rejected in certain  cases, whilst the rest
remain  in  the stomach.   I can  only account for the difference,
by supposing that the  substances which are suitably digested are
retained in its cavity by a vital affinity, which makes them adhere 
ABNORMAL ASSIMILATION.
321
to the sides of the stomach; I will not say that the stomach chooses,
separates, makes a division by a kind of thought, but that it rejects
by a general  antiperistaltic action depending on the  painful sensa-
tion of the pylorus, and that the molecules, which agreeably flatter
the gastric sense,  are retained in spite of this general movement of
repulsion.
  We can, by this explanation, very well conceive how the mat-
ters disagreeing and not digested, should remain free in the centre
of the mass, and be presented the first to the cardia during the con-
traction of the stomach.  This can,  in fact, only take place because
no portion of the  mucous surface attracts them to it.  At any rate,
this phenomenon  is not peculiar to vomiting; the experiments of
3NI. Sarlandiere show that it takes place equally  at the pylorus,
since the most nutritive aliments are retained the longest  in the
stomach.  Besides, a similar process takes place in the  small intes-
tines; and Magendie himself, who will not be accused of being too
much of a vitalist, has  made the remark in express terms.   This
gentleman saw the chyle attached to the mucous surface, and con-
tinuing adherent to it, whilst the indigestible substances destined
to form the excrements remained free, and were obedient to the  pe-
ristaltic movement which conducted them towards the large intes-
tine.  Now, it seems to me, that the choice of matters to be vomited
can only  depend on a similar mechanism.   We  can conceive, at
present, how the  mucosities produced by a slight gastritis, the bile
which this irritation calls in too great  quantity into the stomach,
the blood which  this organ  exhales in some haematemeses, may be
thrown up, even  with some marked efforts to vomit,  without  ali-
ments of  easy digestion, and which flatter the gastric sense, being
rejected.
  We may explain, likewise, by this means, why natural vomitings
seldom empty the stomach entirely, and often allow nutrition to go
on for a length of time; such are those in pregnancy,  in nephritic
affections, on board a ship, and even those from phlegmasia? of the
pylorus of a moderate grade, which often admit, for a term of years,
of a certain degree of strength and fulness of habit.  It is because
in all these  cases the gastric sense  is not entirely perverted; it is
not at all so in pregnancy, or at sea, &c, and in all the  affections of
the pylorus,  and other partial phlegmasia? of the stomach, it is only
so in a  small portion of the  mucous surface of this viscus.   But the
case is  far different when emetics,  and especially those of tartrate
                              11 
.i-^
ABNORMAL ASSIMILATION.
of antimony and potash, are used.  These substances make a direct
attack on  the sensitive expansion of the stomach; they irritate it,
produce an unnatural afflux  towards it, and tend to inflame it; in a
word, it is by depraving this internal sense, the integrity of which
is so important to the preservation of life, that these  poisons, for
no other term is applicable to them, produce that general revolt of
the stomach which gives rise to such painful sympathies during the
perturbating act of vomiting.
  We can judge from these views, how dangerous it is to make too
frequent use of emetic medicines, in cases  in which the  abuse of
irritating ingesta or the influence of another organ has deranged the
regularity of digestion.   What will  be the effects of administering
emetics in cases in which the surface of the gastric sense is  a prey
to inflammation?  The sick can  only escape this kind of poisoning,
by very abundant revulsive evacuations; and often, even after they
have taken  place, there remains a phlegmasia of the stomach, the
cure of which is exceedingly difficult: it is thus that the pretended
adynamic fevers are  produced in the practice of the ontologists, hu-
moralists, and  mechanists.  But if, following in the steps  of the
Italian Rasori,  physicians give in rapid succession doses of tartrate
of antimony and potass, the amount of evils is still  greater.   The
vomiting ceases at the expiration of some hours, but it is because the
spasm  of the  stomach  becomes permanent, and it only becomes
so  by excess of irritation of the mucous tissue; hence the  gastric
gense continues to be depraved,  and profoundly perverted, in those
who have been treated by this method. Digestion is often destroyed
for many years in most of them; they retain a chronic gastritis, with
a convulsive disposition of the stomach  and small intestines; they
become hypochondriac, and neuropathic; and if, unhappily, these
infirmities be  attributed  to weakness of the stomach, if we  add
to the evils which afflict them, a prodigal use of tonics, their life is
nothing for the future but a  succession of  calamities.  The most
melancholy end awaits them, either from a schirrus or softening,
the effect of the slow and progressive inflammatory dissolution of
the membrane in which the gastric sense resides.  It is my duty
to point out these errors, because they serve to throw light, in place
of experiments, on the mechanism and effects of vomiting; because
they are connected  as causes of disease, with the disorders of the
digestive  functions;  finally, because it is high time to  put a  stop to
the contagion of Rasorism, which threatens  to seize on our schools, 
                   ABNORMAL ASSIMILATION.                :12.\!

and to replace the system of Brown, of which our countrymen be-
gin to be ashamed.   I continue the inquiry into the diseases which
have their origin in the exercise of the function of digestion.
   We must place on the next line with emetics and purgatives all
mineral preparations, all bitters, acrid substances, and  corrosives
in small doses;  in a word all medicinal  agents which obstinately
resist assimilation.  If some among them seem to revive the diges-
tive function, it is an illusory advantage; they all produce in the
end a slow phlogosis, which depraves the normal or natural action
of the gastric surface, and its disorganization is the necessary con-
sequence.
   Certain foreign  bodies, such as bones  and pieces of metal, are
sometimes rejected by the pylorus, without  being received by the
oesophageal orifice,  and remain a long time  in the stomach.  Per-
sons known to be tormented by the  presence of these indigestible
matters, have had  repeated  vomitings without being able to get
clear  of them;  but what is most surprising is the innoxiousness
of these bodies during a certain time.  One has reason to be  as-
tonished, when he sees to what an extent the stomach may resist
this cause of irritation  in robust persons.  We sometimes see jug-
glers,  as they  arc  called, polyphagi, who for a series of years
-twallow, with impunity, flints,  knives, and other like substances;
they, however,  all end  by sinking  under  inflammation  of the
stomach and intestines.   We can conceive  that beings  thus privi-
leged will suffer less from the abuse of emetics and  tonics; and it
is on such data that  people prescribe with so much boldness these
medicines to delicate constitutions !
   It is not simply foreign bodies that exalt the sensibility of the
stomach;  the most healthy and nutritive substances, those, which in
a normal state produce an agreeable excitation, raise the strength, re-
vive  and exhilarate the moral faculties,  finally injure  the health,
pave the way for a miserable existence,  and greatly abridge the
duration of life.  No longevity for  gluttons and drunkards, has
been long said;  but the true reason has never been given.   We are
now  going to attempt the examination  of  this subject, which so
nearly interests  the manners  and happiness  of society;  but  we
must set out from the point whence we  deviated, and explain the
bad effects  of  indigestible  substances, which hitherto we have
merely hinted at 
3J4
ABNORMAL ASSIMILATION.
  The stomach, as we have seen, displays, for the digestion of ali-
ments,  an action  proportionate  to  the difficulty of their assimi-
lation; but for this purpose there must exist a certain  affinity be-
tween them and it; otherwise, that is in the cases in which they
are indigestible, it is solely tormented in efforts for their expulsion.
In the first case it is on its internal membrane that the greater part
of the excitation occurs; in the second this membrane docs not act
for the process of assimilation, but rather causes  muscular move-
ments of expulsion, either through the pylorus or cardia.
  We understand, after this reflection, how the abuse of indigesti-
ble ingesta tends  to deteriorate the assimilating action of the mu-
cous membrane, and to give the muscular a convulsive habit. It is on
this account I asserted that mineral medicines in  the end  destroy
the digestive function, and consequently nutrition.  Many vegetable
substances, we have said, have nearly the same effect,  when they
are of such a nature as constantly to resist assimilation.   The kind
of phlegmasia thence resulting  becomes  in  time incurable, and
this is the situation in which  are those who  have used in excess
bitters not nutritive, and peruvian bark.  Still,, however, the altera-
tion thence resulting seems to be less alarming than that produced
by minerals.  The too prolonged use of calomel,  of corrosive sub-
limate, and of purgative salts, is then still more pernicious, and we
see, in fact, that those who have  been addicted to such things be-
come pale, exanimate, and scorbutic, and end their days in a state
of marasmus or dropsy.  It is not the digestive surface alone that
suffers from their pernicious effects, but the whole  animal economy.
The depurating power, always occupied in the expulsion of mineral
molecules, is exhausted; the nervous system loses its energy;  there
is no longer any reaction against  the  perturbating influence of the
air or of moral affections, and new congestions are formed at each
moment in the viscera and the tissues of the locomotive apparatus;
engorgements arise in the lymphatic system,  in the principal secre-
tors, such as  the  liver, &c. and  a vicious nutrition  of heteroge-
neous tissues is created,  the resolution of which is afterwards im-
possible.  Hence those dropsies,  and the scorbutic states of which
I have spoken.
  But how remedy the like disorders?  Will you prodigally admi-
nister stimulants, with the view  of reviving  gastric  assimilation,
they renew the phlogosis, which,  from being latent, becomes acute, 
                   ABNORMAL ASSIMILATION.                325

,ind hastens destruction.  Will you limit yourself tOthe employment
of nutritive substances of the most benign character, such as gela-
tine, albumen, milk, what,  in a word, is called with us the white
regimen, the stomach is not sufficiently stimulated: these aliments
remain in the viscus, without being digested, or else they are ex-
pelled by vomiting or diarrhoea, and the debility goes on increasing.
Such are the inconveniences of the abuse of indigestible substances
intended to reanimate the stomach, to keep the  bowels  open,  to
break down mucosities, and remove obstructions.  Let us now place
alongside of this vitiated state, that which results from an abuse of
the most nutritive aliments.
   Strong and black meats, full of extractive matter  and osmazome,
high seasoned dishes, and fermented liquors, constitute this series,
which has the double bad effect of  supplying an abundant and sub-
stantial  chyle,  and  of  exercising  the assimilating power of the
stomach.  While  the man  is yet young, and grows in height and
thickness, he resists for  a length  of time any excesses of this kind,
especially if he be naturally robust; often even he applauds himself
for them, as the strength of his stomach is augmented, and it seems
to acquire daily a  more considerable  digestive power,  while his
limbs are more fitted for the most violent exercises; the conscious-
ness of his strength inspires him with continual gaiety; every thing
is to him smiling, and  the future only  offers the most flattering
images.
   This joyous mood is, nevertheless,  occasionally  interrupted  by
inflammatory complaints, which are always of the  highest degree
of intensity—gastro-enterites,  pneumonias, cephalites,  anginas,
ophthalmias, and acute rheumatisms, come on  with violence under
the influence of heat and cold, or of the passions,—make rapid pro-
gress, and sometimes terminate in a few days in death. But as all the
sympathies are active in youth, crises by haemorrhages, sweats, and
phlegmonous collections, often come to  the relief of such persons,
in spite of the most incendiary treatment; and we then see them
pass, in a few minutes,  from appearances of the last agony, to the
most complete convalescence.
   The appetite is very  good at the conclusion of  these maladies;
convalescents indulge in it, and  soon  recover a health  as vigorous
as that which they enjoyed before the  phlegmasia?.  This success
encourages them; they are  persuaded, that they owe their life solely
to the energy derived from  their succulent food, and fermented 
32li
ABNORMAL
ASSIMILATION.
drinks; they indulge once more in their use, and many are happy
enough to resist frequently such violent assaults.   But there is a
limit to every thing; to no organized being is it permitted to raise
itself beyond the volume and strength of his species. This excess
of hasmatosis must necessarily turn to the detriment of the funda-
mental organs; and these latter, after having resisted acute conges-
tions, sink under chronic irritations.  In fact, the age of consistence-
has arrived,  the activity of the sympathies has  diminished, the
crises are not so easy; if fresh inflammations come on, they are not
completely resolved, especially if they are continued to be treated
by stimuli; and there consequently remains irritation in the prin-
cipal viscera. The impatience to regain their strength, the remem-  «
brance of the good effects which they formerly derived from tonics
and substantial food, induce the convalescents to have  recourse to
them before irritation is entirely  quieted.  The stomach is then
forced too soon into function; if it be healthy it obeys these stimuli,
and all nutrition turns to the profit  of the  inflammation that re-
mained in the lungs, intestines, &c.: if it be itself  the  seat of an
unextinguished phlogosis, the stomach  refuses to digest; it is over
excited, and the disease recommences.  But very  often,  though
diseased, it is not so to such a degree as to be  incapable of all as-
similation; it still digests, but in producing a feeling of suffering.
The strength returns in an incomplete manner;  a crowd of sympa-
thies is evidenced during digestion, and the person becomes  dys-
peptic,  hypochondriac, and neuropathic.  The pristine vigour is not
re-established;  the health is lost very often for  the whole lifetime,
though fulness of habit and good complexion be yet preserved for
a long period;  and this is what distinguishes the morbific effects of
good aliments from those of indigestible substances: but so  soon as
these latter are used in excess, the  derangement in nutrition is ad-
ded to the painful irritation of  the viscera, and the persons affected
are in the same deplorable  state with  those whom we described
above.
   Some individuals, still more fortunately constituted, are proof
against the effects of the  most  substantial alimentation,  during the.
period of their youth; there are even some who pass through their
virile age without suffering from this cause; but it is at the epoch
of decline, when about fifty years of age, that disorders await them.
   Hence, in  the midst of the fullest health,  when the muscles are
in the most energetic state, when the freshness  of the complexion, 
•
                   ABNORMAL ASSIMILATION.                327

the warmth of their bodies,  the  firmness of their  flesh,  and the
most  wonderful endurance under extreme exertions,  and most
unusual excesses, seem to promise them a long and vigorous old
age, these persons  begin  to feel a slight pain  in  the  right hypo-
chondriac region.   To this they pay  little attention,  because it
usually vanishes by rest;  but it soon becomes troublesome,  and
gives  some uneasiness; their  complexion is sallow, their tongue
foul, and they complain of  a bitter and clammy taste; sometimes
they have eructations; their appetite is diminished, digestion re-
tarded, or even their hunger  may be great, though digestion be
difficult; they suffer from constipation and headach, flushes in
their face, and a sensation of  fatigue and weight, referred to the
limbs; the  urine is in small quantity, red and burning.  They then
have  recourse to  the  advice  of a  physician.  This  latter, if an
ontologist,  pronounces  the  words gastric oppression, bilious tur-
gescence, engorgement of  the liver; and he prescribes an emetic,
and a  purge. Then one of two things takes place; either the copious
evacuations produced by  the medicine  restore for a time the equi-
librium,  or the irritation is exasperated; and in this case  it some-
times passes into the acute state, and these persons have for the first
time a pretended essential  (idiopathic) fever; or at times it re-
mains in a  chronic  state, but with a  degree of intensity  greater
than before a recourse to  the evacuating method.   If the  patients
resume the use of  their customary food before the entire cessation
of their complaints, the consequence is, that they are never dissi-
pated, and  they are in  precisely the same  state as those of whom
we have already spoken.  The only difference  consists in their ar-
riving at it later, because they were more vigorous.  It is now time:
to extend our researches  to the interior of  their viscera, in order
to discover an explanation of the evils by which they are oppressed.
   The slight pain, which they experienced in the right hypochon-
drium, was an index to the irritation and even latent inflammation
of the duodenum,  or the superior portion of the jejunum.   This
irritation acting  on the liver forced  it to an excessive secretion of
bile, which, retained in  the superior part of the digestive canal by the
irritation that opposed  the descent of its contents, and neutralized
the action of the large  intestine, was brought up into the stomach,
tasted in the mouth, and  at times, being absorbed, produced jaun-
dice.  The pain of the stomach, and of the upper portion of the
small  intestine, affecting  the  head-,J. produced in it cephalalgia: the 
328
ABNORMAL ASSIMILATION.
brain being stimulated, rendered the muscles painful,—.aid all thes?
stimulations  conjoined have destroyed  the feeling of  habitual
strength in the individual, and substituted restlessness and sadness.
The gastro-intestinal phlogosis  disturbed the renal secretion, and
rendered the urine of a deep colour, turbid,  and in small quantities.
  Now, if in this state, in place of bleeding the individual, putting
him on regimen, and administering aqueous drinks, we allow him
stimuli to his irritated surfaces, why should we  be astonished that
the latent phlogosis is suddenly converted into acute inflammation?
  By the other chance, he is relieved  by evacuations, but the irri-
tation  is too inveterate and habitual to be entirely removed; and it
consequently returns in a chronic form, and even with greater in-
tensity than before.  Aliments and tonics are also renewed, and
they support and exasperate the malady;  the sensibility of the ali-
mentary canal  is predominant, and all  the sympathies  of the hypo-
chondriasis, the consequence of it, are developed, and life  becomes
a burthen.
  Nor is this all; the liver, so long forced to an excessive secretion
by  the super-irritation of the stomach and  duodenum, contracts a
diseased habit, and the patient constantly suffers from bile.   This
same liver, always  irritated, swells and contracts a degree  of in-
flammation, and is surcharged with albuminous, fatty, or adipocirous
juices; it  unceasingly conveys a feeling of weight and dragging,
which is transmitted to the right shoulder.  The  hypochondrium
swells, becomes puffy, inflated,  and hot,  and we have obstruction
vf the liver joined "to hypochondriasis.
  Add to these evils the swelling of the mesenteric glands, a neces-
sary consequence of chronic enteritis in lymphatic constitutions;
gout or articular inflammations in persons subjected to the action of
cold and otherwise predisposed; the colic which succeeds after an
indefinite time to gastro-enteritis, and which  produces diarrhoea;
nephritis, and the formation  of calculi, a  common effect of vitiated
renal Secretion, itself kept up by this all-interminable gastro-ente-
ritis; cutaneous inflammations called herpes; ophthalmias; diseases
of the throat; the propagation of the irritation of the  cardia to the
left lung, and of the pylorus and liver to the right, whence results
phthisis; mental alienation often brought on by hypochondriacal
delirium, and we may then have some idea  of the terrible effects of
high living and good wine.   If to these be added the effects of to-
nics, bitters, anti-gouty, detergey^,^purgative, and deobstruent me- 
ABNORMAL ASSIMILATION.
329
dicincs, and finally, the deleterious action of all those indigestible
substances of  which  I have spoken, we shall begin to understand
why longevity is of such rare occurrence among the rich, the pow-
erful, the idle voluptuaries, and all those pretended epicureans who
so readily hailed the incendiary system  of the famous Brown.
  The stomach may be affected by poisonous as well as by foreign
bodies, and alimentary substances.   Some of the former, such as
concentrated alkalis and acids, disorganize it, and, in consequence
of the pain thus created, diffuse the irritations through the whole
nervous system; afterwards, if death be not the immediate result of
this commotion of the sensitive apparatus, inflammation takes place
in the membranes of the stomach, and the patient is exposed to all
the consequences of this state of things.   There are other poisons
that do not so  rapidly decompose the tissues  to which they are ap-
plied; they irritate and inflame them immediately, and expose  the
patient, in consequence, to a disorganization consecutive to the in-
flammation; these are called acrid poisons:  others, again, though
generally  stimulating, produce particular effects on certain organs
or apparatuses, even though at first applied to the gastric.  In this
way some produce engorgement  of the head;  and, after having
strongly irritated the nerves of the encephalon, bring on sleep;
whilst others, such as coffee, keep up the waking state; and others,
in fine, like cantharides, exercise a peculiar stimulation on the se-
creting and excreting urinary organs.  It is idle to look on all these
as stimulations in which the stomach has no  share, and as specific
on the organs above mentioned; it  is the stomach which receives the
primary irritation when these matters have  been  swallowed, and
the stimulation it undergoes may constitute a pathological state.   I
have, indeed,  had an opportunity of observing this effect in a num-
ber of persons with  an  irritable stomach.   This  viscus suffered
as much from  the application of cantharides, and the  use of wine
and coffee, as  the encephalic and urinary apparatuses; and  when
these substances penetrate by other ways into the circulation, they
still, in cases where death  is not sudden  and nervous, produce in it
a stimulation which renders it one of the chief agents of the morbid
phenomena that are manifested.   This point  will be again brought
up when we examine the depurative functions.   It is, likewise, to
a modification  of the stomach and splanchnic  nervous apparatus, of
which it is the centre, that are owing the principal symptoms in
tvphu«. whenever caseous portions, arising from the decomposition
                             12
                              » 
330                ABNORMAL As>IMlLATION.
of animal and vegetable matters, have acted on the animal economy.
The phlegmasia in such cases begins in the gastric passages, to be
thence transmitted, with varied facility, to the other viscera; and
we find a similar series of phenomena developed in this as in  the
cases above described, in which the digestive apparatus  is  brought
into an inflammatory condition by the  most  substantial aliments
and agreeable drinks.
   The  small intestines  always participate,  more or less, in the
stimulation of the stomach, subjected to the influences of the causes
which we  have just detailed; but it very often happens, that, like
the colon,  they are only affected consecutively to the first digestion.
We may explain this in the following manner: the stomach assimi-
lating its contents imperfectly, allows an  irritating chyme to tra-
verse the intestines, where in the small ones it only causes uneasi-
ness, but in the large it gives rise to colic, which is only a convul-
sive contraction of the muscular fibres  of this intestine.  In this
latter the contractions are induced for the purpose of expelling the
excrements and-stercoral deposit, the presence of which is revolt-
ing to the internal sense, otherwise tolerably obtuse; but this dou-
ble stimulation of the mucous tissue, in which this  sense resides,
and of the muscular fibres annexed to it, becomes a cause  of phlo-
gosis,  and colitis supervenes.   It is in this way that food  the least
nourishing and most insipid, which did not sufficiently stimulate
the stomach to a display of its assimilating power, and the abuse of
autumnal  fruits taken with watery drinks, give rise to dysenteries
of the  most inflammatory nature,  such as  we meet with towards
the termination of the hot weather.  Erroneously then do we at-
tempt to deduce the nature of the  disease from that of this kind of
food, and  lay down a corresponding method of treatment.  Here,
however,  we must still make some distinctions.
   Insipid  food, vegetables, fruits,  roots, &c.  are  received into a
 stomach, the assimilating power of which  they do not solicit; they
are badly  digested, and retain in  part their  property of foreign
bodies in the intestines, provoking in these latter colics, and move-
ments of expulsion.   Here we have the diarrhoea of indigestion,
the return of  which  is  prevented  by tonics,  and especially red
wine. So  powerful is the  effect of this drink, that it removes colic,
 suspends diarrhoeal  movements, and completes the assimilation  of
 chymous matters  which had already passed  through the  stomach.
 This is one of those phenomena which have  led me to believe, that 
ABNORMAL ASSIMILATION.
331
 digestion goes on in the intestinal canal. This antidysenteric and
 digestive property of wine supposes, however, two things; 1. that
 the stomach is not inflamed; 2. that the intestines are all free from
 phlogosis.  But  suppose that the food above  mentioned, or any
 other of a more  nutritive kind,—the difference is inconsiderable,
 has been taken by a person predisposed to inflammation, the stimu-
 lus of undigested substances  will suffice to bring it into action, in
 one of the three regions of the digestive canal; and wine, opiates,
 diascordium, in place of  checking will increase the diarrhoea, and
 convert it into dysentery.  It is in this way that we meet, every
 spring, with so many cases.   I have made these observations on
 such a number of subjects as  to justify me in giving them as de-
 monstrated;  they explain ho^v the same person who was in the
 practice of curing himself of indigestions by  tonics, suddenly finds
 them converted into a poison, which aggravates his colics,  and ex-
 poses him to acute gastro-enteritis.
   In certain cases, such is the activity of the ingested matters, that
 the evacuations are singularly accelerated and abundant, and throw
 the sick into a state  of rapid emaciation; sometimes even vomiting
 is present, and then  we have  a  cholera morbus from  poisoning.
 And though the spasms and pains arising from  the  stimulation of
 the gastro-intestinal  sense are  enough to cause death  in a short
 period, yet there  is besides phlogosis of the mucous membrane in
 which it resides.  With  still more reason  must  it exist when the
 patient survives the  evacuations, and falls into a state of fever and
 adynamic prostration.
   A default of defecation may likewise become a cause  of disease,
 and always agreeably to that  law so important to be remembered,
 that every undue exaltation of function tends to phlogosis.  In the
 instance  now before  us, this may be caused as follows: the accumu-
 lated faeces solicit the action of the rectum  and colon;  but as this
 action is powerless, the redoubled efforts of the fleshy fibres invite
 more and more of nervous influence, and of blood into the intesti-
 nal" parietes; the  mucous  tissue secretes more humours, is heated
 and phlogosed, and at times inflammation seizes on the entire sub-
 stance of the organ, and penetrates to the peritoneum.   It is thus,
that foreign bodies accumulated in the intestines, can, bv arresting
the advance of their contents, give rise to the most dangerous inflam-
mations.   The bladder and genital organs participate to a certain
extent in the irritation. 
332                OP  THE ABSORPTION  OF

  We have elsewhere  shown to what  a  pitch the moral feelings
may affect the digestive canal and its appendages.
                       CHAPTER VI.

        OF THE ABSORPTION OF NUTRITIVE SUBSTANCES.

Section I.—A summary Description of the Chyliferous Appa-
                            ratus.

  The chyliferous or lacteal vessels, or the lacteal veins, constitute
a considerable branch or section of the  general absorbent system,
which is placed between two laminae of the mesentery, and termi-
nates at the central  trunk  of the  lymphatic system.   As in this
chapter we propose following the nutritive materials on to the san-
guiferous vessels, we shall join to  our description of the particular
absorbents of the mesentery, that of their trunk called the thoracic
duct.
  These Vessels originate from the mucous membrane of the sto-
mach and  intestines, in a manner by us  inappreciable, since we
cannot trace them to their mouths.   We do not know then whether
they traverse this membrane, and open on its internal surface, or
whether they form pores like the puncta lachrymalia, or a kind of
funnels with floating moveable extremities, on the plan of the Fal-
lopian tubes, and endowed with a vitality capable of allowing them
to recognise the assimilated  molecules; or  whether they are simply
lost in the  tissue  of  the  mucous membrane, which last in this case
would absorb the chyle like a sponge, and transmit it to the lacteals.
This last seems to us the most probable method.  Be this as it may,
the lacteal  vessels are in much greater number on the small intes-
tines than  in the rest of the canal: they anastomoze, and intersect
each other repeatedly,  without undergoing any change of diameter,
like the veins; they  go to the  mesenteric, mesocolic, and gastro-
epiploic ganglions, and finally reach the orifice of the thoracic duct,
lo be subdivided and anastomozed  anew. 
                   NUTRITIVE SUBSTANCES.                33S

  The thoracic duct, which is the termination not only of the lym-
phat cs of the abdomen, butlikewise of those of the pelvic extremities,
and of the left side of the head and neck, begins by five or six large
trunks, after which it presents an enlargement called reservoir of
Pecquet, or sislerna chyli; it is situated behind the aorta, and before
and somewhat to the left of the second lumbar vertebra.   This duct
passes through the diaphragm, and ascends always on the left side of
the sub-clavian vein, where it curves in an arched form to open by an
orifice furnished with a valve, which both prevents the return of the
lymph, and the introduction of blood into the duct.  Its diameter
is from two to three lines:  it divides into several branches, which
unite into a single, sometimes a double trunk, previous to opening
into the vein.
  The lacteals, vessels, and the thoracic duct, are composed of two
membranes; one external cellular, more solid, very contractile^but
not muscular, whatever Schneider and Cruikshanck may have sgd
to the contrary, for we find in it gelatine;  another  internal, thin,
delicate,  and transparent, which, though sui generis,  has a  close
analogy to that of the veins, and forms folds called valves.
   The lacteal glands are formed, according to  certain authors,  of
a cellular mass, in the interior of which is secreted a fluid destined
to mix with the lymph and chyle for their elaboration, and which
receives vasa afferentia, and  gives origin to  vasa efferentia, (Mal-
pighi, Morgagni,  Cruikshanck;) while in the opinion of others,
these ganglions are  only circumvoluted  lymphatic vessels,  which
are thus rolled on themselves, to form these  bodies, (Haller, Albi-
nus;) finally,  some, such as Mascagni  and  professor Chaussier,
maintain  that they consist of agglomerations of  lymphatic vessels,
divided, folded,  rolled, and  anastomozed without  end, and  united
into a mass by means of cellular tissue,  thus forming an  organ,
 which receives  many blood-vessels and tri-splanchnic nerves, and
 is enveloped by  a tolerably  dense cellular membrane.  Their vo-
 lume varies,  according to authors, from the twentieth part of  an
 inch to  an  inch in  diameter; but we suspect this  last mentioned
 size to be always indicative of  a pathological state.   Their colour
 is, in general, reddish, sometimes gray or dark, which latter, also,
 seems to us to depend on a state of phlogosis.  They  are enclosed
 in a dense and externally shining membrane, and enjoy great  vi-
 tality. 
334
OF THE ABSORPTION  OF
Section II.—Of the Functions of the Chyliferous Apparatus.

  Absorption in the gastro-intestinal mucous surface is, according
to our view, performed by the laws of vital affinities or vital che-
mistry, which, with a modern writer, I will willingly call organic*
This phenomenon is of the same order as assimilation, to which it
is the sequence.   It is true that  absorption takes up a number of
molecules not assimilable, but this is still accomplished by the aid
of those that are so, and on the express condition, that the foreign
molecules shall not give rise to a too lively excitation; otherwise,
this latter state, by arousing the activity  of the gastro-intestinal
sense, would excite the muscular coat to contractions, the tendency
of which would be at least to expel  the offending bodies.   Hence
the opinion of Bichat, who taught that a peculiar organic sensibility,
which he calls elective as opposed to the introduction of whatever
is^aaapted to the wants  of the animal economy, is only to a certain
extent correct.   A great number of aromatics, medicinal, and even
poisonous substances, enter into the absorbent vessels,  and would
seem  to have obtained  admission only  for the  purpose of being
promptly eliminated through the various emunctories. The organic
sensibility  is then far from being an incorruptible  sentinel; it is
much less delicate than the internal senses, and wo to him who
neglects the advice of these latter.   The absorbing surfaces are, on
the contrary, very greedy, especially when the want of restoration
in the system is decidedly felt; they admit the useless, the super-
fluous, and even hurtful, leaving  it to the efforts of the animal eco-
nomy to expel them by the depurating organs.  The only limit
to the exercise  of  the absorbing power is in the super-irritation or
extreme fulness of the vessels. It even often happens that particles
which are not too irritating to the absorbing orifices, become  ex-
cessively so to  the tissues to which  they are brought by the circu-
lation, and give rise to a phlogosis in the secreting organs.  Among
these  is cantharides, which does not invariably irritate the mucous
coat of the digestive  canal; and also mercury, and many poisons,
which that surface,  too eager for materials  to  act  on,  does not
always  refuse  to  absorb,  whenever  the  will has  overcome  the
repugnance of the senses of smell and  taste to those substances.
  So soon  as the  absorbed  matters  have reached the  chyliferous
vessels, they cease to be under the influence of organic chemistry;
because they are then no longer presented  molecule  by molecule, 
NUTRITIVE SUBSTANCES.
333
to be insinuated into those of the living tissues; they thenceforward
form masses, and as such they must receive their progressive im-
pulsion from contractility.   These small columns of chyle are now
driven towards the centre of the mesentery by  the contraction-of
the lacteal veins, and  the valvular  plaits are in mechanical opposi-
tion to their retrograde  movements.  Thus it is that the laws of
matter are continually associated with those of life in  the perform-
ance of the functions of the animal economy.
  But  does contractility  ways preside over the motion of the ab-
sorbed fluids, when  they have reached the tissue of the lacteal
ganglions? Proof derived from the aid of our senses here  again
fails us.   It is in vain to tell us that  the glands  under considera-
tion are collections of vessels folded or rolled on each other, when
no preparation furnishes us with the proof.   For myself, who do
not admit the division and  subdivision of  vessels without end, I
cannot suppose that such is the structure of the ganglions.  I infer,
on  the strength  of reasons which  I shall adduce when treating of
the capillary system, that  the above mentioned  organs  are  small
parenchyma?, in which sanguineous lymphatic vessels are lost, and
deposit their fluids, which are again taken  up by other vessels, to
be reconveyed into the circulatory stream.   It  seems to me pro-
bable, upon this  account, that the vital chemistry acts for a moment
on these fluids,  and that they only  come  under the influence of
contractility as a propulsive force  when they are disengaged from
the ganglionic parenchyma?.  I shall doubtless  be asked, of what
use is this momentary extravasation; that is to say, of what use is
the lacteal ganglions?  I am reduced to inductions in order to re-
ply to this question;  but, as I am  of opinion that they will be bet-
ter placed in the account of general  absorption, I  refer to that
chapter, and follow the course of the chyle in its progress towards
the blood-vessels.
  The reservoir of Pecquet and thoracic duct call into play merely
the contractility of their coat, which is considerable, for the pur-
pose of conveying the chyle, or in its place the lymph, into the left
sub-clavian vein;  and the aid of the  valves, always necessary for
diminishing the weight of the column, by dividing it into  numerous
sections, is enlisted until the moment in which the fluid has reached
its  d( ^(ination. 
336
OK the absorption  ot
Section III.—Of the Diseases which result from the Action of
                 the  Chyliferous Apparatus.

  These diseases are few in number.  The phlogosis of the thoracic
duct has never been observed, perhaps  because due attention has
never been paid to  the subject; nor do we find  that irritating fluids,
which incessantly traverse the chyliferous vessels, ever produce
in them  inflammation. We can, however,  conceive the possibility
of this phenomenon,  especially in the coats of the thoracic duct; it
must exist in certain cases of peritonitis, and of phlegmasia  of the
cellular tissue of the abdomen and thorax.   But have the peculiar
symptoms ever been  distinguished from those  accompanying such
diseases  in general? It would be natural to suppose, that this inflam-
mation must be opposed  to nutrition,  especially when  concretions
and obstructions are formed in the thoracic duct, or when it is com-
pressed by some tumour; but cannot life still be supported by venous
absorption?   Have  we any proof, that the lacteal vessels of the
mesentery do not  communicate with the veins of the intestines?
Doubtless the chyle,  formed out of solid aliments, does not take
this course; but  in acute  diseases hardly any solid  food  is  taken;
watery drinks suffice for nutrition, and we now-a-days admit that
water may enter into  the venous without following the  longer route
of the lymphatic system. We hence  find it very difficult to assign
to the coats of the  chyliferous vessels their part in the etiology of
diseases.
   Such is not, however, the case with the  ganglions of the mesen-
tery, and it is an additional reason for believing that their structure
and functions are essentially different from those of the lacteal ves-
sels.  These small parenchymatous bodies  are endowed with great
vitality, and while it is impossible  to discover any sympathy be-
tween the lacteal vessels and the rest of the body, we observe very
active  ones between the  mesenteric ganglions and the gastro-intes-
tinal mucous surface.  This discovery belongs likewise to the phy-
siological doctrine, which has shown that  all  gastro-enterites are
accompanied by a tumefaction of the  mesenteric glands. Notwith-
standing that chyle may be charged with acrid, irritating, or even
poisonous matters,  they traverse the ganglions with impunity, pro-
vided they do not inflame the gastro-intestinal mucous surface. Our
attention has been for a  length of time directed to this question, 
nutritive substances.                33?
and we have not observed any instance of mesenteric  ganglionitis
which  had not been preceded by well evidenced gastro-enteritis.
  It is worthy of  remark,  that the swelling, or, as we commonly
express it, obstruction of the mesenteric glands, offers no obstacle
to the  absorption of chyle.  In fact, whatever may be their disorga-
nization, we never observe diarrhoea, unless the inflammation has
passed the ileo-coecal  valve.  Hence we are justified, in cases in
which the inflammation has extended into  the large  intestine, in
affirming that diarrhoea does not proceed from obstructed mesente-
ric glands, but that it depends on the  phlogistic irritability of the
colon not allowing it to bear the presence of faecal matter, nor, as
in common states, to serve for their deposit.   The persistence of
absorption in despite of the engorgement of the lymphatic glands,
seems to us explicable by the numerous anastomoses of the lacteal
vessels; for  the ganglions are never all affected at the same time,
and the chyle, diverted from those that are diseased, still finds a
ready passage through  others which have preserved their normal or
healthy condition.  As to the examples met with in acute affections,
in which  all the ganglia are presumed to be inflamed, their inten-
sity is such, on  account of the violent gastro-enteritis, that all the
 functions are inverted, and all the ingesta  powerfully rejected, as
 well by stool as by vomiting; but such a state of things during any
 length of time is incompatible with life.  Of this nature is  yellow
 fever, in  which all parts of the alimentary canal are a prey to the
 most dreadful of inflammations, which is  afterwards  repeated in
 the other visceral cavities.  Death cannot here be referred to a defect
 of absorption; but is rather the consequence of the sufferings and
 rapid disorganization  of the principal sources of life.   1 have like-
 wise met with general chronic phlegmasia? of  the digestive tube,
 and have always  observed that they kept up a constant diarrhoea,
 or were opposed to every kind of ingestion: but in this case death
 was not the effect simply of an obstacle presented by  the ganglions
 to the absorption of nutritive materials; for besides that the colon
 was irritated, the veins could have introduced a sufficiency of water
 into the circulation to keep it up, and give time for the inflamma-
 tion to subside, as happens on many occasions.  We may hence lay
 it down as a general principle, that in partial gastro-enterites there
 are always ganglions  enough to allow of the absorption, even  of
 chyle formed out of solid food; and thus that when diarrhoea is added
 to these  other dieses,  it is not dependent on th*   obstruction ot 
33a
circulation of  hie  hloop.
these bodies, but simply on the colon  having become too irritable
to admit of the accumulation of faecal matters.
   From these considerations it follows, that the affections of the
ganglions of the mesentery are always of secondary importance in
the causes  and symptoms of diseases,  and we  deem it on this ac-
count useless to dwell any longer on the subject.
                      CHAPTER VII.

             OF THE CIRCULATION OK  THE  BLOOD.

  So soon as the chyle has been poured  into the sub-clavian vein,
it is carried  with the blood by the current of the  circulation,  and
reaches with it all the different parts of the body.   It is therefore
with the circulatory movement that we shall now occupy ourselves.
  The apparatus of the circulation, according to most authors, is
composed of the heart,  its centre and primum mobile; of the ar-
teries,  which  convey the  blood into all the tissues; and of the
veins,  which bring it back to the  heart, whence it issues  anew to
begin again  the same course:  but at the termination of the arteries
the parenchyma? of the organs are  found, which It is necessary for
the blood to traverse before being taken up by the radicles of the
veins.   This is what Bichat has called the capillary circulation.
The circulation ought therefore to  be studied in the^heart, in the
arteries, in the parenchyma? of the organs, and in the veins,  in as
much as the blood is subjected to the action  of different forces in
these parts.

            Section I.—Description of the Heart.

  The heart is a fleshy mass, formed of  fibrine  eminently contrac-
tile;  it is hollowed out into four cavities, two of which receivo the
blood from  the veins, and force it into the two others, which drive
it through the arteries.
  The heart is situated in the midst of the thorax, in an  envelope
called  the pericardium, behind the sternum and the cartilages ot 
CIRCULATION OF  THE BLOOD.
339
the sixth and seventh left ribs, and between the two lamina? of the
mediastinum, before and below the lungs.  It is placed obliquely ; for,
whilst its base rests on the vertebral column behind, its body is in-
clined towards the left, from behind forwards and from  above down-
wards, so that its apex strikes the cartilages of the sixth and seventh
ribs of the left side.   This  organ is connected, in front,  with the
pleura, the thymus gland, the sternum, and the cartilages of the ribs
before-mentioned; behind, with  the bronchiae, the oesophagus, and
the descending'aorta; upon the  sides, with the  left  mediastinum
and pulmonary pleura, and with the phrenic nerves; below, with
the phrenic centre.  Its form is that of an  irregular cone, a little flat-
tened from  before backwards.
   When we examine the heart,  the first object  that engages  our
 attention, is its envelope.  The  pericardium is composed  of two
membranes; the external one is  fibrous, closely connected with the
diaphragm  below, and more or  less  extended upon the  origin of
 the vessels that issue from the base of the heart,  which it encloses
 without adhering  to  it; the other lamina lines the foramen, from
 which it is reflected  upon the origin of the large vessels,  and upon
 the heart itself, in such a manner as to  form a perfect sac without
 opening, the external surface of which adheres closely to all these
 tissues, whilst the intei^al is without  any adhesion;  it is continu-
 ally lubricated with a lymphatic vapour, intended to facilitate mo-
 tion, and which has induced Bichat to  class it among the  serous
 membranes.
   On opening the pericardium the heart is perceived covered with
 this coat, which gives it a smooth and polished surface.   The four
 cavities of the heart are: first, the right  auricle, situated at the fore
 part of the  base, and a little to the right; its  walls are very thin,
 and we find in its interior,  backwards and above, the orifice of the
 vena cava superior;  below,  the  eustachian valve; inferiorly, and to
 the right, the opening of the vena cava  inferior; within,  the parti-
 tion which separates it from the other auricle, in which is the fossa
 ovalis, occupying the place of the foramen of Botalus.   Secondly,
 the right ventricle, forming the anterior and  right side of the
 heart, is in apposition with  the  left ventricle; its form is that of a
 triangular pyramid,  the base of which is from above downwards;
 in its interior, are fleshy columns, more or less strong; it has at its
 upper part two openings, viz. (a) behind, that orifice which commu-
 nicates with the auricle of which we have just spoken, and is named 
340
CIRCULATION OF  THE  BLUOl).
the auriculo-ventricular orifice: it is provided  with the triglo-
chine or tricuspid valve, having a direction towards  the  internal
part of this ventricle; (b) before, the orifice of the pulmonary ar-
tery, furnished with the semilunar or sigmoid valves,  opening to-
wards the interior of this vessel. Thirdly, the left auricle occupy-
ing the posterior and left part of the heart, receiving backwards
and above the four pulmonary veins, as the right  receives the two
vena? cava?; it is as thin as the right auricle, and  presents nothing
remarkable in its interior.  Fourthly, the  left ventricle, situated  at
the posterior and left part of  the  heart, is much  thicker than the
right, possessing  also the fleshy columns,  which, however, are
much stronger; and having at its base an auriculo-ventricular opening
provided with mitral valves, which stretch forwards into its cavity:
it is situated behind the orifice of the aorta, in which  are found
the sigmoid or semilunar valves, directed towards the interior of
this vessel.
   All these cavities are lined  by a smooth transparent membrane^
analogous in its nature to the serous system: it is continued from
the right side with those of the venae cava? and  pulmonary artery;
from the left with the pulmonary veins  and the aorta, and is re-
flected over the valves of all the orifices.
   The heart receives two arteries called coronary, which are given
off from the aorta, beyond the semilunar valves, and  two veins
which empty themselves  into the  right auricle.   Its nerves are
derived from the cardiac plexus, which is formed principally,  as
we have seen, by cords of the great sympathetic, but where also
terminate many filaments of the eighth pair.
   We see going off from the  pulmonary artery, after its division, a
ligament which attaches it to the aorta; this ligament is nothing else
than an obliterated canal, but which formed before birth the princi-
pal trunk of the artery, of which the pulmonary were  then nothing
but insignificant branches.   When  we come to consider the foetal
circulation,  we  shall see the use of this trunk,  which  bears the
name of ductus arteriosus.

   Section  II.—Of the Functions of the Heart in  the Adult.

   The right auricle receives  by the superior vena cava the blood
 which returns from the head  and thoracic muscles; and by the infe-
 rior vena cava,  that which  has circulated in all parts  of the body, 
CIRCULATION OF THE  BLOOD.
341
 except the lungs.  Now, when on the subject of respiration, we have
 seen that the blood loses its vermillion colour in subserving to the
 exercise of different functions devolving on all the organs; it is then
 with black blood  that these  right cavities are in contact.   The left
 auricle receives from the pulmonary veins the blood that has been
 submitted to aeration, and the colour of which has  been  restored
 in traversing the parenchyma of the lungs It follows that the two
 left cavities act constantly on the red blood; nevertheless the two
 sides of the heart are far from having an unconnected action. The
 two auricles act together and alternately with the two ventricles,
 the contraction of which is  also simultaneous.  In fact, the blood
 enters the right auricle by the two venae cavae, and into the left by
 the four pulmonary veins, at the same time.  It dilates these auri-
 cles, which are then in a relaxed state, but immediately they cause
 it to pass through the auriculo-ventricular orifices,  the inaction of
 which corresponds to their contraction. The ventricles are no sooner
 filled, than they contract in their turn, and propel the blood through
 the pulmonary arteries, and through the aorta, at the same moment
 in  which the two  auricles  dilate anew to  receive that of the vena
 cava and pulmonary veins.   Thus the motion of the dilatation of
 the auricles, corresponds to that of the contraction of the ventricles,
 and vice versa.
   The contraction of the four cavities of the  heart is produced by
 the shortening of  their fleshy fibres, a process which tends to con-
 dense this organ, by approximating the walls of its four cavities to
 their common centre, that is to say, the auricles to the base of the
 ventricles, and the ventricles to the base and  opening of the auri-
 cles. It follows then, that if  the triglochine and mitral valves were
 not depressed and applied upon  the auriculo-ventricular  openings
 at the moment of the  contraction of the ventricles, the blood of
 these cavities  would be regurgitated into the auricles; but this de-
 pression of the valves prevents such an effect; and  as the sigmoid
 valves open in an  opposite direction,  they yield and give free pas-
 sage to the blood which is forced through the trunks of  the aorta
 and pulmonary arteries.   When  afterwards the relaxed ventricles
 cease to compress  these last valves, the blood with which the arte
ries are filled, having a tendency to flow back to the heart, raises
and forces them to close up the orifice of the ventricles, thus oppo
sing  an insurmountable  barrier at  the  moment  when a  nev 
wJ-12
C1RC1 LATION OF  THE  BLOOD.
 wave of blood pouring from  the heart  again depresses them and
 forces for itself a passage.
   The pulsatile motion of the heart against the sides of the thorax
 takes place when the ventricles contract or shorten themselves, and
 is occasioned by the simultaneous dilatation of the auricles, and of
 the pulmonary artery and aorta, which throw the heart forwards.

               Section III.—Fatal Circulation.

   The radicles of the umbilical veins take up the blood in the pla-
 centa: this vessel conveys it, on the one  part, into the vena porta;
 on the other, into the  inferior vena  cava,   which,  after  having re-
 ceived the hepatic  veins,  deposits the blood in  the right auricle,
 from which it passes by the foramen of Botalus into the left auricle,
 and is thus diverted from the  right ventricle, and  consequently
 from the pulmonary artery.  The  blood of the superior vena cava
 remains in the right  auricle, because the Eustachian valve is ap-
 plied against the foramen of Botalus:  this blood  then  reaches the
 right ventricle.  But, when this by its contraction forces it into the
 pulmonary artery, the ductus  arteriosus  of which I have spoken
 above,  and which now constitutes the principal branch of this arte-
 ry, turns it. into the aorta,  and thus  forms the  second  diversion
 made from the lungs, which receive  blood only by the two branches
 of the pulmonary artery (always  of small size  in the  foetus), and
 by the bronchial arteries.   We perceive  that this arrangement is
 founded upon the absence  of the  functions of the lungs;  it would
 be entirely useless for all the mass of the blood  to traverse these
 organs, since respiration does not  exist.  But, in  proportion as the
 time of the birth of the foetus approaches, the  circumstances fa-
 vourable to this variation, such as the  largeness of the foramen of
 Botalus, and of the ductus arteriosus,  are lessened; and finally,
 after birth, these openings are  obliterated, and  the circulation is
 carried on in the manner before described.

                Section IV.—Of the Arteries.

  The arteries may  be compared to two hollow trees, having their
 trunks  implanted into the base of  the heart, and sending forth
 their  branches and ramifications, the one   into the lungs,  and the
other  into all parts of the body. 
CIRCULATION OF  THE  BLOOD-
343
  The first, called  the pulmonary artery, arises from the right
ventricle,  and soon divides into two  branches,  each of which is
ramified in the lung of the same side; the second, which is called
the aorta, is the origin of all the other arteries, and the support of
the general or great circulation: this artery presents a number of
peculiarities to the observer.
   In the first place, the aorta, after rising above the base of the left
ventricle,  makes a  curve upon the left side of the vertebral column,
and forms  what is called the arch of the aorta, from which are given
off large arteries to the head, encephalon, face, neck,  larynx, tra-
chea,  lungs, (bronchial arteries,) and the superior extremities.  Af-
terwards the aorta, descending always upon the left side of the body
of the vertebras, traverses the thoracic cavity, where it is confined
to supplying branches to the skeleton and the parts which cover it;
next it perforates the diaphragm, descends upon the anterior part ol
the body  of the lumbar  vertebrae, is then called abdominal aorta,
and furnishes arteries to all the viscera of the abdomen and genital
organs; finally, having arrived at the lower  part of this cavity,  it
divides into two branches called primitive  iliacs, each of which
passes to the inferior or pelvic extremity of the same side, in order
to nourish all the  tissues, even to the extremities the farthest re-
moved from the heart.
   Such is the general plan of the distribution of the arteries, and
the origin of all the branches that we have mentioned, in speaking
of each organ in particular.
   The arteries appear as cylinders, which lose none of their volume
until they furnish other cylinders smaller than those from which
they  were themselves given off.   These separations are made at
different angles, from a right to the most acute.   The terminating
branches  are so small, that they have been compared to hair, hence
the name  of capillary arteries; and either continue into small veins,
or are lost in the tissue of the organs.
   For us  to say more on the distribution of these vessels, would be
to undertake a treatise  on anatomy; we shall therefore proceed to
the consideration of the structure, properties, and functions of the
arterial system.

             Section V.—Structure of the Arteries.

   After having greatly  multiplied the coats of these vessels, anato-
mists have come to the conclusion to acknowledge but three.  The 
ill
LIRCULATION OF  THE  ULOOD.
first is the external or cellular, which is most abundant in  those
parts where the arteries are not supported by any tissue.  This coat
is gelatinous, extensible, and so much the less dense as it!is external
to the arterial canal, for which it forms a real sheath.   The second
is  the proper coat,  composed of  circular, transverse, yellowish,
elastic fibres, with little extensibility; it is formed of fibrine, which
differs one hardly knows how from that of the muscles; it appears
red in the small  arteries, owing  to their  thinness permitting the
colour of the blood to shine through.   The third coat, or the inter-
nal coat, that some anatomists have  gone so far as  to divide into
two lamina?, is thin, smooth, and transparent,  always moistened
with a reddish serum, and  has been compared to the  serous  mem-
branes.  Whatever may be said, these two last have  no analogy to
any others in the body; they are sui generis, particularly the proper
coat, which it would be very erroneous to compare to any portions
of the fibrous tissue.
   Vessels may be distinguished in  the cellular or external coat of
the large arteries; but it is impossible to follow them into the two
others: with regard to the vasa vasorum, we have no means of ac-
complishing their dissection.  This same cellular coat also receives
nerves; they are small and few in the  arteries which are distributed
to the organs under  the predominating influence of the brain; but
the splanchnic arteries are, as we  have already seen, enveloped by
large plexuses of nerves, especially in the viscera of the abdomen.

        Section  VI. — Vital Properties of the Arteries.

   As the external or cellular coat possesses properties common to
the tissue, which, as well as it, are  formed of gelatine arranged in
areolar  laminae, we do  not think proper  to dwell on it  here.
Contractility is extremely obscure in the internal  coat;  but ex-
tensibility is very remarkable, since it can form hernia, in certain
aneurisms, through the rents of the  proper coat  It is particularly
with the properties of this  last that  it is important for us to occupy
ourselves.
   The quality which has most engaged the attention  of anatomists
in the coat in question, is its elasticity.   Some persons wish to make
this merely  physical, comparing the arteries to some inorganic
bodies, which restore themselves to a certain state of equilibrium,
when they have been stretched by the action of an external force. 
CIRCULATION  OF THE BLOOD.
345-
In our opinion, this property considered in the arteries, is altogether
vital.  In fact, it belongs to the particular composition of the fibrine
of their middle coat, a composition which is itself the production of
vital or organic chemistry, and which is intended for uses purely
vital.  That hardness,  density,  weight, extensibility, relaxation,
elasticity, softness, flexibility, &c. do exist in organized as well as
hi unorganized  bodies no  one can doubt;  but I cannot perceive
what science can  gain by the physiologist abstracting these  proper-
ties from the tissues of living beings, to consider them as pheno-
mena pertaining  to matter;  for in fact these same properties, which
serve a purpose altogether  physical in unorganic bodies, have an
object entirely vital in organized ones.   I see here but one point of
resemblance between bodies which have life and others which have
not.   But as these qualities are subservient to  a physical  state in
the latter, so  they are  adapted to a vital one in the former; they
are its work, and  form part of its history.    That they should be
compared in the two classes of bodies, is I believe  necessary, and
even indispensable; but for any one to isolate living, and to compare
them to inert bodies, appears to me to be as  incorrect, as if a per-
son should do exactly the contrary, and consider, for example, the
elasticity of water, and that of gas, as properties borrowed from living
bodies.   It  is thus, in  my opinion, of colours, of  forms, of size,
&c. qualities that are equally the property of all natural bodies.
   I consider  then the  elasticity and  the retraction of arteries as
vital properties, bestowed upon  them by the creative power, ex-
actly in the degree necessary for a due  performance of the  func-
tions of those vessels; these are  nothing but contractility; and this
property, though retarding for some  time  the destruction of  the
vital power,  is  not less the  production of  this power,  and  has
been bestowed upon these parts only to concur to the preservation
of an organized and living being.   It is this that we propose soon
proving in studying the functions of the arteries.
   Though contractility exists  in the coats of these vessels, they have
no sensibility in  a natural  state,  at least in those of a certain size.
Certainly it could be developed in them by inflammation, but even
then it is so very obscure, that pathologists have not yet been able
to deduce from it the diagnosis of arteritis.    It is probable  that the
pain might be perceived in the tissue of the arteries; but it is neces-
sary for this, that other sensations should not  predominate to absorb
the attention of self (moi).   Now, that  is scarcely possible,; for the
                                 11 
 346              CIRCULATION OF THE  BLOOD.
 attacks of acute arteritis, which are  the only ones that can cause
 pain, are generally accompanied  by other irritations much more
 active.

   Section VII.—Of the Functions of the Arterial System.

   The arteries, examined from the heart on to  the capillary sys-
 tem, are organs which have little  influence in the circulation; yet
 they contribute something to it; being always filled with blood, they
 are suddenly and  all  at the same time agitated by the wave of this
 fluid, which the heart throws  into the common  trunks at the  mo-
 ment of its systole.   In examining them with much attention in
 those parts of the body where they are superficial, we remark nei-
 ther dilatation nor contraction; the middle coat  is that which is
 vibrated by the percussion of the blood in its whole extent, and  which
 reacts against  it from its elasticity or  the degree of contractility be-
 longing to it   This reaction cannot fail to communicate a new im-
 pulse to the blood, although it may be very difficult to  appreciate
 it.   When, in that species of aneurism called varicose, the  blood
 passes directly from  an artery to a vein, this latter  presents  pulsa-
 tions; but they are weak, and are diminished more and more  as the
 vein  becomes  dilated, because the walls of the latter, not  being
 elastic, cannot drive back the blood, nor preserve the natural dimen-
 sions.  We can judge by this of  the very important duty of the
 middle coat of the arteries. In fact, were they susceptible of prompt
 and entire contraction, which would suppose them as irritable  as the
 splanchnic muscles, the arteries would contract when the action of
 the heart was  arrested, as for  example, in syncope;  and when this
 organ would again be excited to action, there would be strangula-
 tions similar to those that we observe in the digestive canal.  If they
 were more  dilatable, they would enlarge beyond  measure  every
 time  that the course of the  blood  is  greatly accelerated, which
 would  render  aneurisms as  common  as they  are now of rare
 occurrence.   On either of these two  suppositions, we would find
 at every moment partial  contractions and dilatations  taking place
 in these vessels, and existence  would  be continually jeopardised.
 In truth, the arteries  are dilatable, and contract even to oblitera-
 tion; but for this effect to take place a  long time is requisite.  True
aneurisms, or  the dilatation of all  the  coats of the artery without
rupture, require long and powerful efforts;  and obliteration takes 
CIRCULATION OF  THE  BLOOD.
317
place only when a portion of an artery is void of blood, and even
then there is formed in the vessel a clot, which is not removed  so
as to permit the close approximation of its walls, but after a great
length of time.   Wc  perceive that nature has ordered it well in
the composition of the arteries; she wished that their middle coat
should be sufficiently contractile to repel the blood, but not enough
to obliterate  suddenly  the diameter of these vessels.   This coat is
to keep them always open, and to prevent their closing until they
have become entirely useless.  There is not found any Other tissue
charged with exactly the same  functions;  nor  does there exist  in
the animal economy any  which  can  be  compared to this one;
for which reason we have asserted that it  is sui generis.  It is
formed of fibrine, it is  true, but of fibrine in a particular condition.
We may call it muscle if we please; but it will  be necessary to
grant that it is muscle such as can nowhere else be found.
  We have elsewhere  said that the  arteries  participate in the vi-
tality of the tissues  in which  they  are met  with, and we ourselves
rest our assertion on the nerves that are distributed to those vessels.
The changes that they undergo in their size, when  the organ  in
which they are situated enjoys an unusual degree of vital action,  or
is the scat of inflammation, are independent of the impulse of the
heart; but this  is only observed in the branches, the ramifications,
and minutest divisions, which appear to enjoy a much  greater de-
gree of vital action  than the  large trunks.   It is very  difficult  to
determine how far the  coats of the small arteries are  susceptible of
inviting the blood during the sympathetic influence of the viscera on
each other, and also of measuring the degree of action that the in-
ternal sensitive surfaces (mucous membranes) and the secreting or
erectile organs  can  communicate to those  vessels that convey the
blood to  them.   We cannot form to ourselves any definite idea of
the part that the nervous extremities play in the capillary arteries.
But it is conjectured that the middle coat*, at this degree of tenuity,
is blended with the nerves, and rendered by their presence^ much
more irritable than  it is in arteries of a certain size.

        Section VIII.—Of the  Capillary Circulation.

  It is to Bichat that we are indebted for  having called the atten-
tion  of physiologists  to the capillary circulation;  for, notwith-
standing the assertion  of Stahl, who taught that the  blood was re- 
34*
CIRCULATION OF THE  BLOOD.
gulated less by physical than organic laws,  and the experiments
of Pierre Antoine Fabre, which proved that the blood  in  the ca-
pillary system moved frequently in an opposite  direction  to that
given it by the heart, this viscus never ceased  to be considered as
the sole mover 'of the circulation.   The majority of anatomists
professed that the arteries were converted immediately into veins,
and took no account of the influence exercised  by the  muscles and
the different secreting organs, upon  the  movement impressed by
the systole of the heart.
  The capillary system,  agreeably to modern authors, consists of
a class of vessels extremely delicate, joined together by innumera-
ble anastomoses,  and forming a continuous net-work,  intermedial
between the arteries and the veins.   These vessels, add the authors
who admit the capillary circulation,  enjoy a peculiar action, which
does not depend on  the impulse of the heart; they are not  always
and every  where equally  filled with blood,  as should be the case
if this fluid was only regulated by the uniform action of that viscus
alone.   How  otherwise will  this action be preserved constantly
the same?  Does not  the sum of the middle  arteries exceed very
much in volume that of the larger trunks? Whence it results that
the space traversed by  the blood is continually enlarged.   Other-
wise the coats of the arteries, becoming more flexible in proportion
as they decrease in size,  cannot drive  back the blood by a shook
as forcible  as that impressed  upon it by the larger arteries,  which
cannot fail  to weaken the  impulse of the heart.  Finally, the blood,
reaching the capillary system,  meets with much more ample space,
and greater flexibility,  and it is there that the pulsatile movement
of the heart is destroyed;  so that the molecules of the blood would
Only be propelled  by those coming  after  them  in a slow and weak
manner, if  no other force intervened to hasten their motion and
cause them to arrive at the radicles of the veins.
  It is here that the  vessels  forming the capillary system, and
which  are neither arteries nor veins, play, according to authors, a
very considerable part; they receive, by  the nerves that penetrate
them, partial stimulations which derange this monotonous regularity
of action; and the blood forcibly invited to certain  parts by the ir-
ritation, deserts others without the  action of the heart  being dis-
turbed; or  else, finding an obstruction in some point, it is diverted
from its course,  by means of the  anastomoses, to flow into the 
                 CIRCULATION OF THE  BLOOD.             349

adjoining parts, and even retrogrades, if it is necessary, rather than
accumulate in excess before the obstruction t);at is opposed to it.
  All these observations relative to the diversion of the blood are
very correct; physiology and pathology continually furnish confir-
mation of them.   The experiments of Fabre, repeated by Dr. Sar-
landiere, on the mesentery of frogs, experiments of which I have
been an eye witness, afford a direct proof.  We have seen in these
experiments the blood and all the  fluids rush,  for some moments,
towards the point irritated; and when  they have congested there,
we have remarked that the globules took a different direction, and
even traversed the vessels  that conveyed  them in  an opposite
course, and some seconds after we have  observed them to return
with as much rapidity to the point from  which they had been  re-
pelled.
  There is no doubt that similar variations take place in the move-
ment of the fluids  in man, on the occasion of an increase of action
in the secreting organs,  in the muscular  fibres  of every kind,  in
the skin, and  in the viscera, whether  under the influence of the
passions, or in the orgasm inseparable from the  exercise of their
functions, or  finally in their inflammations.  It appears to  me un-
avoidable that, during the chill that designates the commencement
of visceral irritations,  continued or intermittent,  the blood should
be invited towards the internal organs and  there accumulated, and
should then be diminished in quantity at the surface.   No doubt
that, the  congestion once formed,  the blood may be more  or less
driven towards the other parts of  the capillary system, and that
frequently it traverses, in an opposite direction, the arterial vessels
that had conveyed it there, and the veins which carried it  back to
the centre.
  It is not only from  the interior  to the exterior that these  diffe-
rences are observed; we see great  irregularities in the quantity of
blood that is  found in  different parts of  the skin, and in those of
each viscus, considered separately.  It is thus that anger, shame,
and modesty, suffuse  the face without having the same effect on
the extremities; that the act of digestion invites the blood succes-
sively into the stomach, the duodenum,  the liver, the small intes-
tines, and the colon.  Do we not  frequently observe in the bodies
of those  who sink under  partial  gastro-enterites, a vivid redness
about the inflamed point, whilst the surrounding parts are deprived
of blood?   And if the inflammation has  been of long duration and 
350              CIRCULATION OF THE  BLOOD.
travelled the whole canal, the parts most recently affected  contain
a great quantity of blood, whilst those that have been the first dis-
ordered appear empty, although they still present unequivocal re-
mains of inflammation, such as thickening, ulcerations, and suppu-
rations.  When the inflammation, after having existed a  long time
in the  mucous  membrane of the intestines, attacks the  peritoneal
surface,  the blood  follows it, and the serous membrane  appears
filled with this fluid, whilst the mucous, although  remarkably dis-
organized by the previous inflammation, contains none.   But  we
can only observe this in subjects  exhausted  and rendered almost
exanimate  by the duration of the disease or  by haemorrhages;  for
the plethoric have always sufficient blood, to  allow all the parts ad-
joining the centre of inflammation to preserve a notable redness.
   M. Sarlandiere  in his memoir on the circulation,  published in
the first volume  of Annates de la Midecine  Physiologique, re-
marks that the retrograde movements  of the blood, of which  we
have just  spoken, do not take place  in  the vessels adjoining  the
heart, or even in any vessel of a large size; and that we can only  per-
ceive them in the small vessels, as in those that approximate nearest
to the  capillary system; but he observes, that at this degree of di-
minution the veins and arteries afford examples of them.
   It is in the coats of these vessels which form, according to them,
the capillary  system,  that modern anatomists and  physiologists
locate  the  vital action which gives  these various  directions to
the blood that  traverses it;  hence the opinion,  that these coats,
which are  inert in the  large  arteries,  or which at least act only by
a vital elasticity always the same, become so much the more ener-
getic as the vessels are smaller;  so that the most exalted degree of
activity is met  with precisely in the capillary system.      ,
   I  concur with them in the opinion, that  the small arteries are
more active than the large ones, and that they participate in  the
excitations received by the  nerves which are blended with their
coats.   I think that this arrangement  renders them susceptible of
participating, to a certain extent, in the physiological modification of
the organs of which they form  part.   This  appears  to  me to be
proved in their enlarging so  remarkably in the seats of  inflamma-
tion, and the return to their natural dimensions after resolution.   1
believe,  also, that the smaller arteries, in a  state of inflammatory
excitement, transmit the same modification to others situated in  a
part which sympathizes with that in which  they are found; but  I 
CIRCULATION OF THE  BLOOD.
351
 cannot admit that the capillary system consists of nothing but ves-
 sels; for, since it is proved that fluids penetrate every where, to say
 that the blood is always enclosed in  these vessels, is to  assert that
 the body  of animals is altogether vascular, which is repugnant to
 our belief.   Undoubtedly there is a capillary net-work which pene-
 trates  all parts; but when these  capillaries have reached a certain
 degree of thinness they disappear,  and the blood they contained is
 actually extravasated.   It circulates  in the interstices of the  fixed
 animal matter (which is every where porous) no longer  in  large
 masses, nor even  in small columns, but molecule by molecule, in
 immediate contact with those of this matter;  and it is there that the
 phenomena of nutrition,  of composition, and those  of decomposi-
 tion, must  take  place;  and  there   also is  verified, as  respects
 living  bodies,  the  axiom of the chemists: Corpora  non agunt,
 nisi sint soluta aut fiuida.   It is by the successive dimunition of
 the filiform structure that nature accomplishes this purpose, and we
 may conceive the last can no longer be organized coats, themselves
 containing other vessels.   A glance at the different orders of ani-
 mals ought to throw some light on this question.
   The lower orders of animals,  such as the infusoria, and the polypi,
 afford  no  evidence of vessels.   They are formed altogether of ;i
 homogeneous and porous  animal matter, always identical in its or-
 ganization, whatever may be its size.  It absorbs and admits into
 its interstices the nutritive materials;  it appropriates them, throws
 oft' the  superfluous part, and secretes its calcareous phosphate, with-
 out requiring the aid of vessels or nerves.  Behold here the type of
 the parenchymatous system, or of the proper tissue of the organs:
 it is from  this  that  it is necessary to set out,  in order to  form  an
 idea of the circulation.
   So soon as the mass of animal matter  is charged with  other
 functions  than that of assimilation, or rather when  nutrition re-
 quires  complicated  acts,  and spontaneous generation is met with,*
 vessels and  nerves exist.  There is in worms a central vessel that
 traverses the whole length of the animal,  and  which sends forth
 branches into the different parts of the body, and a  nervous appa-
 ratus to direct the action of this vessel;  but  there is here no evi-
dence of a heart.
  The  fluids are conveyed from the digestive canal into the vascu-
lar receptacle,  and from  this into the animal matter not vascular. 
352
CIRCULATION  OF 1 HK liLOOD.
We know not if this  last returns  them to the receptacle; but still
it is certain that the  greater part of the  animal is not vascular.
  The  vessels are very  short, and  we see them, soon after the;
arise from  the  great  vessel of  deposit, pour out  their fluid into
this living matter, which may be compared to that of the polypus,
,md which  forms,  I repeat it, the greater part of the  bulk of the
animal.
  In the molluscaea heart is found with only one ventricle; but the
vessels which arise from  it are still not numerous; so that gelatine
or albumen not vascular, forms still the greater part of the animal,
and alone secretes the calcareous phosphate; for certainly, the snail
and the oyster have no more need of vessels to secrete their shell,
than the polypus has to form its coral.
  In insects, we find  more  complexity; nevertheless we  are as-
sured that the vascular system is here very limited, and that the
animal matter without vessels is still in a large proportion.
  As we rise  in the scale, animals  present more varieties in their
different parts,  and  more complexity in their  functions, and the
vascular system and the nerves are multiplied  in the same propor-
tion; these, however, are still  so  trifling in fishes and reptiles,
that their circulation cannot save them from death, if they be ex-
posed to a degree of cold amounting to freezing.   We may then
affirm, without fear of being deceived, that the greater part of the
mass of these animals is not vascular, but consists, like'that of the
polypus, of animal matter, in  the interstices  of which the fluids
move without the  aid of arterial or venous coats.  These vessels
terminate after having there poured out  their  contents, and the
organic action of the molecules, which are not vascular, causes them
to undergo alterations, and alone impresses upon them motion until
they are taken up by the radicles of the veins: a heart with only one
ventricle, and remote from the parts in question, could  assuredly
exert no influence over this kind of progression.
  Finally, when we arrive at warm-blooded animals, the vessels are
multiplied; the heart is very vigorous; it has  two ventricles, and
its  impulse is strongly felt far into the vascular system: all this
apparatus is supplied with  particular nerves. But is  this equivalent
to saying, that the heart alone presides  over the movements of the
fluids, or even that,where its influence ceases to be felt, it is always
supplied by that of the coats of the capillary vessels? Certainly not. 
CIRCULATION OF  THE BLOOD.
353
The rudiments of animality, the parenchymatous matter, analogous
to that of the polypus, never disappears; it is that which forms the
proper tissue of  every organ.  Undoubtedly it is found in this class
more varied in its forms than among animals of a lower grade; but
this difference is still not so great as we should at  first sight be in-
duced to believe. Are not gelatine, albumen, and fibrine, the basis
of all our tissues? and are they not formed equally in the  molluscae
and  in  fishes?  Fibrine perhaps  is wanting in  the polypi; but
mucus and gelatine  are found in  them; and we know that fibrine is
nothing but a degree  of improvement of these two  forms,  which
belongs to animals more elevated in the zoological scale.   With re-
spect to the different forms of animal matter afforded by the secre-
tory organs, such as milk,  bile,  saliva, &c. they proceed from the
three primitive  ones; and, if these  do not need vessels for their
existence  in  the animals of the lower classes,  wherefore  do we
make this aid  indispensable in the  mammifera?   The  vessels
are destined  to  convey nutritive  materials;  but when they have
poured them out in  their tissues, they doubtless disappear.   What
signifies our admitting this multiplication of vessels ad infinitum?
That those of a certain size contain others in their walls; that even
these latter, when they are  sufficiently large, contain others of a
third class, is comprehensible; but that there is no limit to this mul-
tiplication is a thing that cannot be admitted.  I believe even that it
does not extend  very  far, and that, in many organs, the vessels ter-
minate abruptly, depositing their  fluids between the molecules of
the primitive tissue,  whether it be  gelatinous, albuminous, or of
fibrine.  This appears to me to take place in the white pulp  of the
brain, the tendons,  the ligaments, the bones, and even the muscles.
With regard  to  the lungs,  the liver, the spleen, and the digestive
canal, they are undoubtedly much better supplied with vessels; but
these latter themselves, becoming capillary, are no more than gelati-
nous cylinders, not  vascular.   The cellular tissues, and the fibrous
membranes  which  serve to contain the vascular fasciculi,  in tire
spleen, for example, and in the erectile tissues, are in a similar situar
tion.  It is the same with the mucous membranes, kinds of  paren-
chyma?, in which the vessels disappear very abruptly.   As for the
serous, areolar, and adipose tissues, inflammation proves to us that
they are very vascular; but always  this same remark holds good,
that their  vessels, whether sanguineous or lymphatic,  are  cylinders
of simple gelatine.  The lymphatic glands appear possessed of vert
                               45 
351
CIRCULATION OF  THE  BLOOD.
little vascularity, as we may infer from the manner in which in-
flammation is  carried on;  we know with what facility their vital-
ity is extinguished, which should induce  us to consider them as
formed in general, like the tendons, by a  mass of gelatine supplied
with a small number of lymphatic and sanguineous vessels, and a
small quantity of nervous matter.
   The calcareous phosphate and the different salts which are com-
bined with the tissues, to give them certain degrees of consistence,
elasticity, &c. do not require, in my opinion, the aid of secreting
vessels, any more  than in the zoophytes, and  in the mollusca.
These salts are collected together by the animal matter itself,  which
forms them from the blood.  I think that it is thus of the other
secretions, and that all the vessels not sanguineous, which we ob-
serve in the  organs that secrete them, are  not entrusted with the
office of separating from the blood the matter that issues from the
glands,  but only to gather  up the molecules, and to bring them
together in a mass,  in  order to be conducted to  their  respective
destinations.
   Thus  then  it appears to  me, that the primitive  organic matter,
not vascular, is much more abundant in our economy than is com-
monly believed.  I think that to it are entrusted the duties of
assimilation, composition, decomposition, secretion, and the forma-
tion of humours, the like of which are  not found in the circulating
fluids; in a word, of every thing that concerns vital or organic chemis-
try.  It is my opinion,  that the vessels, of whatever class they may
be, are not the agents of these phenomena;  that they co-operate only
in conveying to the matter not vascular the  fluids  that these latter
require, and in bringing back these fluids,  their residue, or those of
new formation, either  into the current of the circulation, or into
certain receptacles,  where they are to serve for the accomplishment
of some function.
   It is also my opinion, that in this animal matter, forming the
basis  of all the tissues, and which always  contains more  or less
    nervous  matter, all  pathological phenomena  are developed: I
think that the vessels  and nerves, properly so called, are affected
only secondarily, the one  for the  conveyance of fluids, the others
for the transmission of the stimulation  to correspondent parts.
   In  admitting these propositions, it  must be perceived  that the
phenomena  of muscular circulation, which  take  place in  matter
without vessels, have been confounded with those of vascular cir-
<* 
                 CIRCULATION OF  THE  BLOOD.              355
culation; and, in fact, have all been comprised in the history of what
is called the capillary circulation.  This distinction is, however,
of great  importance in estimating  the forces which co-operate to
the progression of the blood, and we now proceed to endeavour to
make it understood.
  Once in the capillary system or  reticulated structure, the blood
is at the disposal of all the tissues; as the anastomoses are numerous,
it may be drawn  from all sides by  the stimulations which are de-
veloped in the different portions of the animal matter.  But if it is not
diverted  from its course,  it reaches the veins and returns to the
heart without undergoing much extravasation; I say much, for  it
always experiences some, since it is necessary that it should serve
to the nutrition of parts, and supply certain secretory organs whose
action is  never interrupted.  Hence, there always takes place more
or less of extravasation; but it  is not all extravasated.   There is no
doubt that a great number of  venous  radicles may be continued
from the small arteries, since microscopical observations have de-
monstrated it  This is what I call  the great route or direct course
rsl the blood. It undoubtedly exists in all the organs, or at least ad-
joining them; but it  must be larger, if I may so express myself, in
the lungs, where the black blood is presented only to be submitted
to the action of the air; in the liver, where  there  arrives a much
greater quantity than is required for the secretion of the organ, and
for its nutrition; in the spleen; in the alimentary canal, which, ex-
cept during the time of digestion, receives much more than it has
any need of for its  own maintenance.   There are  also tissues in
which this route is considerable, such as  the  muscles, which re-
ceive a great quantity of it,  to supply the contractions  that may be
required, and which may also remain a long time inactive.
   But, on the other hand, there are many  of the tissues where the
sanguineous capillaries are few in  number, because the  functions
allotted to their organs do not require  so great  an  expenditure  of
blood as  the preceding.  Of this number are the tendons, the  liga-
ments, the bones; tissues which, forming a great part  of the mass
of the individual, co-operate,  but in a passive manner,  to the exer-
cise of functions.  They have  a vis  inertia, which depends on their
composition, and this latter is the effect of nutrition.   As it is for
nutrition that the blood is conveyed to  them, they receive but a
small  quantity of it, and almost all that reaches them is extrava-
sated in  the animal  matter of which they are formed.   I should 
>5ti
CIR( 1LATI0N OF THE  BLOoD
even be induced to believe, that the whole of this fluid there under-
goes extravasation, and that consequently the great or direct course-
is not found in them, but exists in the adjoining parts.
  It should be the same case with the sclerotica and the membranes
which secrete the humours of the eye: the chief course of the blood
cannot be there; but this fluid can  be  diverted from them by the
vessels which form the ciliary processes, and by those of  the cho-
roid coat, and of the conjunctiva.
  If the brain receives a great  quantity of blood, it passes  princi-
pally into its pia mater and gray substance, and it is there that the
direct route must be found by which, through the veins,  this fluid
is deposited  in  the  sinuses; the white pulp receives only a very
small quantity,  and we cannot admit  there the direct termination
of the arteries into the veins; but vessels pass through it to convey
the blood to the central grayish matter  in  the corpora striata, and
in the interior of the medulla oblongata, &c.
  The  serous membranes, the fatty and areolar tissues, being en-
trusted  with a secretion, or, as  it is  commonly called, an exhalation,
undoubtedly receive  a great quantity of blood;  but except when
they are in a phlogosed state, we can discover in  them no redness;
it is therefore presumable, that the arteries have  not there a direct
junction with the veins.
   The mucous membranes vary much in  respect to their colour,
and their secretions; so that it  is difficult to determine if the san-
guineous current traverses them without interruption. I cannot be-
lieve that it does; but they have behind them  numerous capillaries,
into which the blood could easily be diverted, particularly in the
lungs, the digestive canal, and  the genital organs.
  We proceed  now to view all these tissues in action, in order to
observe their relations to the  circulation, as  considered in the ca-
pillary system.
   We will commence by observing,  that  all these tissues never
evince,  simultaneously, the highest degree of action.  Let  us sup-
pose the circulation to be excited by the muscular  system: a great
number of locomotive muscles are contracted; they  invite the blood
in abundance into their fibrine, perhaps a hundred times more than
is required for their nutrition;  whence it would result,if this is the
fact, as  I believe it to be,  that the blood being extravasated into
their fibrine assists their contraction, and that it will be diverted from
the direct route much more when the muscles are  in activity than 
CIRCULATION  OF THE BLOOD.
357
when they are in a state of repose.   The same  extravasation that
assists their contraction, increases their nutrition, since they acquire
greater size,—as ought to be the case.  The  muscles, after having
made use of the  blood  for  their contraction,  throw it into  the
venous system; and this cause,  added to the stimulation that they
transmit to the  brain, and to the heart, by means of the nerves,
imparts to this fluid a motion much more rapid  than that to which
it was subjected the moment before.
  Let us contrast this acceleration of the course of the blood, with
that which is produced by the influence of an organ in that pathologi-
cal state called fever.  In this case the stimulation, produced in the
inflamed point, commences by inviting  the  blood towards it,  and
hastening the movement of its molecules without the heart's parti-
cipation;  but like the muscles,  in contracting, it returns to it more
blood than it received before; then it acquires force; it is  reflected
to the brain and the heart: this latter hastens its contractions, and
the  blood is poured in  abundance  into all the capillary tissue.
Well,  in this  case the muscles do  not  act; more frequently the
blood, which abounds in  their tissues, follows the direct route with
so  little extravasation, that the nutrition  of the organs is prodi-
 giously diminished.
   During these two kinds of accelerations, the  blood is differently
 affected in the  capillary system of the other tissues, according  to
 the degree of action which will be imparted by the causes peculiar
 to them.  Thus, in the capillaries of the pulmonary vein and artery,
 where the great route is extensive,  this fluid will always abound
 whatever may  be the  cause  that hurries the action of the heart;
 whilst there scarcely arrives more than usual in the serous tissue of
 the lungs.   The same difference will be observed in the abdomen;
 the blood will flow in abundance into the vessels called mesenteric,
 without any increase of  colour in the  peritoneum and the tissue
 contained in its different folds.  With regard to the mucous mem-
 brane, it will be very differently affected according to the nature of
  the case: in the acceleration of the  blood by exercise,  it will not
  be  more injected; in fever, it will always be more so, and its  se-
  cretion will be much increased, not because more blood arrives in
  the capillaries which  are situated  behind  it,  but because it will
  participate in the irritation  of  the point inflamed, if it be not itself
  primarily inflamed, that is to say, the principal cause of the febrile
  state.   It is then evident, that in the first case it will not divert  the 
358
CIRCULATION  OF THE BLOOD.
blood from the great route of the mesenteric capillaries, whilst in
the second this deviation will be very considerable.
  The same observation may be made with regard to the liver: in
the acceleration of the blood,  occasioned by exercise, this fluid will
traverse, without remarkable deviation, the great capillary route
of this organ;  whilst, in the acceleration caused by gastro-enteritis,
the secreting vessels of the liver,  excited by this phlegmasia, will
divert a great quantity of blood from the direct course, and fill
with bile the digestive  canal already stuffed with mucosities pro-
duced by mucous inflammation.
  If we cast a glance over the skin, we shall  observe  in it diffe-
rences no less remarkable in  the two kinds of acceleration that we
are now contrasting with each other.   We will first observe that
the skin has no resemblance to the  greater number of internal ex-
halent surfaces: these latter,  except, however,  the mucous  mem-
brane  lining  the lungs, are not increased in action  by the in-
fluence of the  blood alone which reaches them;  a peculiar stimula-
tion is always necessary to dispose them to receive  this  fluid in a
greater quantity than usual.   The skin, on the  contrary, is, in its
normal condition, the natural  resort of the blood accumulated in
the interior; it receives it by a kind of reflux;  it becomes the di-
verticulum of the  viscera, and the  pores  with which it is filled,
while allowing much of the serosity to escape, free the body of the
fluids  that the acceleration of the blood would otherwise  render
superabundant in the economy.  Hence as long as the  individual
enjoys good health, exercise produces, with  the colouring  of the
skin, a considerable evacuation of sweat.  The same thing happens
in fever, where the skin is not diseased; this is confirmed in acute
and chronic peripneumonias:  but if the cause of the fever is of such
a nature as to transmit a constrictive irritation to the skin, the blood
will be presented in vain to its tissue; it will not expand; and,
although the  skin may be burning,  it will also be dry,  hard,  dis-
coloured, pale, or  overspread with livid  spots; in a word,  it will
exert no derivation from the capillaries which place the blood at
the disposal of its excretory vessels.
   There are certainly very considerable differences in the quantity
of blood which traverses the parts where the irritation predominates,
and where the sanguineous capillaries abound; theyr are still greater,
if we compare these tissues with those in an opposite temperament, 
CIRCULATION OF  THE BLOOD.
359
which have no sympathies, and where we have said that the ca-
pillary system was not enough developed.
  For  example, in vain would any  cause, whatever it might be,
accelerate the course of the blood; the tendons, the aponeuroses,
the bones, would never receive a greater quantity than usual.  If it
were otherwise,  we would see them  swell  and soften in fevers
with plethora; become thin and  be dissolved in febrile atrophies,
as takes place in the muscles and the parenchyma? of the viscera,
and the foundations of the animal edifice would be destroyed.  But
this never  happens; these tissues are  inert and entirely passive in
the greatest  exaltations of the circulatory function.  The blood,
urged on by the  heart,  is presented to them in vain; they repel it
or receive only the quantity necessary to their nutrition; the blood
flows into the medullary membrane, the periosteum, &c.
  But, without stopping to consider the tissues whose inertness is
go striking, it is sufficient to examine  the  humours of the eye in
the accelerations of the course of the blood.   Has any one  ever
seen the  turgescence  of the capillary system surrounding them,
communicated to their membranes, and cause them to  lose in an
instant their transparency? This could only happen whenever in-
flammation is developed in them; but then their animal matter would
have changed its condition, the stimulation would  have rendered
them more porous, extravasation would become more considerable;
perhaps even sanguineous vessels would be developed there, as is
seen to take place  in such cases in  the serous membranes  of the
principal viscera, and the direct communication of the arteries with
the veins would  be then established.
  It is urged, in favour  of  this general communication, that the
tenuity of the vessels is such in the  white tissues, and the tendons,
that the red globules are there decomposed, which  renders the pas-
sage of the blood imperceptible.   Well, this opinion coincides per-
fectly with our own; for this extreme  tenuity of vessels is equiva-
lent in  our minds to their disappearance, and the passage of the
molecules of the  blood through the interstices of the animal matter,
which has ceased to  be organized,  in  the form of vascular walls.
But observe,  that the opinion wliich I combat is founded upon an
hypothesis; for who has  seen  these vessels?  Inflammation, it will
be said, renders  them  perceptible.  To this I will reply, that it
creates them,  as in adhesive exsudations, by giving to the animal
matter a new disposition, by rolling it in  small cylinders, and by 
360
CIRCULATION OF THE BLOOH
preparing it for the reception of the stream of the blood.  But, in-
flammation abating, these cylinders disappear, the organic  matter
resumes its former arrangement, and does not admit any longer the
blood in streams, but only in molecules which roll slowly between
its own.  Besides, I repeat it, when we have imagined the smallest
vessels  possible, it is absolutely necessary to admit that the fluids
which nourish their walls pass between their molecules without be-
ing contained in  these vessels.
  When the fluids,  red or white, circulate  in streams, I say that
there are vessels; but I can no longer perceive them whenever these
streams cannot be demonstrated by any optical instrument; other-
wise I do not see why it should not be maintained that the animal
matter which forms  the circulatory vortices, is nothing but vessels.
And what would be the limit of this extraordinary multiplication!
The hardest mineral substances have interstices between their mo-
lecules; wherefore then  deny that animal  matter  should 'possess
them? It has them therefore; and if it possesses them, the  fluids
ought to traverse them when they have arrived at the termination
of the small vascular branches.  It is there, and not in the vessels,
that all  the transformations of animal  matter  ought to take place;
they are produced  with  rapidity or  slowness, according to  the
vitality of the tissues, and  it is this which determines the  duration
of the passage of the fluids.   This last is not then submitted to the
impulse of the heart, nor even to that of the coats of the capillary
vessels; the latter on the contrary are  governed by it; and  if the
capillaries are seen  to be rapidly agitated in an inflamed tissue, it
is because the movements of transformation, whether nutritive
or secretory, are primarily accelerated in the animal matter to which
they present the blood; for they are subject to its sway, whilst it is
rarely if ever at their disposal, as we have already more than suffi-
ciently  proved, when  studying  the  deviations of the blood in
the febrile state,  and in the  acceleration  produced  by muscular
action.
  Whether this acceleration arises from the  repeated contraction of
the muscles, or results from a point of inflammation, or simply from
the exaltation of some function, as in digestion, or in the excitement
of a moral affection,  invariably is it the case that it has its first cause
in an irritation which does not originate in  the vessels, but rather
in the molecules of  the animal matter.  It is this matter which is
agitated, which disturbs the regularity of the course of the  blood 
CIRCULATION OF  THE  BLOOD
361
 in the capillaries that contain it; it is its irritation which, transmitted
 to the encephalon  by the nerves, its conductors, is reflected to the
 other organs, and developes there the phenomena of the part from
 which it originated.
   It is thus that we explain the capillary circulation.   Let us  now
* recapitulate.

 Section IX.—A  Summary  View  of the  Phenomena of the
                    Capillary  Circulation.

   The blood, having reached the  capillary  reticulated structure,
 does not, await there in a state of stagnation the demands of the dif-
 ferent tissues, in order to flow in greater or less quantity to one or
 the other; it continues to circulate, propelled on by that which comes
 from  the heart, and  the greater part of  its molecules reach the
 venous apparatus, because there is always, in certain places that we
 have pointed out, a direct communication of the small arteries with
 the small veins; in other words, because these sets of vessels dip
 equally into the'capillary net-work.
   The small cylinders which form  this net-work are immersed in
 the midst of animal matter not vascular; they are themselves formed
 of it; they are to pour out in  the interstices  of its  molecules the
 fluids necessary to  its  nutrition, and functions; they always furnish
 it; they  receive  continually the effete portion, which changes the
 quality of the blood that traverses them, while accelerating greatly
 its progress towards the veins.
   When any  portion  of this animal matter enjoys an unusual de-
 gree  of action,  the capillaries are compelled to furnish more blood
 to it; the extravasation  becomes more  considerable; the  blood is
 more altered, as is  proved by its colour being always blacker in the
 seats of inflammation  than in healthy parts.   Then the regularity
 of the course  of the blood is more or less disturbed:  its movement
 is always greatly  accelerated,  and this may  be carried to such a
 pitch, that this  fluid traverses  with great  rapidity the capillaries
 adjoining the inflamed part, in an entirely opposite direction to that
 of the natural state.
   Certain tissues, much less active than others, receive, appropriate,
 invite, and divert, in short, only a very small quantity of the blood
 contained in the capillary net-work; it is on this account, that this
 latter i" always lr*s considerable in these tissues than in the others.
                               46 
362
i TRCULATION OF THE BLOOD.
  When the course of the blood is greatly accelerated, that part of
it which  is directed  to the inert  tissues  is diverted  and drawn
to war. Is  the capillaries of parts  naturally more  active; and as it
exists in all parts of the tissues which expend little of the fluids,
so there is found always within their reach capillary net-works of
derivation which prevent the blood from remaining in the vicinity
of the inert tissues.  It is thus that the blood  which  progresses
towards  the serous  is  diverted  by the capillaries of the mucous
tissues, or of the secreting  organs;  that which ought to go to the
bones, by the capillaries of the cellular tissue, and of the marrow;
that which is directed towards the tendons, the aponeuroses, and the
ligaments, by  the muscles; that which progresses towards the
white pulp of the brain, by the capillaries of the cineritious portion;
and that which would be too abundant for  this last, by the sangui-
neous net-works of the first, &c.
  In numerous cases, the partial irritations generated in the mole-
cules  of the animal matter are too inconsiderable  to react upon the
nervous apparatus to the extent of agitating the heart; then the de-
rangements of the capillary circulation take place  only in the neigh-
bourhood of the diseased part, and  form around it a kind of inflam-
matory atmosphere.  The action of the vessels of the part increases,
not in frequency, since  that depends on the heart, but in force; the
extravasation  is more  considerable, and all  the  local changes are
perverted.
  The explanations that I have just  given, appear to me adapted to
reconcile  the opinions of those physiologists who  maintain that the
blood may be thrown by the  heart even into the veins, with the
belief of those who affirm that the capillaries alone  exert an influence
over its progression.  I believe what I have declared to be founded
on facts, and I confidently expect that experiments will soon come
to the support of this  theory.

Section X.—Summary Description of the Venous Apparatus
               in general, and of its Divisions.

  The veins are cylindrical tubes, destined to bring  back to the
heart, with all the fluids that have been absorbed, the blood which
that viscus had sent out into all parts of the body by means of the
arteries.   They are usually divided into two systems: the one ge-
neral, which terminates directly in  the heart; the other peculiar to 
                                            s
                 CIRCULATION  OF THE  BLOOD.              363
 the abdomen, and which terminates in the first  It appears to me
 that it is more natural to divide the venous apparatus  into three
 tre'es, which are essentially very different.   The first is the pulmo-
 nary one, the branches of which are ramified through the lungs, and
 the trunk implanted in the left auricle of the heart; the second is the
 general tree or great venous apparatus.  We distinguish  in it the
 two trunks terminating in  the right auricle; from  those two, the
 superior has its branches and ramifications  in the head, face, neck,
 and the superior  or  thoracic members; whilst the  inferior, much
 more expanded, has its  branches  in all parts of the  body.   The
 third venous tree is only an appendage of the second; it  consists of
 the vena porta, and  is composed of a very short trunk which has
 its roots in the digestive organs, and its branches in the tissue of
 the liver.

     Section XI.—Of the general Structure of the Veins.

   The walls of the veins are much thinner than those of the arteries;
 they are of a grayish hue.  We  discover three membranes in their
 composition:  1. The external, which is cellular, compact,  formed
 of an infinity of interlaced  filaments, which dip between the fibres
 of the second: 2. This  latter,  which is the middle, and called
 proper membrane,  is fibrous,  lax,  extensible, and very contrac-
 tile.  It is composed of longitudinal and parallel fibres, more evi-
 dent in the  divisions of the vena cava superior than in those of
 the inferior,  in the superficial veins than in the deep seated; but the
 readiness with which these veins  contract, proves that  they have
 also circular fibres.   Bichat and  some other anatomists do not con-
 sider this coat as muscular,  by which is meant that it is not formed
 of fibrine: it is in fact gelatinous;  is gelatine in a particular condi-
 tion, adapted to the functions of  this class of vessels.   In the cere-
 bral sinuses whicli perform the offices of veins, the dura mater sup-
plies the place of the two coats  of which we have just  spoken.
 3. The third, or internal coat,  is called internal membrane; it
 is even, smooth,  and polished,  nearly  resembling that  of the
 arteries,  but  more  delicate, and forming the valves by its folds.
These are of a parabolical form:  their free  edge is turned  towards
the heart: the adherent one is convex; they are formed of two lami-
na? very difficult to separate, in which are frequently distinguished
white fibres crossing each other:  they do not exist in the pulmonary 
.50 1
LIRCULATION OF  THE  BLOOD.
veins, in the vena cava superior, in the inferior as far  as the iliac
veins, the internal jugular, the sinuses of the brain, and the vena
porta.   They are generally found in all other parts; but they vary
in number and situation.
   The coats of the veins of a certain size contain small arteries,
veins, and absorbents; the internal has exhalent  porosities,  since it
is always lubricated writh  a  dewy lymph.   According to  some
authors,  nervous filaments  from the ganglions are  found in the
veins;  but others deny  their existence.   Besides, they must be
very few in number;  for the sensibility and  the sympathetic rela-
tions of these vessels are very trifling.
   The venous trees of the lungs and digestive viscera have  but one
arrangement, which reigns throughout the tissue of  these viscera;
they accompany with  sufficient regularity  the arteries of  those
parts, and exceed them in bulk.  We have already seen that they
are destitute of valves.   The great  or general venous tree has
two subdivisions, the one of which, or  the deep-seated,  accom-
panies the arteries, being always of a more considerable diameter:
there are no valves found in it  The other  portion of this tree is
superficial,  sub-cutaneous, and unaccompanied  with arteries.   In
the cephalic cavity, the small veins of the dura  mater  empty their
blood into the sinuses which furrow the internal face of the  bones
of the  cranium, and which are formed by the folds of the dura ma-
ter.  These sinuses possess no contractility,  nor do they contain a
valve which could present an obstacle to the  progress of the blood.
The superficial division of the general venous tree forms frequently
a very considerable and irregular net-work, in the sub-cutaneous cel-
lular tissue; there are many valves found in it, and its  extensibility
is very great.
   The venous tree of the abdomen merits particular  attention; it
arises  from all the veins of the viscera of this cavity, except the
kidneys and their appendages, and, in the female, the  uterus.  All
these veins join together to form two principal ones,  the inferior
 mesenteric, and  the splenic, that  unite in their turn  to  form the
 vena porta, the diameter of which is  less than that of the two veins
 by which it is formed.
    The  vena porta, about four inches in length, extends from  the
 vertebral column to  the transverse sinus of  the liver;  it is situated
  under the small extremity of the pancreas,  behind the duodenum,
  and covered afterwards by the hepatic artery and the communis cho- 
                 CIRCULATION  OF THE  BLOOD.         -     36*
 ledechus and hepatic ducts.   Arriving at the concave surface of the
 liver, between two protuberances that are called portal eminences,
 it is divided into two branches,  which separate at a right angle, to
 the right and left forming the sinus of the vena porta.   These two
 branches accompany the  hepatic artery  in all its divisions; they
 r.mify in the tissue of the liver, always  enveloped  by a prolonga-
 tion of the fibrous membrane of this viscus, which is known under
 the name of the capsule of Glisson.   The vena porta  may then
 be represented as a tree having a very short trunk, and branches
 which end in the two capillary systems,  located, the one in the di-
 gestive organs, and the other in the liver.  This is the only exam-
 ple of the kind to be found in the body, since all the other veins
 have but one capillary system at the extremity, their trunk being
 always implanted in one or the other auricle.

 Section XII—Of the Functions of the different Venous Ap-
           paratuses, or of the Venous Circulation.

  It is from the general capillary system that the last subdivisions of
 the venous tree, or the venous radicles, draw up the blood.   This
 fluid immediately ascends in their branches in order to arrive at
 their trunks, which empty it into the auricular cavities of the heart.
 This is the general fact; but there are other particular ones in con-
 nexion with this first, which serve to explain  it.  These we now
 proceed to  set forth.   The veins are not  inert tubes; they are en-
 dowed with a contractility, in virtue of which they exert a con-
 tinual pressure on the contained fluid.   This pressure ought neces-
 sarily to produce its  displacement; but does it force it to advance
 towards the heart, notwithstanding the diminution of the space that
 it traverses, in passing  from the ramifications into  the  branches,
 and from the branches into the trunks? or rather is this pressure
 confined to acting in a general manner upon  the fluids, whilst the
 centripetal  progression would be exclusively produced by the mo-
 lecules which reach the veins, as propelled by the impulse of the
 heart, and by that of the capillary tissues?  In other words, is the
 contraction of the venous walls directed from their  extremities
 towards their trunks, or  is it only perpendicular?   If we  reflect
 upon the action of the lymphatic vessels, we shall be inclined in
favour of the first mode of action, for it is impossible to imagine a
vis a tergo in the absorbing mouths.  There is in this case no im- 
 'otiti              CIRCULATION OF THE tlLOOll.

 pulse of the heart to determine the chyle and the lymph into these
 mouths, whatever they may be; it is requisite then that they should
 be endowed with a pumping  and an absorbing  power, and that a
 contractile movement, directed from the extremities and branches
 towards the trunks, should alone effect the progression.
   Now, if this property is granted to the  extremities,  and to  the
 coats of the lymphatic vessels, I do not see for what reason it will
 be denied to the veins,  particularly since  they are seen to take up
 blood which has been extravasated in the parenchyma of the organs,
 or upon some surface. Such is that which the umbilical vein absorbs
 in the capillary tissues of the internal surface of the uterus, in or-
 der to conduct it to the embryo.
   I think, therefore, that the veins are endowed with contractile
 movements, acting from the circumference of the body towards the
 centre, and I believe that this action is  one of the principal forces
 which cause the return  of the  blood  to the  heart.   These move-
 ments cannot be  continued; they ought then to alternate with a
 state of relaxation; and we can, without fear of error, imagine them
 altogether similar to those of the heart. But they are so slight, that
 as yet they have not been rendered by any process perceptible in  the
 majority of the veins; they are, however,  very visible in the vena
 cava of frogs, at the point where it joins the auricle.   In  the ex-
 periments that  doctor Sarlandiere made upon the circulation,  we
 have observed  these  movements independent of the heart, since,
 after having removed this organ, we have seen the contraction and
 relaxation of that  vein continue during many minutes in  the  cut
extremity, and persist even after the fluid  had ceased to arrive.
   Many physiologists have  likewise observed this  contraction in
the vivisections of large animals; they have attributed it to the
muscular fibres which they discover round the  trunk of the vena
cava.  These fibres ought undoubtedly to produce it; but it can take
 place without their assistance, and in gelatine alone, as we have
ascertained to be the  case  in the frog.  Now, I believe that these
contractions are common in the whole extent of  the  venous coats,
although they  may  be  only distinctly appreciable in the trunk of
the large veins.
   Next to the contraction of the coats of the veins, it is necessary
to admit, as auxiliary causes of the centripetal movement, the im-
pulse of the heart and the action of the capillary tissues.   And,
indeed,  these powers contribute  to  this effect in a very efficient 
CIRCULATION OF THE  BLOOD.
367
manner, by acting as a vis d tergo, and because, moreover, irrita-
tion of the  capillaries is propagated immediately into the venous
radicles.
  It is here necessary to recal to mind the distinction of the two
routes that we have admitted in the sanguineous circulation.  The
blood of the  veins which correspond to the arteries in that which
we have named the great route, ought to be more acutely sensible
to the impulse of the  heart; hence the aid of valves  is in them less
necessary.   This is observed in the veins of the lungs, in those of the
abdomen, and in the jugulars, where, besides, the progression of the
blood is facilitated, throughout a great^ part of the diurnal circle,  by
the perpendicular direction.  It is not thus with regard to the veins
of the limbs; we have  seen that the quantity of blood which traverses
them was susceptible  of numerous variations, according as the mus-
cles were more or less exercised.  The impulse of the  heart  is
much weaker in them than in the veins of the viscera; hence they
are provided with valves very near each other.
  The most powerful vis a tergo is produced on them by muscular
action; and when this latter becomes feeble, the blood always un-
dergoes there a considerable diminution, which soon  brings  on
atrophy.
  With respect to tissues where the direct communication of the
arteries with the veins does not exist, where the blood is necessarily
extravasated, and the impulse of the heart almost nothing in  all
their veins, the molecules simply propel  each other, but with a
slowness proportionate to that of  nutrition: besides no sympathetic
irritation happens which can accelerate the  movement; it is but in-
flammation which renders them sometimes  more rapid, by expand-
ing these tissues, and imparting  to them,  for a longer or  shorter
period, a more vascular organization, one approaching nearer to that
of the other parts of the body.
  It is now time to treat of the venous circulation of the abdomen.
A great number of arteries pour  out the blood into the intestines
and into the spleen.   This blood passes immediately into the radi-
cles of the vena porta; and as it is little removed from the heart,
it doubtless still preserves much of the impulse which it received
from  that  organ.  It  is nevertheless  necessary to admit that  it
receives a very considerable impulse from the stimulation imparted
to those viscera during digestion.  Be this as it may, the blood of
the  vena porta, instead of arriving  directly in  the vena cava,  is 
368
CIRCULATION  OF THE BLOOD.
poured into the liver, and traverses anew a capillary apparatus, be-
fore reaching the heart.   This singular arrangement has caused the
belief that  the blood of the vena porta  was destined to aflbrd the
materials for the secretion of the  liver.  We shall  consider this
question when speaking of the functions of that viscus.   The sub-
ject now before us is simply the circulation of the blood: and it ap-
pears to us that it may be considered in the venous system of the
abdomen,  independently of  every secretion.   If, indeed, I ex-
amine the liver and the spleen in  reference to the circulation, I find
in them many very  remarkable peculiarities.
   In the foetus, in which there is  scarcely any biliary secretion,
the liver receives  by the umbilical vein an enormous quantity of
blood, so great that the bulk of this viscus is  proportionably more
considerable than in  the adult.  Now, since this fluid is not destined
to the formation of bile, it must have another use.   For myself, I am
of the opinion that  the liver serves at that time as a reservoir for
the blood;  that this  fluid is deposited in it, to be within reach of
the heart,  in order that this organ  may never fail of its  supply,
and that it  may always find the fluid there in a state fit for the per-
formance of the functions.  And indeed, if the current of the blood
which arrived at the heart was confined to a simple vein, I do not
think that  there would  be a sufficient  quantity to insure the con-
tinuance and regularity  of its pulsations.
   If, on the other hand, the action of the heart became weakened,
so as not to take up  the whole of the blood which might be placed
within its reach, this fluid would remain stagnant:  but  if it stag-
nated in a simple vein,  the vessels  would  be liable to  enormous
dilatations; the blood would coagulate there; the vein which should
contain it would lose its elasticity,  perhaps even rupture.  There
was then required  near the heart not a vessel, but a reservoir of
blood. But suppose that nature had placed  there a large sac similar
to the stomach for example, then  the inconvenience of coagulation
would still have presented itself.   It was therefore  necessary that
the reservoir of blood destined for the heart should be a capillary
apparatus,  in which  the fluid could  be accumulated without danger
of excessive dilatation, followed by loss of tone, or rupture, or coagu-
lation.  Now, the liver fulfils this office for the right, as the lungs
for the left side of the heart.   Let us compare next the foetus with
the adult, agreeably to this interesting view of the subject. 
CIRCULATION OF THE BLOOD.
369
   In the foetus, the superabundance of the  blood afforded to the
 right auricle,  is kept in deposit in the capillary tissue of the liver;
 in the adult, the same phenomenon occurs, with this difference only,
 that the vena porta takes the place of the umbilical vein, supplies
 the same capillaries that this vein supplied, and prevents, like it,
 every irregularity of the action in  the heart.   Finally,  in all ages
 of life, the lungs perform the same office in relation to the left ca-
 vities of the heart.
   The liver and the lungs  have then a  double office;  the one rela-
 tive to their particular functions as organs of secretion and ab-
 sorption,  the  other which is common to both,  and exclusively
 in the province of the circulatory function.   With  regard to the
 spleen, I confess that, so far, I can imagine no other use for it, but
 that of being auxiliary to the circulatory function of the liver, since
 it is confined to diverting a part of the blood of the abdominal aorta,
 in order  to pour it immediately into  the liver, and in this manner
 to co-operate in the supply of the reservoir of  the right  cavities of
 the heart.  In other words, the spleen is nothing  else than a small
 or secondary reservoir, or auxiliary  of the great one which is situ-
 ated in the liver.
   Let us inquire now  into the office of these two reservoirs or di-
 verticula, in cases  of very great acceleration of the  course of the
 blood.  Every time locomotion  is hurried,  the  muscles throw a
 greater quantity of blood than usual into the veins.  The heart is
 therefore compelled to increase its pulsations; it forces the blood in
 a large quantity into the viscera: that which issues from its right
 ventricle is accumulated in the capillaries of the lungs;  it compresses
 and diminishes the bronchial vesicles, and affords  an abundant pul-
 monary exhalation: that which is driven from its left ventricle takes
 different  directions, according to the arteries that it traverses.   The
 blood which is too abundant  in the  head and  muscular apparatus
 flows back into the superficial veins, and into the  skin,  which be-
 comes swoln, expanded, and covered with sweat  This does not
 happen with that which is superabundant in the abdomen:  not be-
 ing able to proceed to the skin nor penetrate into the secreting ves-
 sels of the abdomen, which reject it, unless they are already over-
 excited, this fluid  finds a retreat only in the ramifications of the
 vena porta, in the spleen, and in the liver, the numerous  capillaries
 of which serve, without any inconvenience,  as a place of deposit,
until the  heart shall be able to give it a passage, and re-establish the
                                47 
370
CIRCULATION  OF THE BLOOD-
equilibrium.  If it were otherwise, and that the secreting vessels
of the abdomen were as easily opened as those of the skin and of the
lungs, it is evident that all violent exercises would produce hae-
morrhagies by the mouth and by the anus, or rather vomitings and
diarrhoea. *
   We now propose offering a summary of the phenomena of the
circulatory function.

Section XIII.—A Summary of the Phenomena of the Circu-
                             lation.

   The heart is stimulated by the blood brought to it: the veins pre-
sent this fluid to the two  auricles at the moment in which these
latter are at rest; and these by their contraction drive it into the
ventricles, which are at rest when the auricles are in  action.   The
ventricles have no sooner received it than they contract and throw
it into the  arteries; these  vessels react on the  contained fluid,  by a
movement of elastic contraction; and as the portion  coming from
the heart prevents its retrograding, the arteries convey it to their
extremities,  which pour it. into the capillary  system.   Having ar-
rived in this system, the blood  follows different directions; a part
is directly  transmitted to  the veins, without having undergone any
extravasation, and returns promptly to the heart; another is diverted
from the vascular current by the secreting organs, and  which varies
greatly in quantity, since  some of them, such as those of the skin,
are obliged by the mere afflux of the blood  to deprive it of a large
portion of  its elements, whereas  others only  receive and divert it
from the vascular current, in proportion  to the degree of action
with which they are endowed, independent of the heart; another
portion of  the blood serves for the performance of muscular move-
ments, and of the internal and external sensitive functions; whilst,
finally, another is destined for nutrition.  It follows from this, that
the blood,  once out of the large arteries, may traverse the capillary
  * What has been just said on the functions of the liver and of the spleen, is
only the summary of what 1 published in the 8th volume of the  Memoires de la
Sociele .Medicate cf Emulation.  I have sought only to simplify and perfect this
theory, which for the last nine years I have advanced in my course of physio-
logy. My having read a memoir inserted in the Journal G£ne>al de M<-decine,
appeared to me to render this short note necessary. 
CIRCULATION OF THE  blood.
371
 system, and the interstices of fixed animal matter, in every direc-
 tion, even go through the small vessels in a very short time in en-
 tirely opposite directions.  In the round of the circulation, the blood
 is enriched  by different principles  furnished to it by the air, and
 aliments,  and  by the fluids deposited on the surfaces, large and
✓small, which it traverses.  Absorbed by the veins, the blood returns
 to the heart by the triple  impulse of the contractile power of its
 containing vessels, of the particles which are constantly sent for-
 wards by the arterial extremities, and, finally, by the capillaries
 and fibres of every description.
    The greater  number of  the veins convey it directly to the heart,
 while making it traverse a space continually decreasing,  by which
 means the  fluid is more and more compressed;  other veins, after
 having brought all their contents into a single column in their cen-
 tral trunk, diffuse it anew into the capillary apparatus of the liver,
 in which it forms, together with the blood proper to this viscus, a
 reservoir, the office of which is to furnish blood to the heart, and
 to serve in certain cases as a safe retreat for this fluid.
    The heart is  placed between  two very powerful forces, between
 which it  must preserve  an equipoise  during the entire period of
 existence:  1. the  impulse  of the double  current of venous blood
 which advances to it, and tends to keep its two auricles in a state of
 continual dilatation;  2. the resistance of two columns of arterial
 blood, which tends incessantly to restrict the contractile movement
 of its two ventricles, or its  systole.  The heart  is associated with
 all the tissues by  the  most  active sympathies: as the irritations of
 all points of fixed animal matter may hasten the return of blood
 towards this viscus,  it must always  be ready to accelerate its con-
 tractions, in order to afford a passage to this excess of fluid.  Hence
 a  great number  of  variations  in its movements, which  all take
 place through the medium of the nervous system;  and hence the
 heart is furnished with nerves of every description.

  Of the Alterations of the Circulatory  Function,  tvhich may
                  become causes of Disease.

    These alterations must be examined in the beart, in the arteries.
 in the capillary system, and in the veins. 
312
CIRCULATION OF  THE  BLOOD.
       Section  XIV.—Of the Alterations of the Heart.

   The cause of the changes in the state of the heart must be sought
for in the influences  which  may derange, that  is in those which
support, its  action.
   The heart receives its share of the  stimulations  acting on tli^
animal  economy,  by means of the  nerves, which it possesses in
common with all the  other organs. We find it accelerating its con-
tractions, under the influence of the intellectual operations, and  of
the passions; and so soon as an irritation of any moment is developed
in a tissue, the heart always  participates in it by an increase of its
palpitations. Let us examine separately the influences which it re-
ceives from each apparatus.
   We have elsewhere  said,  that whenever the encephalon was
strongly stimulated by the exercise of thought, the irritation of this
organ was diffused, by means of the nerves emanating  from it,
through all  parts of the  body; but that it only produced well mark-
ed effects in the more mobile tissues, the  first which are destined
to be in action in the  various relations.   Now these tissues are the
viscera, their  annexed  secretory and excretory organs, and finally
the skin: the remainder of the body seems to me susceptible only
of being affected in a consecutive manner,  either by the  disorder
of the circulation or by the spread of the irritation  at first developed
in the most nervous and sanguineous tissues.
   But of all the parts which more  immediately receive cerebral
emanations, .none is affected in a more lively manner than the mus-
cular tissue  of the heart. We have elsewhere treated of the disor-
ders occasioned, in the lungs and digestive apparatus, by this irri-
tation; let us now examine the ones  peculiar to the heart, whicli,
however, is always affected simultaneously with those viscera.
   Pleasure  in  general, and  more particularly that  very distinct
modification of it  called joy,—pain  in all  its. varieties,  whether
physical, as that resulting from external violence, or irritation in-
flammatory  or not, or moral, as  in fear, shame, anger, &c.  cause
the heart to palpitate  with violence.   In this irritation the  organ
does not always propel  the blood with a celerity proportioned to
the stimulation it receives; which shows that the force of the pulse.
and the heat and redness of the skin, do not invariably correspond
with the heart's action, though it be observed on many occasions.
In all other  cases the  heart seems to undergo a kind of constriction, 
CIRCULATION OF  THE BLOOD.               373
  which narrows the arterial orifices, so  that the  blood, in place of
  circulating more freely, is retained in this organ, and in the lungs
  and brain,  and is not sufficiently oxygenated to  meet the wants of
  their  respective functions.  I say their functions, for the tissue of
  the heart  requires that vessels should  convey red blood to it as
^well as to the  brain; and the pulmonary sense cannot fail to suffer,
  when it does not meet with enough of oxygen in the atmosphere.
  Hence results a feeling of suffocation,  a momentary suspension of
  the respiratory  act  in the  lungs, and impending syncope in  the
  brain.  These phenomena are sometimes carried to such a pitch, that
  if a person walk he is obliged to stop short; and he feels at  the
  same  time a pain in the heart, more or less  extended to the chest
  and epigastrium,  and to the arm of the same  side: from this group
  of symptoms  has been formed a general or idiopathic disease called
  angina pectoris.   More frequently it does  not take place unless
  the heart have been organically altered; but it may be observed
  when the organ is healthy,owing to the causes already pointed out.
     Here then we have two kinds of palpitations from a moral cause,
  for pain from  a physical agent is a moral affection; one  in which
  the circulation is really accelerated, the other in which the course
  of the blood seems rather to be retarded. When these  two kinds
  are kept up for a length of time,  they finally fix the irritation in
  the tissue of the heart, and give rise to  disorders, a picture of which
  I shall present, after I shall have pointed out the  other  influences
  that may impair  the  action of the heart,  and  which, from being
  natural as they were, pass into a pathological  state.
     Irritation of the organs may, without being distinctly and acutely
  felt by the centre of perception, so act upon  the  heart as  to occa-
  sion a great increase of its movements, as happens in all phlegma-
  siae of a certain degree of intensity. The course of the blood is on
  such occasions always greatly accelerated; to which general heat
  and the increased redness of the parts are  joined, constituting the
  principal phenomena of the state called fever. The kind of accele-
  ration of the  heart's pulsations which  produces  it has not received
  the name of palpitation, though it has the closest analogy to  this
  latter state. In fact what can more nearly resemble fever than those
  violent and durable agitations of the heart, the effect  of anger,
  wounded self-love, &e. in which we observe, during several hours,
  a full pulse,  burning skin, sparkling eyes, and red face?   Has  not
  the appetite likewise disappeared, and i* not thirst associated with 
374
eincuLATioN op  the  blood.
this state? Does not the person experience also a feeling of distress,
and even of severe headach? So great is the resemblance, that very
often at the expiration of a certain time we discover that the person
thus affected is sick, and we give the name of fever to the  disor-
dered circulation under which he suffers.   The  heart is not at this
time the only  part irritated; the other viscera, and  especially thev
stomach, evidently sympathise with  it, as happens in  that kind  of
acceleration, the product of inflammation, and to which we affix the
epithet of fever.  Whenever there is fever then, the circulation is
greatly deranged; the blood  arrives in all  the tissues in greater
abundance, and the viscera among other parts receive from it a pe-
culiar irritation, for the blood is a natural incitant to the entire or-
ganization.
  As irritation of the heart is the fundamental phenomenon of fever,
no person can be surprised that this viscus retains and appropriates
to itself the  irritation, which it first experienced  only  sympatheti-
cally; and that, consequently, it becomes diseased in those who often
suffer from inflammations carried to the extent of causing fever.
  Thus we  find that irritation, under the form  of pleasure, or  of
physical or  moral pain, and inflammation even without pain, often
act on the heart with such intensity, as to alter its normal state, by
becoming fixed in its tissue.  We hence learn why diseases of (lie
heart succeed  various phlegmasia?, whether acute or chronic.
  Certain tissues of a structure analogous to that of the  heart, such
as the  locomotive muscles, would  seem to transmit with more rea-
diness than other parts, inflammation to this viscus, after having at
first irritated it by sympathy; hence we often see it becoming dis-
eased after muscular rheumatisms.  Those of the articulations seem
to produce the same effect.   It remains for us to ascertain whether
these rheumatisms do not act in preference on the tendinous tissues
of the heart, which, like the ligaments, belong to the fibrous system;
and whether the irritation of the synovial capsules has not a tendency
to be repeated in its internal or external membranes, which consti-
tute a part of  the serous tissues.   I do  not  after all believe very
implicitly in the constancy of the transfer of irritation to analogous
tissues: it is  very evident in some cases, as for example, in irregular
gout; but  in many others in which it does  not take place, the irri-
tation may traverse  the body in all  directions, and  stop in organs
of a totally different texture  from  that of the tissues  in which it
originated.  It is thus that the heart, of which we are now treating,  , 
CIRCULATION OF THE  BLOOD-
375
 receives its irritation  from all the organs, and may retain and ap-
 propriate it to itself, no matter from what part it was transmitted.
   Among the different organs the action of which stimulates the
 heart, are the locomotive muscles, which are the means of associa-
 ting with the sympathetic influence of the nerves another not less
^powerful—that of the blood, to which this viscus is very sensible.
 I pointed out the fact, that whenever a muscle enters into  action,
 it attracts more  blood than usual, and hurries it  into the venous
 system.   Let us now  suppose a great number of these muscles act-
 ing simultaneously, and with great energy, as in walking, running,
 leaping: the heart will be in consequence  doubly stimulated; first
 by the arrival of a greater quantity of blood, and then by the sym-
 pathetic transmission of the muscular irritation through the medium
 of the brain; and if this double stimulation continues, the circulation
 will be greatly disordered.  But we anticipate, as the  question  at
 present is of those derangements peculiar to the heart.  Experience
 proves then that the kind of palpitation to which this organ is sub-
 ject,  is one of the most powerful causes of its diseases,  and that all
 these depend on irritation  retained by it after excesses of the nature
 just mentioned.    None other indeed give it such terrible shocks; it
 is felt striking against the sides with extreme violence; the pulse is
  full, frequent, and hard, and the blood is propelled into all parts of
  the body with extraordinary impetuosity.
    The disorders experienced by the heart during the  too precipitate
  and violent action of the  muscles, are still  more readily produced,   ,
  if the exercise be taken in an ascending direction; for in this case
  we  arc obliged to make the chest the point of support for all the
  locomotive muscles.   To accomplish this,  we suspend respiration,
  and only allow of the dilatation of the chest when the want of air is
  very strongly felt.  The lungs  are therefore of necessity engorged,
  and refuse  in part passage to the blood sent to them by the right
  ventricle, whence results  a permanent plenitude of  the two right
  cavities of this viscus, which may thus contract a fixed irritation.
    When giving the effects of strong passions, we must include the
  violence which the heart undergoes from the blood;  for this fluid is
  retained in the  lungs  by a spasm which is opposed to  inspiration.
  This latter process is as it were bound up, and if to this state we
  add the constriction of the heart, which, in place of expanding to
  receive the blood, is contracted, and  retains it in its  auricles, we
  shall form  an idea of the facility with which this  organ  remains 
376
CIRCULATION OK THE BLOOD.
permanently irritated. Tickling carried to excess, always producei
precisely analogous effects, in as much as the kind of pain resulting,
and the  efforts of resistance  made, render  the  chest immoveable,
and determine the spasm of the heart.
   To all these evident causes of disease,  we must add  another not
less so; I mean external violence, as by blows over the region of
the heart, violent jars and falls, permanent pressure, and crushing.
The heart is always powerfully irritated by such causes, and very
generally retains the effects of them during after-life.
   Finally, the sudden action of cold must be placed on the list of
the most frequent causes of diseases of the heart.  Cold repels the
blood from the surface, and, accumulated in consequence in the vis-
cera,  this fluid gives rise to a distention in which  the heart must
necessarily participate.
   I do not at present speak  of its being under the influence of ex-
treme heat, because this effect is referable to the stimulation of the
nervous  system, of which the brain is at once  the centre and the
point most irritated.
   We see now how numerous are the accidental causes of the irri-
tation of the heart; with these we  must associate congenital hyper-
trophy, the existence of which is productive of extreme irritability
of this organ; and afterwards examine the alterations in its tissue,
and in what manner they act on the circulation.
   When the  heart is more than ordinarily irritated, we observe de-
rangements in the circulation corresponding with the kind of irrita-
tion and  the  region of the heart occupied by it.   If  it is the exter-
nal surface or serous membrane which is irritated, constituting the
disease called pericarditis, the diastole is incomplete; the heart re-
ceives less blood than in its normal or natural state, and consequent-
ly this fluid must be stagnated  in the viscera.   In addition to this,
the effort exercised by the venous columns on the two  auricles is
of a painful  nature, as  is also the  contraction of the four cavities.
This pain is keenly  felt in the acute state, and from this results  a
stitch more or less analogous to that of pleurisy.
   On this perception follows  a feeling of oppression; but this latter
depends less  on the local pain than on the uneasiness  resulting from
the difficulty with which the blood traverses the  lungs,—a difficulty
producing deficient oxygenation, so that the pulmonary sense and
the brain undergo a  peculiar kind of irritation, by which the entire
locomotive apparatus is thrown into pain, and the patient is fearful 
DISEASES OF THE HEART.                377
of suffocation and syncope.   This oppression is redoubled on the
slightest motion; and the contraction of the  inspiratory muscles,
restrained as they are in their efforts by the pain in the heart, ne-
cessarily adds to the  oppression.  The digestive  organs likewise
suffer, and soon  experience a degree of  inflammation which cannot
but add to the distress of the patient
  If acute; pericarditis continue for some days with the same inten-
sity, death, is the necessary consequence of the two causes conjoin-
ed; the defective circulation and deficient oxygenation. Where the
disease becomes chronic, the pain from inflammation is diminished;
but the  collection of pus in the pericardium, by preventing  the ex-
pansion  of  the  heart,  is an  obstacle  to the circulation, and the
patient is exposed not only to the oppression  caused by defective
oxygenation, but also to other accidents which likewise occur in
aneurism, and which we shall soon examine,  when treating of the
mode of disorganization of the heart in that disease.
  When irritation occupies the internal surface of  the ventricles,
the openings into  the arteries being  more  easily contracted in
diameter than  those which admit the blood into the auricles, this
fluid enters with facility into the ventricles, but is discharged  with
difficulty.  Hence result palpitations, during which the heart, ex-
tremely large and tumid, strikes with violence against the parietes
of the thorax. The extraordinary motion to which it is constantly
subjected, invites a greater quantity of blood than usual  into its
tissue, which swells, and acquires much more strength.  This  kind
of hypertrophy is so far peculiar, that the pulsations of the arteries
are weak, and present a contrast with the force of those of the heart.
In such cases the patients are perpetually harassed by the difficulty
of breathing, and of walking; but they have  less  oppression  than
is felt in chronic pericarditis,  and do not complain of approaching
syncope.
  When the irritation of the  internal  surface of the  heart is not
predominant at the arterial orifices,  the force of the pulsations of
the arteries corresponds with that of the heart.  The same thing
takes place when irritation exists only  in the fleshy tissue  of this
organ.  These two states necessarily bring on hypertrophy, with a
free course for the blood through the four  cavities.   The changes
thereby induced in  the  circulation are as follow: the heart contract-
ing with much more frequency and force than in its normal condi-
tion, and the blood  which traverses it meeting with no obstacle,
                              48 
378
CIRCULATION  OF THE BLOOD-
the viscera are always  powerfully stimulated, and the respiration
is full and strong, and performed with a kind of hissing noise called
puerile, like that in children.  In these latter the heart is, in fact,
proportionally more energetic  in its  functions than  in  adults—a
condition  seemingly necessary for the growth of the  former;* but
this force diminishes with advancing age, as we find that the activity
of the organ goes on continually decreasing from the first day suc-
ceeding conception until death, except in cases of rapid growth,
and acute.inflammation.  When, therefore, there is a deviation from
this rule in an adult, and when his  heart seems to be large and
vigorous,  and contracts with more than ordinary frequency, with-
out receiving stimulation from any inflamed  part, we are justified
in considering this viscus as in  a state of over-irritation, which
frequently produces a true hypertrophy.
   With a  full, frequent, and hissing respiration,  in persons labour-
ing under hypertrophy, without organic  obstruction, are always
associated a great  heat in every part of the  body,  especially  ob-
servable at the extremities, which with difficulty become cold; and
also  considerable energy of the brain and muscular apparatus, a
ready assimilation, arid  usually a small proportion of adipose  mat-
ter: such persons would seem to live more than others.  It is to be
observed,  however, that they do not  bear well  stimulants of any
kind; indeed an  irritating diet harasses them,  and gives rise to gas-
tritis, of which they always have a slight degree; heat overpowers,
whilst cold weather gives them new vigour: they have at first great
readiness  for exercise, but after a certain period they cannot tolerate
it without experiencing dyspnoea, and prickings  of the  skin, as if
thousands of needles were  penetrating  it.   Many persons in this
situation  have a great  propensity to sexual indulgences,  and can
enjoy them without much exhaustion.   I am disposed to refer this
last to a threefold cause in the male sex, viz.: a more  abundant se-
cretion of semen, a greater facility for erection, and a lively stimu-
lation of  the brain; the two  first depending on the extreme readi-
ness  with which the blood is brought to the genital organs.
  * When the growth is very rapid about the epoch of adolescence, the heart,
compelled to extraordinary action, undergoes an almost continual super-irritation,
by which it is exposed to hypertrophy, and sometimes to chronic phlegmasiz of
the parenchymatous structure of the lungs, running into phthisis pulmonalis. 
DISEASES OF THE  HEART.
379
   Such as we have described them, are those individuals attacked by
 hypertrophy of the heart, without pain and obstruction to the course
 of the blood.  They are by it rendered liable to many diseases. The
 too violent impulse of the blood on  the brain  expos s them to
 profuse nasal  haemorrhages,  cerebral  congestions, epilepsy,  and
 apoplexy.  In the lungs the same impetus, and the plethora to which
 such subjects are prone, expose them to sanguineous congestions.
 which, like those of the brain, are brought on by violent passions,
 Over running, undue exertions, venereal excesses,  stimulating in-
 gesta, and are announced by  pneumonias, haemoptyses, or fits of
 asthma, which are distinguished  in  this particular, that they are
 speedily cured by bleeding.  The habitual congestion of the diges-
 tive viscera renders them liable to acute gastro-enterites. The sub-
 jects of whom we  now  treat have,  in  all their inflammatory com-
 plaints, a very hard and  much more frequent pulse than in other
 persons, and even preserve these  peculiarities during the period of
 convalescence, in spite of the return of appetite and strength.  The
 heart at last becomes disorganized, if the necessary precautions are
 not adopted.
   We refer to what has been said above of these  disorganizations;
 and must now inquire into the manner  in which  they modify the
 circulation of the blood.
   Perpetual obstruction to the  course of the blood must  naturally
 exist in all  cases  in which the  heart is softened, dilated, weak, or
 hardened, or its proper arteries ossified, or it attacked by hernia or
 laceration of its fleshy columns, or the openings of the arteries nar-
 rowed or obliterated by  vegetations*  &c.  Independent of  the
 dyspnoea,  oppression, and  fear of suffocation  produced  by these
 obstacles,  they also  give rise to a forced delay of blood  in  the
 venous apparatus of the viscera, livid countenance, an intolerable
 cough, and mucous expectoration, wakefulness, and even the im-
 possibility of circulation and locomotion, gastritis,  and finally gene-
 ral dropsy, under which last these unfortunate beings generally sink.
 In order to  explain  the extreme oppression brought on by exercise,
 we must remember that the muscles, in a state of contraction, drive
 into the veins and propel towards the heart, a much greater quan-
 tity of blood than usual.  Now,  whenever the  heart has lost its
 energy, it is incapable of freeing itself from this increase of blood;
 hence augmentation of the dyspnoea, and the necessity under which
the patient is to suspend muscular  action, in order  to relieve him- 
380
CIRCULATION OF THE  BLOOD.
self.  We must moreover remember, that locomotion  diminishes
the free play of the chest, in order to furnish a fulcrum of a more
solid kind for  the respiratory muscles:  but how can there be any
curtailment of the extent of respiration, in unfortunate creatures
who never have enough of air, without the dyspnoea which already
torments them being aggravated.  It is for this reason that the re-
cumbent posture is to them insufferable, and they are in consequence
deprived of the renovating  influence of sleep.  They are finally
unable either to lie down,  or move an  arm,  or swallow,  or even
speak, without a redoubling of that suffocating oppression which
must finally end their days.

          Section XV.—Alterations in the Arteries.

   Let us next inquire into the diseases of the arteries.  It was for
a long time  imagined, that the too violent impulse of the blood sent
by the heart against the arteries was adequate to produce their dila-
tatipn, especially at that part called the bifurcation of the aorta.
Without venturing to deny this fact,  I must needs still think that
this dilatation, usually  called aneurism of the aorta, is the pro-
duct of inflammation.  We find it in fact in all parts of  the general
arterial tree, and always attended by an alteration of the coats of
the arteries, precisely similar to that usually produced by a phleg-
masia.
   Inflammation may penetrate by many channels into  the coats of
the arteries; sometimes it is directed there by blows, falls, violent
muscular efforts; but  this  cannot take place, except in  the superfi-
cial arteries, and  the membranes.   At  other  times inflammation
insinuates itself by means of the capillary vessels, thence to ascend
to their trunks, and even to the heart.  It is thus that we meet with
 arterites, after pneumonias and gastro-enterites, as occurring in cer-
 tain epidemics. It may likewise doubtless happen, that the inflam-
 mation developed in the internal membrane  of the  heart extends
 even to a considerable distance into the aorta.  Particular observa-
 tions are yet wanting to elucidate sufficiently these facts—though
 analogy gives them great probability.
    When the inflammation is great, and much diffused  in the appa-
 ratus of centrifugal vessels, it cannot fail to  be  very soon mortal,
 though we find it difficult  to  characterise it with precision.   Pain
 in these vessels is very obtuse, and if tissues endowed with more 
DISEASES OK THE  ARTERIES.
381
sensibility  be inflamed, it is impossible to recognise it.  We are
taught, however, that its signs are strong and hard pulsations, with
a swelling  and burning pain perceptible in the course of the super-
ficial arteries.   I do  not believe that the strength of the pulse  can
be made to depend solely  on the inflammation of the arteries, but
I am not surprised that attention has been directed to this symptom,
since it so  often  accompanies  inflammation of the internal surface
of the  heart  I have  always remarked, that in acute phlegmasia of
the arteries, the superficial veins were engorged and livid, a symp-
tom always remarkable  after death, and  accompanied by large
ampulla? on  different regions of the  skin, in those  especially in
which  the  veins are most numerous.
   But how can  arteritis produce engorgement of the veins and am-
pulla?,  if the capillary system does not participate in the inflamma-
tion? I am  of opinion, therefore, that this phenomenon is not limited
to the  large arterial branches;  but prevails doubtlessly with more
intensity in the small vessels, the venous or arterial nature of which
is uncertain, and produces in them the same effect as a rubefacient
or a blister: the blood must of course be called from all parts to these
tissues, take perhaps a retrograde course in the adjacent veins, re-
main stagnant in them, and produce together with ampullae thcvari-
cose enlargement of which we spoke.  In this manner are the viscera
 gorged and inundated with  blood  and serosity, and finally so dis-
 organized  as to become unfit for the performance of their functions.
 Sufficient  attention has not been paid to observe the extent to which
 inflammation of the very  vascular organs may penetrate in  the ar-
 terial and  venous vessels;  if we were assured that it always extended
 some  distance,  we would cease to  be surprised at finding it some-
 times  reach the heart.'
  • Some physicians, relying on a statement of Peter Frank, have attempted to
refer inflammatory fever, which they were at a loss to dispose of, to an inflamma-
tion of the arterial system; and hence seemed to justify the term of angiotenic
affixed to this pretended idiopathic or  essential fever by professor Pinel.  But
the symptoms of arteritis are not those of this fever.  What is an arteritis which
terminates in from one to seven days, without any consecutive lesion ? Why, be-
sides, should those authors tell us that, when this fever is protracted, it is changed
into ataxic, adynamic, or pneumonia ? Is  it not evident that the words inflammatory
fever only designate a slight shade of gastro-enteritis in a sanguine subject ? Ar-
teritis is much more tenacious than the ephemeral fevers, or simple synocha; and
if they were always produced by it, why do we see them converted into diseases 
S32
CIRCULATION OF THE BLOOU.
   I do not know whether inflammation of the arteries, at first g.-.
 neral, may not  sometimes remain of a  local nature  by  a kind of
 imperfect resolution, or whether it  may not have been circum-
 scribed in some parts only of the arterial  apparatus:  be this as it
 may, we unquestionably meet with such; they are always chronic,
 and constantly unappreciable.   The inflammation passing from the
 internal membrane soon  gains the other two  coats of the artery,
 thickens and engorges them with lymph, hardens, ossifies, and at
 times contracts them: in other cases thesoftening which they undergo,
 renders them susceptible of dilatation which  produces an impetus
 of blood, and the efforts of the adjoining muscles.   If these derange-
 ments occur in the  arteries of the  extremities, there  results an
 aneurism purely local, which exerts no  influence over  the general
 circulation.   If many arterial branches are converted into the same
 state in different parts of the body, we find the disease appear in
 different regions, and require a repetition of the operations resorted
 to in such cases.   This is what has been called by physicians the
aneurismatic diathesis.   But if the chronic inflammation attacks
 in preference the parts of the aorta adjacent to the heart, the gene-
 ral  phenomena arising from the obstructed circulation are produced
 in the same way as in the organic affections of this  organ.
  The change in the aorta may then be  of two  kinds:  in the first
we have inflammation,  which,  by diminishing the caliber of this
vessel, keeps  up a perpetual obstacle to the discharge of blood from
which were never thought of being attributed to arteritis ? I do not say that this
last cannot exist with the symptoms thought to  characterise synocha:  on the
contrary, I believe, from experience, that it may be superadded to inflammations
of all the large viscera, in certain cases not yet well defined ; but of what we are
most assured is, that whenever fever ushered in  by the usual symptoms of the
pretended angiotenic fevers, terminates easily and promptly by sweats, we can
never show that it was arteritis.  The disorder of the circulation is of a very dif-
ferent intensity from that in angiotenic fever. When so prolonged as  to pass
into adynamic gastro-enteritis, &c. the arteritis may be associated with it,  since
it may coincide with the other disease ; but in such cases this is not what consti-
tutes the essence of angiotenic fever.  Arteritis  is then but a  complication of
the gastro-enterites constituting this latter fever,  a complication by which itvbe-
comes much more alarming, is opposed to a favourable  termination, and aids in
giving it a fatal character.  On the other hand, we And, that angiotenic fever
really termiaates in a putrid fever, unaccompanied by arteritis. There is no rea-
bon therefore for regarding this phlegmasia as the cause of fever, which,  even
though it should depend on it, would not therefore be essential or idiopathic. 
DISEASES  OF THE ARTERIES.
383
the heart, to the injury of this viscus, which, thus overloaded by its
natural stimulus, contracts  irritation, and  passes into the state of
hypertrophy.   In the second kind, the aorta, softened by chronic
inflammation, yields to the impetus of the blood which the heart
incessantly drives against  it, or dilated, while it at the same  time
becomes thicker, it forms  an aneurism  of varying extent,*  com-
monly near the heart sometimes in the middle  of the chest, and
even in the abdominal cavity.   I have seen the  bifurcation of the
aorta so enlarged by these  means, as to obliterate the mouths of the
sub-clavian and carotid arteries, and of  the  arteria  innominate,
whence followed the complete cessation of the pulsations in all the
arteries of the face, neck, and  thoracic members.   The patient
could not walk without experiencing giddiness and lipothymia: he
was pale, and weak, and ate little; but suffered no pain.  He died
suddenly in a syncope.   I  deposited the morbid parts in the ana-
tomical cabinet of the hospital of the Val-de-Grace.   I regret not
having  ascertained whether  the disorders of  this soldier did not
originate in an acute disease; but I can imagine that this is no un-
common occurrence, for it seems to me that all violent inflamma-
mations communicate more or less irritation to the vascular system.
Why should we be surprised at it,  since these inflammations act so
powerfully on the heart? Cannot the irritation under which it then
suffers by sympathy, be participated in by  the arterial  system, and
ought we to be surprised that it occasionally existed in a chronic
degree in some parts of this vast apparatus?
   We ought also to  learn whether chronic inflammations which
commenced in the  skin or in the absorbent and locomotive appa-
ratuses, under the  names of herpes, scrophulas, syphilis, rheu-
matism,  and gout, have  not sometimes a tendencjr to reach the
arterial vessels, and thus also produce all the above disorders.   We
shall not, however, be surprised to find  that inflammations of the
arteries are more frequent  than those of the veins, as it is generally
admitted that the former system of vessels is much more abundantly
supplied with  nerves than  the latter, receiving them as it does from
the viscera, which are also all subject to inflammation.
  • Dr. Fallot, physician at Namur, has communicated to me a case of chronic
inflammation of the aorta, in which this vessel was thick, tuberculoifs, and even
ulcerated in several  places.  This fact is given in the Annates de la Midecinc
Physiologique, tome 4, page 325. 
384
CIRCULATION  OF THE BLOOD.
   Section XVI.—Disorders of the Capillary Circulation.

  We shall find, on examination, that the disorders of the capillary
circulation are extremely numerous.   Of these, without doubt, thr
principal is inflammation, which originates much more frequently
in the capillary  net-work than in vessels  of a  certain caliber.   I
have just said that it could be transmitted along  these  latter, and
even  reach the heart; but here  I  must direct  attention  to the
congestions of this system, which do not attain the height of inflam-
mation; they always originate either in irritation  or an obstacle  to  i-
the course of the blood, whether this be near or remote from the
centre of the circulation, or in the heart itself.
  Those which  proceed from irritation would always rise to inflam-
mation, if  the viscera in which they are  seated did not undergo
such a derangement of function as to bring on death.   This is what**
has been called  by physicians in later times  apoplexies, because
they  have  compared such  congestions to those of the brain: it is
one of the most violent disorders to which the circulation can be ex-
posed. We see it take place, without any preliminary inflammation,
in the brain and lungs, owing to moral affections,  for we know that
they irritate prodigiously the viscera, and also after very violent ex-
ercises. But more frequently these congestions have been preceded
by a slight irritation, which, sometimes inflammatory, though not
febrile, prevailed in a chronic degree; it all of a sudden acquires force
by the causes already enumerated; the blood is driven with violence
into the viscera  in sanguine habits; it passes from the vessels which
carried it,  and is extravasated in larger quantity than usual between
the particles of animal matter, or in the intersl ices of what are called
primitive fibres, and then the functions of the viscus are interrupt-
ed.   If this latter be a secretory organ, and communicate external-
ly, it may  be preserved from disorganization by a  haemorrhage.  In
this way ha?moptysis has  frequently dissipated pulmonary conges-
tions.   But if there be no passage for the elimination of blood from
an important organ, as the brain,  haemorrhage,  so far from being
advantageous, is fatal.  Sometimes also it takes place by means of
the serous  membrane of the viscus, which  still leaves us some hopes
from the pleura, when the evil is  limited  to one side of the chest;
but this kind of haemorrhage is not  less unfavourable to the brain
than that which takes place in its medullary tissue. 
               DISORDERS OF THE CAPILLARIES.            JOJ

  The flat and membranous viscera are less exposed to this kind of
congestions than the parenchymatous ones,—though even they are
not always safe, since we find the digestive organs occasionally suf-
fering under them. If the hasmorrhage in such cases takes place bythe
mucous surface, the cure is easy; but if it be poured out on  the free
surface of the peritoneum, or even in the inter and sub-peritoneal
tissue,  death comes on suddenly accompanied with great pain.  A
similar remark applies to the uterus.   I have  seen this result  pro-
duced by falls, and violent bodily commotions.  Moral causes may
also give rise to it in  very sanguine and irritable habits.  We know
how a state of hypertrophy and aneurism of the heart can give effect
to the causes  capable of producing visceral congestions.
   Congestions of a similar nature are sometimes formed in the exter-
nal tissues, such as the skin and cellular membrane;  and they are
especially observable in  women in whom the menses have been
accidentally suppressed.   These persons are all of a sudden covered
with red or black spots,  without any antecedent inflammation, con-
stituting what has been  termed the morbus maculatus.   It is an
extravasation from error loci, but still originating under the influence
of irritation.   There ensues no disorder of the general circulation,
and the large viscera do not suffer from it.  The  absorption of
the extravasated blood may take place without inflammation, but
sometimes this latter comes on,  and phlegmon is the consequence.
   External violence is likewise productive of this effect  by con-
tusing the smaller vessels, as we see in  what is called ecchymosis.
   It would be useless to  repeat here, that whenever a portion of the
sanguineous mass  is thus accumulated in a tissue, the blood brought
by the vessels  and directed  to  the congestion is  not admitted.
We have already treated of this point when speaking of the capil-
lary circulation in general.
   Some physiologists have asserted that a simple reflux, in  another
portion of the vascular apparatus, of the blood which was  directed
towards a congestion, could so derange the circulation as to affect
the motion  of the  heart, and that fever would be  the conse-
quence.   I do not believe that we can admit  the existence of such
fevers of somewhat  a mechanical nature.  So long as the conges-
tion, whatever it may be, is not followed by an inflammatory irri-
tation, the heart is not made sensible of it, as we know from con-
gestions produced by a  mechanical obstacle to the course of the
blood, as in pregnancy, voluminous tumours of the abdomen, eff*
                                10 
3$<)
CIRCULATION OF  THE BLOOD.
sions in the chest, &c.   Do we not meet constantly with persons
who are so affected by these causes, suffer from dyspnoea to the ex-
tent of suffocation, without any febrile movement supervening?  If
therefore, fever at times follows irritative congestions, it is because
the same irritation which produced them is converted into inflam-
mation; but never does  the forced and purely mechanical delay,
whatever it may be, give rise  to  the febrile state, unless  indeed
extensive lacerations become inflamed, or that masses of extravasa-
ted blood undergo a putrefactive movement,  which shall perform
the office of a stimulant and produce inflammation.

           Section XVII.—Changes in the Veins.

  The circulatory movement in the veins  may be impeded in va-
rious ways: and first, inflammation of the capillary system may,  as
we  have just seen, extend to them; again, the veins of the surface
are not exempt from external violence, the necessary effect of which
is to inflame them.   As  yet we are  without a precise measure  of
the extent to which this cause may affect them. They are unques-
tionably interested in extensive phlegmasia? or oedematous inflam-
mations of the sub-cutaneous tissue.  This kind of lesion merits our
attention; for inflammation is commonly tenacious in the vessels, on
account of the facility with which it is propagated beyond the point
in which it originated.   In such cases we find a varicose state with
a marbled skin, covering the seat of inflammation, and associated
with these may also exist  umpullx and a singular  abundance of
lymph.
  But of all the diseases of the veins, the most frequent, beyond all
doubt, is the varicose state, which is most  generally the effect  of
compressions that retain the blood  in these  vessels.   The external
veins are most exposed to it, because they are not, like the internal
ones, supported  on all  sides.   Let a compression  be exercised  in
the abdomen on the iliac veins, by  pregnancy  or any tumour what-
ever, the branches which pass along under the skin of the thighs, and
still more of the legs, will  become swelled and varicose.   It also
happens very frequently that the continued efforts of the muscles
of these parts,  as, for example, fatiguing marches, prolonged stand-
ing, occasion varices:—they are even found to originate in a great
many persons  without our being able to refer them to any extraor-
dinary muscular effort—and we can only account for it in the natu- 
DISEASES OF  THE VEINS.
387
   ral weakness of the vessels, which yield to the impetus of the blood
   ascending against its own gravity.   After all, whatever may be the
   cause of the varices at the  surface of the body, they are seen to
   pass into inflammation, producing  always a phlegmono-erysipela-
   tous affection, which is very prone to gangrene, or which at the
   best leaves behind it ulcers called  varicose, to cure which is very
   difficult.
     If varices are the cause of inflammation they may also be  the
   effect  of it as we see every day  in haemorrhoids.   Formerly
   the  haemorrhoidal tumours were represented as always primarily
   varicose,  and the flux was attributed to the rupture of the dilated
   veins.  Notwithstanding the writings of Stahl, this opinion was long
i   prevalent in the schools, so difficult is it to eradicate old prejudices.
   It is true that  the  active character of many other haemorrhages
   was conceded to that author,  but  the one before  us was ranked
   among those of  a passive nature: at one time the cause was to  be
   found  in engorgement of the abdominal viscera, especially of  the
   liver, or obesity of the omentum and mesentery; and at last we were
   told of debility and predominance of the venous system, necessarily
   brought on by the decline of life, and which alone could explain
   the production of haemorrhoids.  I have myself beard Bichat deliver
   this antiquated theory.  Finally, however, people yielded to evi-
   dence, and the haemorrhoidal flux is now  placed among  the active
   haemorrhagies.   It is  admitted  that irritation determines an afflux
   of blood to the inferior portion  of the mucous membrane  of  the
   rectum, and that sanguineous effusion is one of the effects of this
   state.   Nothing can be more correct, and this extraordinary accu-
   mulation of blood often occasions the dilatation of  some  veins,  the
   rupture of which may be productive of a very dangerous haemor-
   rhage.
     We  have examples of the veins participating  in  the  inflamma-
   tions of their viscera.  This kind of lesion has not been sufficiently
   studied, nor has it been admitted except when the veins  have been
   found  filled with pus, though we know that all inflammations do
   not end in suppuration.  The veins, filled as they always are by a
   dark blood, from which they  derive  their colour, are rarely sus-
   pected of being inflamed.  We ought to observe whether  their coats
   are not thickened, and their vasa vasorum engorged, after acute
   phlegmasia? of the abdomen. One thing is very certain, that I have
   often found the vena cava extremely voluminous in those subjects 
368
CIRCULATION OF  THE  BLOOD.
dead from violent  gastro-enteritis, with  very great sanguineous
engorgement of the liver; and I believe that this excessive disten-
tion might very well  be accompanied by a true phlogosis.   Could
we but determine this, and mark the symptoms which designate it
in the course of those diseases,  we should perhaps obtain some  in-
sight into their prognosis, and some valuable indications to direct
us in the use of local blood-letting, and topical applications.
  The vena porta? is found likewise very much engorged in those
who were victims to gastro-enteritis. No inference was drawn from
this sanguineous turgescence  in the acute form, preoccupied  as
minds  were by the  idea of essential or idiopathic disease; but the
case was different in the chronic state.  To the engorgement of this
vein most writers attributed the affections of the liver; and haemor-
rhoids, flatulencies, dyspepsia, and hypochondriasis, were in their
minds  nothing else  but an extension  of  the  varicose state  of the
vena porta?. Though it is very evident that the effect has here been
received as the cause, since it is irritation of the  intestinal mucous
surface that  accumulates  blood in the veins of the  abdomen,  yet
we ought not on this account to deny  the possibility of a consecu-
tive  phlebitis.  I believe, moreover, that the engorgement occa-
sioned by the gastro-enteritis may impart a varicose dilatation to
veins much less voluminous than the  trunk of that  called  porta;
for I have found the pancreas enveloped in varices in the body of
a man  who sunk under the above disease.
   We never hear  of the inflammation  of the  pulmonary veins,
doubtless because the capillaries of these vessels  do not participate
in the  condition of  the parenchyma? in acute and chronic peripneu-
monias: it remains however  to be ascertained, whether the large
trunks near the heart are not secondarily  affected by the phlegma-
sia.
   As to the varicose state, it doubtless exists  in  chronic catarrhs,
and aneurisms of the heart and large vessels,  which are attended
with a stagnation of blood; it is then  that  the pulmonary  paren-
chyma is liable to be infiltrated with serum, whence results what has
been for a long time called oedema of the  lungs.   But it was an
error to make it an essential  or primitive disease; for never can
such a state of things  be  produced without a forced stagnation of
blood, the cause of which we must always regard as an inflamma-
tory irritation of the substance of the lungs, or  some obstacle  op-
posed  to the evacuation of its disgorgement. 
DISEASES OF THE  VEINS.
vS9
  The obstacles to the current of the blood, which have their seat
in the heart, retain this fluid in the parenchyma of the liver; and
hence this viscus attains to a great size in persons who sink under
diseases from the above cause.  But an  attentive examination will
show us, that the tumefaction of the liver is due to an accumulation
of blood alone,  and  that the  secretory vessels of  the bile are not
at all enlarged, whereas they are  very much so when the volume
6f the organ is the secondary effect of an inflammation of the diges-
tive  canal.
  We sometimes find the veins of the  brain  considerably dilated
in consequence of apoplectic congestions and inflammations of the
encephalon; but we do not meet  with voluminous varices, because
the walls of the sinus, strengthened by the dura  mater, will not
yield to this kind of alteration.
  We have elsewhere remarked that violent exercise, long run-
ning, &c. greatly accelerated the  circulation; and that the heart, no
longer able to transmit all the blood  brought  to it, allowed its ac-
cumulation, on one side, in the liver, spleen, and abdominal viscera,
and, on the other, in the lungs and head.   The veins are, in these
cases, the refuge or reservoir.  From this we can  understand how
important it is for the prevention of haemorrhages and extravasa-
tions in the large cavities where  the blood would be decomposed,
that all the veins should freely admit of dilatation,  and return after-
wards to their original diameter; and, likewise, that those of the
viscera should be without valves.   We have also said, that what
produced the  greatest relief in these extraordinarily hurried move-
ments, was the reflux of blood towards the surface, and the abundant
sweat thence resulting.  In spite, however, of this great and pow-
erful aid, nature is sometimes unable to  prevent the formation of
visceral congestions,  which are followed by fatal  extravasations, if
the  blood, forced out of the  vessels, does not find a vent externally,
or by dangerous inflammations.
  This would be the place to explain the phenomena of inflamma-
tions and haemorrhages, if we could  flatter ourselves thereby with
discovering the real essence of those morbid states.  Without ven-
turing to promise complete satisfaction on these heads, we will ex-
hibit the view which we are  accustomed  to take of them.  When
blood is drawn to a particular tissue by means of irritation, there
results a vital  erection in this latter; no inflammation has as  yet
taken place, for vital erections are means necessary to the discharge 
390              CIRCULATION  OF THE  BLOOD.                  ,
of  the functions; but they must disappear after a certain  time, to
accomplish which it  is only necessary that the stimulus  cease to
act in the parts which are the seat of it;  but if the stimulus be al-
ways acting, the vital erection becomes permanent, and thencefor-
ward assumes a morbid character.   It is then an  inflammation if
the part be very sanguineous; a sub-inflammation, if it be but slightly
so, or rather if it be such that the erection invites more lymph than
fibrine furnished with its colouring matter.y
   The vital erection once converted into  inflammation, the  phe- j
nomena of organic chemistry are perverted; the organ is at  first hy-J
pertropied, and, if the irritation persist, it changes its nature, either ,
by the production of pus, or by being in some other way deteriorated.
   The  blood, attracted by irritation, keeps up the vital erection,
even when the irritating  agent  which had thus attracted  it is no
longer present.  It is on this account that a state of plethora  so pow-
erfully aids the effect of inflammatory agents.—But is not plethora "
itself a primary cause of phlegmasia?  The affirmative reply to this
question  is very difficult, for we can hardly imagine any person to
be  entirely protected from the external agents  of irritation.  Were
there nothing else but digestion, it would be enough to provoke a
stimulation of the gastric or intestinal mucous surface, and plethora
would convert it into inflammation. But how many other agencies
torment our organs?  Besides, the tissues  continually transmit irri-
tation to  each  other, and that which receives the inflammatory im-
petus first, is not always the one to retain it.   A person of plethoric
habit may have contracted a slight or even a violent irritation in
the prima viae; but if he be exposed to cold,  and there follows a
bronchial inflammation, from that moment the  gastritis disappears,
  * I have elsewhere said, (see the Vital Laws) that those very strong and very
permanent erections called spasm, repel the fluids; more attentive observation
compels me to recal this assertion, which I had advanced on the faith of others.
The opinion is supported by the circumstance of the spasmodic state suppressing
the secretions which the organs are destined to perform ; and hence it is inferred,
that the part is less moistened with fluid, and, as it were, dried up; but we ought
to reflect, that if the fluids do not flow or transude from the part  in a  state of
spasm, it is because they are retained there by the irritation.   Of this kind are
almost all the phlegmasia of the highest grade, when in their first period.  The
afflux of fluids to the tissue affected with spasm is not the less real or continued,
and if this state lasts not only in secretory organs, but in a muscle or an erectile
tissue, some degree of inflammation is the invariable result. 
INFLAMMATION.
391
 and  gives way to a violent pneumonia.   A female may be in that
 state of plethora which precedes the menstrual epoch; on the dis-
 charge supervening, the uterus invites to itself all the irritation ot
 the other viscera; but in other  cases, the vital erections of the lungs
 or gastric passages having been urged too far by unusual stimula-
tion,  the excess of blood, which ought  to have  been evacuated by
fathe uterus, is drawn to this organ, and there produces inflammation.
 The head, lungs, digestive viscera, and uterus, are the parts most ob-
 noxious to vital erections beyond the normal state; and on these
 organs does general  plethora usually direct its force.   But it must
 be well  understood, that it is equally favourable to  the production
 of a phlegmasia in any other tissue in which an extraordinary and
f accidental irritation  has arisen.
K   Such is the state of things in irritative congestions, which, when'
ffformed,  do not, however, always follow the march of inflammation.
  It may even be affirmed that it enters into the design of nature, to
 have the blood eliminated rather than  remain in the organs in which
  it had been drawn by too lively an irritation.   The uterus is, of all
  organs, that in which the elimination is most easy, as would seem
  from its very structure; but for this process to be accomplished, the
  vital erection in it must not be too intense; for, if it passes  certain
  limits, the monthly congestion is of itself converted into inflamma-
  tion, unless the irritated state of the viscus be due to a cause which
  can supply the place of the haemorrhage, as in the case of an embryo.
    Nature has not formed the other viscera to become the means of
  sanguineous elimination; but when persons have a good constitu-
  tion, the congestions of blood in their  internal organs give rise to
  a sympathetic irritation in the orifices of the mucous surfaces, and
  the equilibrium is restored by nasal haemorrhage or  by a haemor-
  rhoidal flux.  Whenever this event does not take place, it is owing
  to the debility  of the individual, or because his viscera have been
  too much irritated by his manner of living.   Then the congestion
  of these latter  continues, and, if not removed, it goes through all
  the stages of inflammation.
    This view explains to us the efficacy of local blood-lettings.  If,
  indeed, at an early period of the attack they be resorted to, on the
  portion of the skin  corresponding to the inflamed viscus, they ope-
  rate revulsively, and produce haemorrhages analogous to those which
  nature always tends to bring  on in similar circumstances, and thus
  they prevent the congestion from degenerating into phlegmasia 
 392              CIRCULATION OF THE ULOOl*.                  ,
                               ■*.
   After haemorrhagies of the incipient or forming, come those of
 the advanced stage of congestions, and of the epoch  when  they
 definitely assume the inflammatory character. We can, it seems to
 me, attribute them only to a change  in the organic action of the
 inflamed part: but can this  change be  satisfactorily explained? I
 dare hardly promise it.  I think, however, I have remarked, that
 an accidental increase of irritation often determines these haemor
 rhagies, by suddenly inviting a greater quantity of  blood than the
 diseased tissue can contain;  that is to say, more than  the transmuta-
 tions or elaborations of vital chemistry can dispose  of.   It is thus s
 that apoplexies come on,  in persons  whose encephalon has been  ■;
 much irritated; effusions in  the pleura and peritoneum,  already in-  *-
 flamed; haemoptyses, in subjects labouring under chronic pneumonia;
 haematemeses, mcelenas, and copious bloody discharges, in those
 long suffering under gastro-enteritis.
   To these we must join mechanical causes;  as for example, the
 rupture of a  vessel produced by ulceration, unusual  efforts,  obsta-
 cles having their seat in  the heart and  accumulating blood in the
 lungs, as also the erect position. Do we not in fact see ulcers of the '
 legs furnishing blood in the standing posture?   Doctor Scoutetten,
 whose sagacity is  well  known, having suspended  several  dead
 bodies by the feet,  found that the blood escaped from the inflamed
 parts much more readily than those  in a healthy  condition.  He
 proposes himself publishing the result of his experiments, the like
 of which no  person had before thought of making.
   Violent commotions, such as falls,  may  destroy the  contractile
 power of the vessels,—after which they no longer retain the blood
 brought to them,  and ha?morrhagy is the consequence. In this way
 I have seen the peritoneum  filled with blood, and death take place
 in a short time.   At any rate, such causes may leave behind them
 an irritation,  which may be  converted into a phlegmasia.
   We learn then, from what has been said, that when blood is ac-
 cumulated in a part by any mechanical  force whatever,  it may be
 eliminated by extravasation; but it is very remarkable that inflam-
 mation does not take place in consequence.  By a similar peculiarity
 it happens, in my opinion, that congestions of the  lungs and liver,
 produced by aneurism of the heart, do not give rise either to pneu-
 monia or hepatitis.   When  these  diseases appear in aneurismatic
feubjects, they are always the effect of some peculiar  irritative agent 
39S
                         CHAPTER  VIII.

                       OF THE DEPURATIONS.

     We must first remind the reader of the uses of the very com-
   pound fluid, to which the sanguineous vascular apparatus serves as
   a reservoir; since besides the part which we have seen  it perform
'   in innervation, in muscular action,  and in all the vital erections,
   the  blood serves also  to furnish the materials  of secretion and
   nourishment for all the organs.
a.    But to be fit for such purposes it must be deprived of the foreign
[; principles introduced into it, and freed from the superfluous serum,
*'  by the aid of which the molecules suitably assimilated had obtained
   access to its vessels.  Our body in fact constantly admits the recep-
   tion  of more matter than is  necessary for its support.  This super-
   abundance is observed, in  the first place,  in  the digestive canal,
   which makes a selection, and the residue constitutes foecal matter.
   The  second  separation  is seen  after intestinal  absorption in the
   depurating organs, which hasten to eliminate  a superfluous serum,
   the retention of which  would distend the blood-vessels, and op-
   press all the functions.   The evacuation of the superfluous water
   is therefore one of  the first and  most  important of the internal
   functions to which we have  given the epithet  of organic.
    This explanation cannot be regarded as a hypothetical fact, since
   after the completion of the diurnal circle, the body, though pre-
   viously heavier, from the superabundance of  absorbed substances,
   is constantly restored to its accustomed weight and volume.  In the
   period of the most rapid growth, so  slight is  the daily increase in
   the bulk of the  body, that it cannot be adduced as an exception to
   the law just laid down.  Were it otherwise, there would be no fixed
   limit to  the  increase in volume of animals,  and  animated nature
   would cease to be what we find it.
    Now, depuration consists in this multifarious elimination, viz.:
   in that of worn out matter and  salts  detached from the solids,  or
   repelled by the animal fluids, and of unassimilable molecules, such
   as certain aromatics, resinous, and other principles found in aliments.
   mineral particles, and finally the superfluous water.
                                  30 
394
OF THE DEPURATIONS
  The organs charged with this process are,  next to the digestive
canal which concurs in it to a limited extent, the skin, the kidneys.
and mucous surface of the respiratory apparatus.
  But may we be allowed  to ask how this eliminative depuration
takes place? It seems to me that this question  is of the greatest
importance as to its bearing on our studies.  Thus, if the fluids eli-
minated be not endowed with a peculiar power by which they are
directed to such and such emunctories, it is very certain that their
separation, in the mass of circulating fluids, and their subsequent
expulsion, cannot be any thing else but a vital action of these emunc-
tories—and to this conclusion we are  forced to assent  It is then
indispensably necessary for us to study this vital action in its nor-
mal type, to enable us to have an idea of its aberrations, which be-
come so many causes of disease.
  Setting out from this undeniable  principle,  I shall be led to
establish,  1.  That the  three eliminating  and depurating organs,
which have just been mentioned, are constantly exhausting a cer-
tain portion of vital power, and that this exhaustion becomes a «
habit to the animal economy; 2. That these three organs are always
in simultaneous action, but unequally so, and in  such a manner that
whenever one of them acts more, the  others act less, and vice versa;
3. That all three alike evacuate serosity, but that each  adds to it
principles peculiar to itself, and  which it  alone is required to eli-
minate.
  This laid down, we may next proceed  to an examination of the
three depurating organs.

              Section  I.—Of Cutaneous Depuration.

  I have  already noticed the structure of the skin when examining
this envelope as an  organ of touch, and we  then saw that it was
impossible to  discover in it vessels specially destined to furnish in-
sensible perspiration and sweat.  All that can  be advanced  with
any certainty, is that the vasculo-nervous net-work expanded over
the surface of the cutis vera, enjoys a vital action in virtue of which
it operates this evacuation.   It now behoves  us to  inquire into
what is actually evacuated.  Insensible perspiration and sweat are
essentially the same thing.  There takes place through the cutane-
ous tissue a continual disengagement of caloric, which carries off
with it serosity, holding some salts in solution,  mucus, animal oil. 
OF THE DEPURATIONS.
395
and carbonic acid, without mentioning certain  aromatics, such as
garlic and some others.   When caloric disengaged by the skin, is
too much loaded with fluids, it deposits them, and the sweat appears
in drops.  If, on the contrary, the caloric contains  no more than it
can dissolve, we see only a vapour or gas; but if this gas be collected
and condensed  in a small space, we  are soon assured that it unites
all the elements of sweat
  The skin contains likewise  excretory canals coming from the
glands situated in its tissue: these canals are not so much intended
to complete cutaneous  depuration, as to furnish  an oily humour
which coats the surface of the skin, renders it smooth, and protects
it in its relations  with foreign bodies.  This fluid doubtless contri-
butes  to render the perspiration unctuous; but it  does not furnish
alone the oily matter of the sweat.
   The vital action of the skin is in direct  proportion to the quan-
tity of blood which reaches it; and this again is proportionate  to
the rapidity of the circulation, and the stimulus from external heat
When these conditions are fulfilled  to a moderate extent, there is
only transpiration or insensible perspiration; in a greater degree this
latter is changed  into sweat, whilst again in a more exalted  stage
sweat disappears; such  is the general law,  confirmed even by facts
which seemed to constitute so many  exceptions to  it.  Thus in cer-
tain fevers the product of gastro-enterites,  the  skin, although of a
burning heat, and penetrated by blood, is dry and even arid, not-
withstanding that the patient, tormented by thirst, very often makes
use of a large quantity of drink, and passes very little urine. Hence
the heat and dryness are here coincident in the mucous membrane
of the  digestive canal, and in the skin.   We can,  it  seems to me,
only explain this phenomenon by admitting that the caloric exhaled
by the skin is abundant enough to support  in a gaseous form all the
serosity eliminated from it.   What appears a confirmatory fact is,
that frequently at this time the cold bath, by cooling the cutaneous
envelope, brings  out sweat, a proof  of the  diminished irritation of
the skin.
  If the skin be covered with sweat, in inflammations of the sub-
stance of the lungs, it is because these phlegmasia? exert an  influ-
ence over the cutaneous apparatus, as irritating as that produced on
this latter by the mucous surface of  the digestive canal; or rather,
it is on account of pneumonia accelerating the circulation, and send-
ing, like muscular exercise, much  blood into the tissue of the skin, 
396
OF THE DEPURATIONS
without imparting to it the same acute irritation as in gastro-ente-
ritis.   The correctness of this explanation is shown in the circum-
stance of  that form of gastro-enteritis of itself not painful, or pre-
vented from being so by suitable treatment,  allowing  likewise of
extremely abundant sweats, which are suppressed so soon as  the
digestive  passages are excited by heating drugs.
   External cold, and  all irritations of the  viscera which do not
drive the  blood towards the surface, diminish cutaneous depuration;
the first acts as a direct sedative, driving  the blood from the exte-
rior;  the  second operates  revulsively,  and invites this fluid to the
interior.
   All these facts tend to prove, that cutaneous elimination, in order
to be accomplished with an energy proportioned to the rapidity of
the circulation, requires the skin to be but moderately excited.
   When the skin is chilled and  pale, the serous evacuation from
the surface is usually diminished; but,  during this time, we occa-
sionally observe cold sweats.  In order to  be able to attribute them
to the atony, or relaxation of the skin, we ought constantly to meet  •
with  them when its vital action  is diminished; but as this is not the
case,  we can only account for them by  a  peculiar mode of irrita-
tion in this  membrane,  by which it is rendered  susceptible of ex-
haling a serous fluid without being solicited thereto by the supera-
bundance of blood.  Such sweats always correspond to the suffering
of certain internal  organs, as in the uneasiness of lipothymia, and
may,  in my opinion, be referred to  spasmodic alternations of con-
striction and relaxation  of the cutaneous surface.

         Section II.—Renal or Urinary Depuration.

  The kidneys are double organs, with some exceptions, as when
a single one is found situated on the lumbar  vertebrae,  and gives
origin to two ureters.  They are deeply seated behind the  perito-
neum, on the lateral portions of the vertebral column, in a line
with the two last dorsal and two first lumbar vertebrae, and are sur-
rounded  by a cellular  tissue, always abundant, and more or less
loaded with adipose matter.  The kidneys are of  an ovoid  form,
with a concavity at the  internal  border; and in the foetus they are
surmounted by the renal capsules.
  We discover in them two different  substances: the cortical and
the tubular.  The first, or external, is of a brownish-red colour, and 
OF THE DEPURATION'S.
397
penetrates internally so as to embrace the other or second by pil-
lars  or  kinds of arches; its tissue is  granulated, and it contains
innumerable  sanguineous  vessels: to it is  attributed  the office of
secreting the urine.  The second,  which presents small cones of
unequal size, and of a  red  colour, darker without than within, is
composed of an  assemblage of small capillary tubes, adhering to
the cortical portion  by their external extremity, and open on the
summit of the cones internally.   These cones have a  rounded and
truncated summit, and bear the name of papilla?; they are  pene-
trated by the orifices of the tubuli  uriniferas of the tubular por-
tion, which are nothing more than the excretors of the  urine, and
which, when subjected to pressure, allow it to escape.
   These papilla? are lined by a membrane, which forms the infun-
dibula, or calyces, and  the pelvis.  The infundibula are small
tubes which,  by means of  one extremity, embrace one or more of
the papillae, and by the other are  continued into the pelvis.    This
last is a reservoir which occupies  the centre of the gland, and cor-
responds, on  the side of its free portion, to the  concavity  of the
kidney: it receives all  the infundibula in its deepest  portion, and
by its internal part is continuous with the ureters.
   The pelvis and infundibula are formed by means of a proper
membrane, whitish and resisting, which is of the fibrous character,
and lined internally by a mucous  membrane of very obtuse  sensi-
bility.
   The kidneys are enveloped in a whitish  and fibrous membrane,
adherent to the cortical surface, and penetrating  by the fissure  or
concavity so as to be reflected over the pelvis, which is, consequently,
but a continuation of it
   These organs receive their nerves from the great sympathetic, in
conjunction with  some filaments  from the  eighth pair; the  blood
which supplies them is derived  from arteries  detached from the
aorta, and called renal or emulgent; their veins correspond to the
arteries, and the lymphatics in them  are quite numerous.

     Section  III.—Physiological Action of  the Kidneys.

   The kidneys are, together with the skin,  the principal organs for
the elimination of the superfluous serum; but the former secrete a
fluid called urine, in which are contained many principles peculiar
to it; the chief of these  is urea, a substance susceptible of becoming
a-,id and forming  salts.   The materials found in the urine arc urea, 
398
OF THE DEPURATIONS.
a gelatinous animal matter, muriate of soda and of ammonia, phos-
phat of soda and of ammonia, either separate or  combined in tri-
ple salts, phosphats of lime and of magnesia, phosphoric, uric, and
benzoic acids.   At times we discover in the urine the sulphats of
soda and of lime, the oxalat of lime, the urat of ammonia, silex, &c.
   Urine is, then, a very compound fluid; and physiologists usually
consider its discharge as  the means of eliminating the superabun-
dant salts and molecules which are detached from  the solid parts.
It has been thought to contain more phosphoric acid than common,
when there was a softening of the bones in disease; and those who
attribute gout to the loss  of the phosphat of lime, which gives so-
lidity to the osseous system,  have not been backward in affirming,
that the elements of this salt, and even the salt itself, entire, were
collected and eliminated by the action of the kidneys; but more re-
cent experiments have not corroborated this assertion. Scudamore,
who has analyzed the urine of gouty persons, discovered its resem-
blance to that of all those who suffer from any febrile movement.
Consequently, if the urine becomes more acid, and charged with
salts, mucus, and animal matters, in the gouty, we must refer this to
the irritation which alters the function of the kidneys, and, owing
to the diminution of the serosity, which is the basis*of their secre-
tion, renders it more concentrated whenever the  sweating  is pro-
fuse; whereas, in the case in which cutaneous  depuration  is sus-
pended, the urine is so  much the more limpid, and  less charged
with foreign particles, as  it contains a larger proportion of serous
fluid.   This remark has led physiologists to establish as a princi-
ple, that the kidneys always discharged very nearly the same quan-
tity of substances other  than the serosity, which  alone is suscepti-
ble of any great  difference in its proportion.   This conclusion is, in
our minds, a very  rational one.
   Does the urea exist in the blood, or is it formed by the kidneys
at the expense of certain principles which they draw from the cir-
culation?  This problem is hot yet solved.   It was at first thought
that the urea was simply collected by the kidneys, and  afterwards
believed, that these organs prepared it from all that was brought to
them;  but  some experiments have again led to the belief, that it
exists in the blood.   Still, however, we cannot  regard these ex-
periments as conclusive;  and we await  the result of new ones,
before  our opinion can  be definitively fixed.  After all, I  do not
think that we  absolutely require very exact notions on this point, 
OF THE DEPURATIONS.
399
in order to establish the relations between the kidneys and the other
organs, and  to  indicate the manner in which the former become
causes of disease.
  The secretory or eliminating action of  the kidneys  is  not, like
that of the skin, in a direct ratio to the quantity of blood brought to
them.  Whenever the circulation  is  greatly accelerated, were it
even by muscular exercise,  the blood is driven towards the surface;
and consequently it is the skin which becomes the chief eliminator
of the superabundant fluid:  the  kidneys at this time supply but a
small quantity of urine, much loaded with salts.   This is a remark
of which the pathologist ought not to lose sight.   What  most effi-
caciously augments the urinary depuration,  is the coldness of the
skin, and we may draw the  inference therefrom, that this membrane
is associated with the kidneys, by what is called reverse sympathy.
But how are we to explain this kind of relation? We see manifestly
that whenever external cold, a chill from  moral causes, or that pro-
duced by visceral irritations, are opposed to the excitement which
gives rise to insensible perspiration and sweat, the eliminating func-
tion  of the kidneys  is augmented: these two kinds of excitation
are then  in an inverse  ratio to each other.  But it may next be
asked, is it the ganglionic  nerves  which are the directors of this
movement of irritation?  How shall we venture to advance this pro-
position, when we can discover no  filament of those nerves in the
cutaneous tissue?  To give it feasibility, we ought to prove that the
vital action  arrested in the cutaneous exhalents is reflected to the
viscera, which  finally direct it to the renal  tissue.  The first part
of this novel assertion is a well established fact; for we are positively
sure that when the  blood is driven  from the surface, it  is always
drawn towards the viscera.  The  second would in its turn have
some weight, if it were proved that the viscera could exercise sway-
over the kidneys.   Let us examine this novel question.
  Whenever we desire to excite the flow of urine, we take into the
stomach water which holds in solution a small quantity of irritating
matters,  such  as salts, acids, alcohol, acrid substances  derived from
the vegetable kingdom, or  even from animals, as cantharides; for it
is well understood that pure water does not pass with equal promp-
titude by the  kidneys.  It is therefore impossible for us to deny
that a moderate excitation  of the gastric sense is not repeated in the
eliminating tissue of the kidneys.   Let us,  however,  bear in mind
that this sympathy does pot  take  place in a decided manner: the 
400
OF THE DEPURATION!*.
blood is iii rapid motion, for then it is always, as wc have already
seen  driven towards the surface, and the stimulation received by
the stomach serves only to  render the sweat more  abundant.   On
this  account  diuretics  become  sudorific^,  when taken in warm
weather or while going through violent exercise; and sudorifics
administered in  the cold season and while the body is at  rest are
converted into diuretics.  Now these observations  give a high de-
gree of probability  to the proposition above laid down; for  incases
in which the cold suppresses  the exhalent action of  the skin, the
quantity of blood at the surface is notably diminished, owing to the
circulation not being sufficiently accelerated to direct it there, and
the mucous surface  of the stomach and its muscular tunic acquire a
manifest degree of energy,  since the  assimilating faculty is always
augmented in a remarkable  manner.
   We may then I think admit as an established fact, that the exha-
lent action, suppressed  in the  skin  exposed to  cold, is transmitted
through the medium of the  digestive passages to the tissues secret-
ing and eliminating urine, and that there exists no  direct  relation
between the kidneys and the  cutaneous surface.
   The influence of the irritation of the mucous surface of the
stomach on the kidneys, only succeeds when moderate, in  produc-
ing an increased  formation of urine.  So soon as this irritation be-
comes excessive, the  superfluous  serosity can no longer be elimi-
nated by the renal passages,  but  must find an outlet by the skin,
either in the form of sweat; or  if the surface be  hot and burning,
as in gastro-enteritis of  great intensity, it is exhaled  as vapour. But
if this disease, though  intense,  be apyretic, that is to say, if  it do
not sufficiently accelerate the  circulation so that the blood  may be
driven towards the  surface, and if the skin becomes cold, both urine
and perspiration are simultaneously diminished; and we always find
in such cases that the stomach is averse to the ingestion of  liquids,
and frequently even to all kinds of ingesta,  so great is the con-
nexion of action  between this organ and the depurating viscera.
   The other phlegmasia? likewise exert  an  influence  over  the kid-
neys: that of the liver, which is always accompanied by a gastro-
enteritis,  tends  greatly to  lessen  the  quantity of  aqueous  fluid
evacuated with the  urine; and we find that several of  the principles
of bile, and especially  of the colouring matter, are eliminated by
the kidneys; encephalitis being usually associated with gastritis,
these organs are modified nearly in the same manner as in the latter 
OF THE DEPURATIONS.
401
disease.  Peritonitis puts a stop to the secretion of urine, and  as it
also diminishes that of sweat,  intestinal absorption  scarcely takes
place; the ingesta are rejected; all which exhibit a new proof of the
intimate connexion between this absorption and serous elimina-
tions.   Phlegmonous  inflammations, and  especially those  of the
lungs, having this peculiarity, that they propel the blood in abun-
dance towards  the surface, whereby the cutaneous exhalation is
augmented, must of course  render the  urine  more concentrated.
We may say the same of the acute inflammations of the skin,  such
as the eruptive, which are always accompanied by a phlegmonous
turgescence of the sub-cutaneous tissues. Finally, the inflammation
of the kidneys cannot but greatly derange their depurative  action:
those which  are acute and phlegmonous suppress it entirely, and
sometimes induce in its place a haemorrhagic discharge; those of a
chronic nature, on the contrary, are  at times reduced to an irrita-
tion of the secretory vessels, which furnish urine in extraordinary
abundance.
  The moral affections exert a powerful agency on the eliminating
function of the kidneys: in fright, the urine is augmented to an
astonishing extent,—which  can, we think, be attributed only to a
certain degree of irritation of the digestive organs, reflected to the
plexuses and ganglions of the  great sympathetic: and we must re-
member that in such cases there is always a spasmodic constriction
of the skin with a chill, which  diminishes cutaneous exhalation;
but if the passion be of such a nature as to excite strongly the cir-
culation,  and  drive  the blood towards the exterior, as in fits of
anger, the perspiration  is augmented,  and the quantity of urine
diminished.
  Would it not seem to result, from all these points of analogy,
that these two eliminators, which we have just examined, do not act
independently of the viscera; and that, consequently, the modify-
ing causes by which their action is deranged do not perform  it by
means of a direct and  peculiar influence?   This is what it  greatly
behoved us to demonstrate, so as to  give their true  value,  that is
what is founded on sound physiology, to the signs drawn from the
nature of the sweat and urine, in order to throw light on the diag-
nosis of many diseases.
  The product of the depurative secretion of the kidneys is always
accompanied by a mucus which comes from the follicles of the pel-
vis and  bladder: occasionally this humour predominates, as in the
                              51 
 102                 OF THE DEPURATION^.

 cases in which the surfaces over which the urine passes are seized
 with inflammatory irritation.

          Section  IV.—Of the Excretion of Urine.

   The urine,  after having traversed the  canals called  ureters,
 reaches the bladder, where  it remains for some time before being
 finally expelled.   Let  us glance at the organs destined to excrete
 this fluid.
   The ureters are two fibrous canals, continuous with the pelvis,
 and lined by a membrane of a  mucous nature, analagous to that of
 the pelvis and infundibula: they are endowed with contractility to
 that extent which can be enjoyed by  the gelatinous tissues.
   The bladder is formed after the same plan as the digestive canal:
 we discover in it a mucous  membrane, furnished with an internal
 sense of relation, which lines the cavity; a muscular tissue of great
 strength is united to it, by means of laminated and cellular leaflets:
 finally, the  major part of this organ is covered by the peritoneum,
 which leaves it to be reflected over the internal surface of the pel-
 vis, and over the inferior portion of the muscles of the abaominal
 parietes.
   The mucous membrane of the bladder, having very intimate re-
 lations with the encephalic centre,  contains in consequence vasculo-
 nervous matter in a state of  sensitive expansion; and like all tissues
 oT this kind it is furnished with follicles, destined to secrete a mu-
 cus. This double disposition of parts is especially remarkable in the
 space  comprised between the orifices of the two ureters and the
 mouth of the urethra, in what is called the  trigone vesical.   It is
 at this part that the sense is most active, and the mucous secretion
 most abundant
  The neck of the bladder  is embraced, in  the  male subject, by a
 large gland called prostate, of a structure similar to that of all the
 secreting organs; and as such we refer to the account of the secre-
 tions produced in the generative act.
  The ureters of each  side enter  the bladder at a small distance
from its neck, and are in this place covered by the  peritoneum;
they have entrance obliquely, by penetrating the mucous membrane
a little above the point where they pass through the muscular coat.
  The vesical apparatus has  arteries which come from  the  hypo-
gastric, and  nerves, some of which  belong to the great sympathetic. 
0V THE DEPURATIONS.
403
and others are detached from the sacral nerves, which, as we have
.seen, are derived from the brain.

            Section V. —Function of the Bladder.

   The internal sense of the bladder is not productive of any sensa-
tion in the normal state, unless the urine be  accumulated to a cer-
tain extent in this cavity,  resembling, in this respect, the sense of
the  great intestine,  in  being intermittent.   When the bladder is
full, the desire to urinate is felt; it depends on a twofold cause: 1.
the stimulation produced by the urine on the mucous surface, and
more especially on the triangular region adjoining the neck; 2. the
distention of the muscular fibres.   The first of these two sensations
is the most  perceptible, and is evinced in a  kind of pricking and
tickling, which  are referred to the external  extremity of the ure-
thra; the second, only manifest when the bladder is greatly distend-
ed, consists in a sensation of weight,  and,  as it were, of a foreign
body occupying the hypogastric region.
   These two sensations make a call on the brain, and instinct de-
termines the will to allow the ejection of urine; but the will may
still refuse,  and all this is accomplished in  a manner which we shall
soon become acquainted with.  The  mechanism of the expulsion
of urine has not, we think, been  suitably  explained.  Does it de-
pend on the direct influence exercised by the will over the muscu-
lar coat of the bladder, or simply produced by the exercise of vo-
lition on  the muscular fibres compressing the  neck, the  bladder
acting in other respects by a  power peculiar to it?  The first mode
would seem to us inadmissible; the second is alone  susceptible of
proof, since the urine  is evacuated in the new-born child, in the
person asleep, and  the  apoplectic, the one in a state of stupor, all
of whom are deprived of the power of volition.   In  all these cases
it seems to me very certain, that  the ejection of urine is a purely
instinctive act; or, in other words, is dependent on the spontaneous
contraction  of the  bladder, which calls to its aid and service the
cephalo-splanchnic muscles, with the understanding,  however, that
they obtain  their contractile stimulation  from the brain, on which
it acts by  means of its ganglionic nerves.   If, therefore, the adult
when awake and attentive to the sensation of  the want, can suspend
the indulgence of it,  he  does it by the intervention of  the brain, and 
401
OF THE DEPURATION^
in one of the two following ways:  1. by contracting the spinnctei
of the bladder;  2. by refusing to allow the cephalo-splanchnic mus-
cles to aid in the effort made by the muscular coat of the bladder to
bring about the ejection: but, in return, he enjoys the power of se-
conding this effort, by inducing a contraction of the diaphragm and
the abdominal muscles stronger than that produced by mere instinct
in persons whose intellectual faculties are suspended, and in whom,
consequently, there is  not the possession of volition.
   Such are the modifiers of the bladder in its natural condition; but
this viscus has numerous sympathetic  relations  with  many other
organs,  such as the kidneys, stomach, intestines, &c. which we shall
meet with in its pathogenia.

Section VI.—Pulmonary Serous Elimination and Depuration.

   The internal surface of the bronchia?, and especially of the air
cells, must be regarded as a passage for the elimination of the su-
perfluous serosity, and as an organ of real depuration.   In fact, ex-
piration gives issue to a great quantity of water  that escapes with
the air,  in the form of vapour, which is the bearer of carbonic acid,
as we had occasion to learn when giving an  account of respiration.
This depuration is, indeed, the most important; for,  without  it, the
blood remains black, surcharged with carbon,  and totally unfit for  i
the support of  the functions.   But at present we have to consider
pulmonary exhalation as diminishing the superfluous water, and as
concurring with the two processes already detailed, to maintain the
equilibrium of the animal economy.
   This serous evacuation is in a direct ratio to the quantity of blood
brought by the  artery into the pulmonary tissue;—as a necessary
consequence, it follows, that whenever the current of the blood is
accelerated, or  this fluid driven from  the surface, by cold,  or any
other spasmodic affection of the skin, the pulmonary exhalation will
be in greater abundance; and, hence,  will be often in an inverse
proportion to that of the skin:  I say often, for, in many instances,
both  are simultaneously augmented,—as  in  violent catarrh and
pneumonia, in which we see respiration very frequent and the skin
covered with sweat at the same time,—a  coincidence likewise re-
marked in violent exercises.   It is very remarkable, that at this
period the urinary serosity is greatly lessened in quantity; but when 
OF THE DEPURATIONS.
405
the blood is driven from the surface by the coldness of the skin,
the increase of pulmonary exhalation corresponds with that of the
urine.
  It follows, moreover, from this, that pulmonary exhalation may
be at times increased together with augmentation of the cutaneous
discharge, and at  times  with the urinary;  but that this  latter is
never in quantity correspondent with the increase of sweat.
  The phlegmasia? of the different organs do not act by a peculiar
sympathy on the exhalent orifices of the bronchial vesicles.   We
phall at first find that they increase or lessen the pulmonary depu-
ration by accelerating  or retarding the course of the blood; then
that in irritations of the viscera which are of such a kind as to sus-
pend or retard the respiratory movements,  as in tetanus, peritonitis.
and certain gastrites which bring on attacks of asthma, the blood
though accumulated in the lungs does not lose so much serum, and
is not so completely depurated, as in the natural condition.
   As  regards moral  causes, they can only  act in one  of two
ways;  those which retard the action of the heart and the respiratory
movements, must of  course diminish the pulmonary exhalation,
whilst those which accelerate the circulation, such as joy, and anger
in its period of explosion, will never fail to increase the evacuation.
   When we speak of visceral irritations, whether inflammatory or
nervous, or the  product of moral causes, which  retard the respira-
tory movements, we do not mean to intimate that they act imme-
diately on the muscles.  Their  first impression  is always  directed
to the  pulmonary  sense, which  resides, as we have  seen, in the
tracheo-bronchial membrane; it is this impression diffused through-
out all the splanchnic  nerves, and transmitted to the brain, which
provokes the contraction of the air cells, opposes the enlargement of
the parenchyma, and  retains sympathetically the action of the in-
spiratory muscles, which cannot as we have seen be at variance with
 the surface of the lungs.
   It is however not the less certain, that these modifiers  diminish
 pulmonary depuration by lessening the number and extent of the
 inspirations and expirations, and not by closing the exhalent ori-
 fices by a spasm sui generis.
   The mucous secretion is in  association with  the depuration of
which we are now treating, in  the  same way  as it is with that of
the urinary organs, and as  the sebaceous  matter is associated with
that of the cutaneous  transpiration; it is performed in the trachea 
406
OF THE DEPURATIONS.
 and bronchial branches,  by means of follicles  readily observable;
 but it is very difficult to distinguish them in the pulmonary vesicles,
 though these latter be furnished with mucus, and this humour aids
 that of the bronchiae in giving some consistence to the vapour issuing
 from the chest: notwithstanding this, however, its transparency is
 not affected, as we may readily convince ourselves by examining
 the icicles which are formed on the beard of persons who travel in
 the open air during cold weather.  If this exhaled fluid be tasted
 it is sharp and saline, as well as the  sputa of the thickened mucus
 sometimes expectorated during a state of full health; but we never
 discover in it any fat or oily matter, such as the skin and kidneys
 habitually furnish.  Hence  each depurating organ is charged with
 the function of evacuating, together with  the superfluous water, the
 principles peculiar to it.   If then they can be auxiliary to each
 other on the  score of the balance of fluids, they can never become
 so  in reference to depuration properly so called.

 Section  VII.—In what manner the Action of the Depurating
              Organs becomes the cause of Disease.

   We have admitted the existence of the two fundamental facts in
 the depurative functions: 1. The waste of vital  action;'2. Thf
 evacuation of a certain quantity of fluids.   It is therefore from the
 derangement of these two orders of phenomena, that the diseases of
 which we are now to seek the causes result.
   Whenever the exhalation from the skin is increased to  an extra-
 ordinary degree,  as in the case of  copious and continued sweating,
 there supervenes an eruption of small red pustules of an inflammatory
 character and accompanied by a great itching:  they are called su-
 doral pustules: they may be converted  into  erysipelas, or phleg-
 mons,  or carbuncle, and  be attended with all the effects of these
 phlegmasia?.   We  likewise find  them occasionally giving rise to
 real herpes, especially if the  physician take it into his head to treat
 them by hot bathing and diaphoretic drinks.   In all these cases the
 irritation is not limited to the exhalent tissue, but is participated in
by  the sebaceous  follicles, the action of which is exalted conjointly
with that of this  tissue.   Another effect of excessive sweats is the
habit acquired by the skin of giving them out by the slightest exci-
tation.   I have seen many examples of obstinate sweating after the
long use of sudorifics: this discharge throws the patient into extreme 
OF THE DEPURATIONS.
407
debility, and is very difficult of cure, because its suppression gives
rise to visceral irritations.   Whenever the cutaneous exhalation is
checked by the  sedative action of cold, or by a chill  proceeding
from any other cause, the excitation of  the skin must  be replaced
by that of some other part; and its place is usually supplied by the
depurations from the kidneys and the pulmonary vesicles.  If, now,
this transfer of irritation be made with  too much impetuosity, ne-
phritis,  catarrh,  or pneumonia,  may  be the consequence; and, if
the irritation received by the parenchyma of the lungs reach the
serous membrane, pleurisy is of inevitable  occurrence.   Here,
then, we have the transfer, though a normal one, of the cutaneous
irritation, converted into disease; but in numerous other instances,
this same transfer is abnormal, that is, in place of being reflected
to the internal depurations, irritation arises, by an error loci,  in
other tissues,  which again is productive of disease.   If it  be  di-
rected on the mucous membrane of the digestive organs, a gastro-
enteritis or colic will supervene; and in case it should not stop  at
this part, it may fix itself on the liver,  and give rise to hepatitis;
or it may even  traverse the digestive canal, and exhibit itself on
the serous  membrane of the abdomen by  producing a peritonitis.
The portions of mucous membrane lining the eyelids,  nasal fossae,
mouth,  fauces, pharynx, and larynx, may also contract this supple-
mentary irritation, and we shall then see the attacks of ophthalmias,
coryzas, gingivites,  aphthae, amygdalites, pharyngites, and  laryn-
gites, also called croup.  In the female, the  same aberration may
produce uterine catarrhs, or suppress the excretion of the menstrual
blood, and  become the cause of metritis,  or of inflammation of the
principal organs of the abdomen, chest, or head, and other parts
on which the hemorrhagic irritation will be directed.
  But the irritation which has just abandoned the skin is not always
transferred to the  mucous membranes;  it  may affect the synovial
and  tendinous capsules,  and the inflammation  thence resulting
will  receive the name of gout; or else  it will take place in the
tendinous,  aponeuretic, or muscular  tissues,  and  give rise   to
rheumatism: if  the glandular and  cellular tissue of the mamma?
be boundaries of this transmission, an event of ready occurrence
after child-birth, because at that time these organs are in an excited
state, a phlegmon of the most painful character will  be  the result
In other cases, we shall find the  parts affected by the sedative im-
pression on the skin to be the superficial lymphatics, and the sub- 
408
OF THE DEPURATIONS.
cutaneous tissue of any region of the body; and there will follow
glandulo-cellular inflammations, of varying intensity, which will pro-
duce vast collections of matter; or which, passing into the chronic
state, will keep up an oedema, deforming the part.   Such is the ele-
phantiasis of the Arabs, in the opinion of Dr. Alard.   Finally, the
encephalon itself may, though less frequently, become the abnor-
mal assistant to the skin; and apoplexies, paralyses, phrenites, and
insanities, will be the consequence of a chill of the cutaneous sur-
face.   We know that sanguineous apoplexies are tolerably frequent
during great frosts.
  The transfer of cutaneous irritation having once taken its direc-
tion  towards an organ or tissue, it is very common for it to follow
the same course at each recurrence of  the  sedative action of cold
on the exterior.  Such, in  my opinion,  is the reason  why relapses
from diseases occasioned by this cause are so frequent, and of such
ready occurrence. Those who have had a cold never  cease to catch
fresh colds, and their  lungs become studded with tubercles; the
gouty and rheumatic relapse on  the  slightest diminution of tem-
perature,  &c.   The animal frame becomes habituated to this kind
of irritation, which assumes a chronic character; the depuration is
not completely performed; the fluids are unceasingly invited and
accumulated in the interior; nutrition is depraved, and wonderful
disorganizations are brought about in the cellular, lymphatic, and
parenchymatous tissues, &c.  This is what may be very conveni-
ently seen in the post mortem examinations made in cold and tem-
perate climates;  whereas those who sink  under disease  in hot
climates,  exhibit the cellular and parenchymatous tissues dried and
wasted; and more frequently  humoral  congestions  are only met
with on the digestive mucous surfaces, and  in the brain.
  We see now how many obstinate and dangerous  diseases  may
ensue from the torpor of the skin; still, however, they are nothing
more than the effect of the transfer of the cutaneous irritation pre-
siding over the evacuation of the superabundant water. There are
others depending on the morbid course  given to the fluid itself.  It
will  be seen, that I speak of the  vicious increase of secretion, and
of dropsies. Thus, whenever an internal organ contracts inflamma-
tion  after the torpor of the skin,  the whole  fluid of perspiration is
not drawn towards it; but  it reacts on  the viscera,  which latter
bring into action the supplementary depurating organs; so that there
only remains to the one inflamed  its own  irritation, in virtue of 
OF THE DEPURATIONS.
409
  which it acts on the blood or the lymph, as if it had been irritated
  by any other cause than by cold. Cases may indeed present them-
  selves, in which the exhalent action suspended in the cutaneous
  tissue is replaced by a secretory or exhalent one independent of the
  inflammation.  It is in this way that cold produces bilious and bloody
  vomiting, mucous diarrhoeas, salivations, very abundant leucorrhoeal
  fluxes, ascites, and even general dropsy taking an extremely rapid
  extension.
     If we pass to diseases in which we recognise for causes the dis-
  eased actions of the kidneys, we shall find these organs contracting
  irritation, not only in consequence of suppressed  cutaneous  exha-
  lation, but even from the long continued use of diuretics; for the
  kidneys by dint of excitation acquire,  in common with the skin, a
  vicious habit of hyper-secretion.  Diabetes may  therefore be the
  consequence of this order of things, and rarely does it exist with-
  out a shade of inflammation.  Among  the modifiers, the operation
  of which is specifically on the kidneys, we shall mention canthari-
  des, balsamic and terebinthinate substances, uva ursi, the  alkalies,
, and soap, the prolonged use of which may lead to renal irritations
  of a very dangerous nature. Physicians generally, now-a-days, are
  of opinion, that the abuse of vegetable food, and saccharine drinks,
  which pass off too readily by the urinary secretion, is adequate to
  the production of diabetes.  The urine at such times is deteriorated;
  it no longer contains urea, or animal matter, and holds in solution
  a small proportion of salts, but it has  suspended  in it sugar in a
  particular state.  I do not  know  whether this oetiology be well es-
  tablished; but I have seen cases of saccharine diabetes which did
  not depend on the above cause: they were entirely the consequence
  of an inflammation attacking simultaneously the mucous membrane
  of the stomach and the tissue of the  kidneys.
    The causes diminishing the formation of urine,  render this fluid
  very concentrated,  as we  have already seen.  There thence results
  an irritation, exerted on the  mucous surface of the pelvis,  ureters,
  and bladder, which is soon converted into inflammation.  The for-
  mation of gravel, occasioning attacks  of nephritic  colic, is another
  consequence of this mode of  irritation.   We  meet with them in
  fact in robust persons, who, relying on the vigour of theicstomachs,
  indulge  immoderately in  the  use of strong food, high  seasoned
  dishes, and who drink undiluted red wines, highly charged  with
  tartaric acid, and a colouring principle. The urine of these persons
                               52 
410
OF THE DEPURATIONS.
 is much loaded with urea, salts,  and animal  matters; it is readily
 decomposed,  and  forms calculous concretions, and the excretory
 Canals which give it passage take on inflammation.
   The kidneys receive, moreover, irritation by the sympathy that
 unites them with the bladder and the genital organs: on which ac-
 count gonorrhoea, when it has traversed the urethra and reaches the
 bladder, produces inflammation of this latter, which is continued to
 the  kidneys:   Excessive venery also  produces nephritis without
 vesical inflammation being observed.
   The kidneys we are told become heated, and subsequently in-
 flamed and gravelly, by the person being much in bed.  This would
 seem to us to depend on the concentration of urine and inertia of
 the bladder, which retains and allows  the urine in  its cavity to be
 concentrated by absorption.
   The inferior part of  the rectum is likewise  associated in  action
 with the kidneys, whence must  result frequently the  transfer or
 propagation of the haemorrhoidal  irritation to these  organs.
   The mucous surface  of the kidneys  and the rectum, is not by
 any means protected from a catarrhal irritation originating in those
 parts by the influence  of cold: it is a very powerful cause of the
 formation of calculi.   This kind  of phlegmasia is distinguished by
 the great abundance of mucosity in the urine, accompanied by pain
 in the region of the kidneys, but without any sign of vesical in-
 flammation.  The renal organs may, finally, receive irritation from
 the muscular tissue, to which itself had  been transferred the impres-
 sion of cold on the skin.
  The causes of disease of the bladder  are frequently the same as
 those of the kidneys which we have just spoken of, and which are
 either produced by sympathetic influence  or  by the irritation of
 urine too concentrated;  but the bladder has some peculiar to itself.
 As a reservoir for the urine, it may suffer from the  forced delay of
 this fluid, which losing its serum by absorption becomes too  irrita-
 ting to its mucous  membrane.  It may likewise be injured  by its
 extreme distention, the sad consequences of which are inflammation
 of its  neck too frequently united to a palsy of its muscular tissue.
 The bladder may also, as an organ sympathising with the skin, con-
 tract an internal inflammation following  cold, which is one  of the
 most usual  causes of catarrhus vesicae: its proximity  to the vesicul*
 seminales, and the rectum and vagina, expose  it moreover to parti-
cipate in the irritation of those parts. 
OF THE DEPURATIONS.
411
  The calculi of which the bladder is the recipient may come from
the kidneys; but it is very possible also that they are the results of
a particular mode of irritation of its internal membrane causing the
decomposition of urine.   Wc all know that any foreign body in-
troduced into its cavity serves as a nucleus for a calculous concretion.
After all, whatever may be  the origin of vesical calculi,  their pre-
sence is always annoying to the bladder; and it may be said while
on this subject, that  we can  only hope for  a complete  cure by the
operation of lithotomy, when the bladder has not been disorganized
by  the prolonged irritation it sustained from those foreign bodies.
  There is no irritation of whatever  nature it may be, or in other
words, whatever be its primary seat and its intensity, which cannot
be transported to the bladder; and what favours these kinds of me-
tastasis, is the state of super-excitation in  which this organ is so
frequently met with from the causes already enumerated.  In fact,
the abuse which we  make of the genital organs, syphilitic irrita-
tions, the  inconsiderate  use of gastric stimulations which always
become so for the- kidneys, and the neglect in evacuating the urine
at proper times, in the end  impart to the cystic tissue an irritability
which multiplies its relations with the  other parts of the animal
economy, and renders it susceptible of being the seat of metastases
which would never  have reached  it, had  it not deviated from its
normal degree of  function.   Consequently those who wish to pre-
vent the gout, herpes, and other affections of the external parts of
the body, from being transmitted to  the bladder, ought  to turn to
account what we have just elucidated, and husband an organ, with-
out the integrity of  which there is no complete happiness in life.
   Whenever the  bladder is filled with urine  which it is unable to
expel, pain is experienced and extended to the large  intestine, in
which it produces a very inconvenient evolution of gas.  We see
in this case the effect of a real sympathy exerted on the colon; but
there exists reciprocity between  these two organs, fori in flatulent
colics  the bladder very rarely fails to be disturbed in its function.
Inflammations of the pelvic peritoneum, and of all the organs conti-
guous to the bladder, give rise to a retention of urine, unaccompa-
nied by vesical phlegmasia?; but this is only because the movements
of the bladder increasing the pain of the diseased parts, instinct re-
tains this  viscus in a state of  immobility.   Practitioners  ought
 never to  lose sight  of this  by no  means  unfrequent  cause of the
retention of urine 
413
OF THE DEPl RATION-
  The intellect exercises, in certain cases, a marked sway over tho
bladder;  as in the instances of shame or timidity.   This mental
affection prevents us from gratifying the desire to urinate; and it
would therefore seem  that the bladder is susceptible of being in-
fluenced  in this respect similarly to  the genital organs  and  the
rectum.  Timid persons cannot urinate in the presence of otKers;
a power which they are unable to control, constricts the neck of
the bladder, so that  it  does not yield to the  pressure of the dia-
phragm and abdominal muscles.   The effort produced by the con-
traction of these parts,  causes the discharge of some drops of urine;
but so soon as it ceases, the bladder no longer  contracts  to expel
the remainder.  This  is among the number of  those causes that
produce inflammation of the neck,  and  a paralytic distention of the
fundus of this organ.
  It is worthy of remark,  that whenever an inflammation of the
urethra retains the urine  in  the  bladder,  on account of the pain
which its  passage  would  give  rise  to,  the renal  secretion  is
greatly diminished.  This fact of  general notoriety in gonorrhoea
evinces a very active influence exerted by the viscus which serves
for the deposit over that secreting the urine: dilatation of the ureters'
and inflammation of the kidneys are the consequence.
  The existence of a mucous membrane furnished with an internal
sense in the duct of the ureters, affords an adequate explanation of
the pains and convulsions of the limbs,  brought on by renal calculi,
while passing down to the bladder.   We have a right to infer from
this, that the excretory ducts in question receive branches from the
cerebral nerves: but sympathetic irritations springing up at the same
time in the intestines, in which gas is evolved and colicy pains felt;
in the stomach, which eructates violently, and is contracted even to
the degree of producing vomiting; in  the cremaster muscle, which
draws up the testicle to the abdominal  ring; in the spermatic cord,
which, together with the testicle, becomes painful; in the diaphragm,
and, in a word, in  the whole visceral  apparatus of the abdomen,
seem all conclusively to prove, that the great sympathetic contri-
butes to the vitality of the mucous membrane of  the  ureters.   As
similar phenomena are evidenced  by the inflammation of the pel-
vis of the kidneys, we cannot deny them an organization precisely
analogous.   Do not these views serve to corroborate the  opinion
which we advanced above, when  we  said that the entire visceral
apparatus concurred in the transfer to the kidneys and their depen- 
OF THE DEPURATIONS.
413
dencies of the irritation which it received from the skin, at the time
that this envelope was subjected to the sedative-influence of the ex-
ternal cold?
  Excessive pulmonary exhalation is not  an appreciable cause of
disease; but the irritation producing or suddenly increasing it after
a chilling of the  skin, may, by being transmitted to  the follicles,
the tracheo-bronchial membrane, the parenchyma, and the pleura,
be converted into an inflammation, as we  have already remarked
when treating of  the alternate states of perspiration and the flowing
back of blood  from the surface to  the viscera.  Whenever a cause
of the nature of those indicated is opposed to the complete perform-
ance of inspiration and expiration, pulmonary depuration is defec-
tive; and then the blood remains serous and carbonated, and returns
partly in this state into the aortic  circulation.  There results from
this, uneasiness, feebleness, a notable diminution of irritability, and,
possibly, an ocdematous state of the lungs.   Are we not justified in
suspecting that the retention of pulmonary serosity contributes, sym-
pathetically, to the general dropsy consecutive to that of the paren-
chyma, in the cases of continual dyspnoea  produced by certain ca-
tarrhs, and the influence of a chronic irritation of the digestive pas-
sages?  Ought we not,  in consequence, to  infer the indication for
diuretics to supply the want of pulmonary exhalation?  This is my
opinion; but the  attention to husband the sensibility of the stomach
ought to guide every physician in the employment of these reme-
dies, which are always more or less stimulating.
  We have not yet sufficiently observed, whether in  certain bron-
chial inflammations, in measles for example, the  phlogosis be  not
opposed to the depuration  of blood in  the lungs.   Recent experi-
ments have shown,  that the section of the pneumo-gastric nerves
(eighth pair) rendered aeration and digestion of very difficult per-
formance. This fact proves, be it  said incidentally, that the nerves
of the great sympathetic require  the aid of the brain in order to
support suitably the action of the  viscera.   In the above cases pul-
monary depuration must be impeded.
  For the better  understanding of the phenomena of depuration.
I shall now glance at the effects of certain  poisons.
  When a noxious substance is introduced, through  the  stomach.
into  the animal  economy, as  in  the instances of acetate  of mor-
phium, putrid meat, certain poisons,  it first gives rise to irritation
of the gastric  passages; all the sympathies linking these with  the 
144
OF HIE DEPURATIONS.
other viscera are awakened,—such as the pain and oppression ol
the head, pain in the limbs, accelerated pulsations of the heart, dry
and burning skin, a suspension of the urinary and  mucous secre-
tions; finally, after afebrile and uneasy state, of varying duration,
but which  seldom  exceeds twelve hours, all  the depurators are
opened simultaneously; many of the secreting organs, and especially
the mucous cryptae, associated with them, participate in their mode
of excitation.  We find, appearing at the same time, copious sweats,
urine depositing a sediment,  sero-bilious  stools, sometimes saliva-
tion, and often an abundant secretion furnished by the mucous fol-
licles of the tracheo-bronchial surfaces.
   How can we explain such  phenomena, without admitting, that
the irritation exercised on the internal sense  of the stomach is dif-
fused throughout the entire apparatus of  the  great  sympathetic and
the brain, and that the stimulation reflected and transmitted repeat-
edly from one order of nerves to another, finally terminates by a
super-excitation of the depurating, and many of the secreting or-
gans, which, opening like the former on  surfaces  of relation, may
become their coadjutors or substitutes?  Does not this fact confirm
anew the  opinion of the skin being associated with the kidneys
through the medium of the  visceral nervous apparatus,—always
aided in its function  by the excitement of the  brain?  I mean to say,
that this organ, put into play by stimulus  from the viscera,  reacts
on the great sympathetic, and imparts to it sufficient energy to re-
vive that of the heart, propel the blood  towards the skin,  excite
the action of the kidneys, and even combine with these if necessary
the bilious, salivary, and mucous secretions.
   But a circumstance no less worthy of our admiration is,  that
even when the poisons of which we have spoken,  or other similar
substances, have been introduced into the course of the circulation
by injecting them into the veins, or by absorption following their
insertion into the flesh, the effects have been precisely identical with
those detailed above.   M. Magendie relates in his journal, experi-
ments which place this subject beyond all doubt, and M. Orfila has
obtained similar results.   It  is  always by an irritation primarily
developed on the digestive surface, propagated to the brain and to
the apparatus of ganglionic nerves, and accompanied by the most
usual  symptoms of gastro-enteritis, that nature prepares the depu-
rative  evacuations by means of which the elimination of foreign
unassimilated bodies is accomplished: she could perform nothing 
OF THE DEPURATIONS.
415
without this combination of irritative movements.   The  gastric
passages and the ganglionic nervous apparatus are therefore  the in-
struments which she is always obliged to wield, when she is pow-
erfully disturbed.   The irritation of the brain alone would produce
merely impotent convulsions; the heart would not act, or it would
only do it to a trifling extent, were it only brought  into play by
cerebral influence; it would indeed force the  blood  towards the
surface in such a manner as to excite  sweat, as in the case of mus-
cular exercise,  but the kidneys and  glandular organs in  general
would not participate in the action of  the cutaneous exhalents. No,
we repeat, the  brain and heart irritated  by it  alone would never
succeed in placing the depurating and secreting functions in such a
condition, as to enable them  simultaneously  to  give issue to the
matters troublesome to  the animal  economy; the great  sympa-
thetic, the regulator of the vascular movements, must direct influx
towards the interior of these organs, in such a manner as to render
them fit  at  the same  time  for  secretion  and excretion, and not
so as to throw  them into a state of spasm or of inflammation.
   But let us take up this last idea.   Whenever a poison operates
with too much violence,  the depurative secretion does not take
place; the cause of this I find in the inordinate irritation of the gas-
tric viscera, which is productive of a  double effect: 1.  that of con-
tracting action by inflaming them; 2.  that of paralysing the brain by
inviting to it too large a quantity of  blood, whence results  either
the comatose  state  or  convulsions,  which  finally exhaust the
strength.
   I have not yet however said  all on this interesting subject, and
 who can ever exhaust it? Even though there  should be no foreign
 matter to eliminate, the effects of strong stimulations of the animal
 economy would still be the same,  and accomplished as follows: in
 the same way  that we cough, or sneeze,  or make efforts to  urinate,
 or to go to stool, in consequence of simple irritation of the mucous
 surfaces of  the bronchia?, of the nasal fossae,  rectum  and bladder
 respectively, without there being any matter on these surfaces, the
 evacuation  of which is necessary; so  also does it happen, that the
 stimulation of the  principal organ of digestion, the centre of the
 chief cords of the  great sympathetic, excites a series of irritative
 movements, which, if not arrested by too powerful a gastro-cerebral
 congestion, will finally terminate in  an  evacuating  process of the
 eliminators, and frequently of the secreting  organs  which fill the 
416
OF THE DEPURATIONS.
part of auxiliaries to them.   It is thus that a paroxysm of intermit-
tent fever terminates in sweating, and that moderate gastritis ends
in evacuations of every kind.
  The reason of all this is, that neither elimination nor depuration
are the object of all these combined efforts of the febrile state.
They take place by sympathies which unite the action of all these
organs, because such is the natural course of irritation; beginning
in a certain organ, and in a certain degree, it must terminate in  a
certain  corresponding manner; and, in the case before us, this ter-
mination is the definitive transmission of irritation to the secretory
organs, whether there be a peccant matter or not in the body.  In
the normal state, this irritation serves to eliminate the products of
digestion,  together with the effete portion of animal matter, and
so far is unaccompanied by any febrile disturbance;  but when the
system  is affected in its centre of excitability, this irritation is at-
tended with a febrile movement, not because there is much matter
to evacuate, since the efforts are the same whether there be foreign
bodies to be expelled or an ordinary depuration to be performed,—
but because the  movements, which were only in miniature in the
normal state, become very much magnified, on account of  inflam-
mation.
  We see, from this, how gastro-enteritis  is the basis of all the va-
rieties of typhus, and why malignant fevers, of all kinds, have al-
ways been confounded with those of a sporadic, putrid, and adyna-
mic character.
  I shall say nothing of the  corrosive poisons introduced into the
stomach or injected into the veins, for the rapid disorganization pro-
duced by them does not allow of the system's putting forth  its con-
servative  efforts.  Nux vomica, taken  into the stomach in small
quantities, may excite the reaction spoken of above, but in larger
doses it engorges the  brain  and  spinal marrow, by giving rise to
sanguineous exhalations in the arachnoid,  and convulsions, which
are speedily mortal.   In fine, all the poisons, in small doses, cause
depuration, whilst,  in larger portions, they kill by disorganizations
and convulsions.
  It follows, as a consequence of all these views, that  it is not a
critical  depuration that ought to  fix the attention of physicians in
the treatment of the  acute phlegmasia?, but the arresting as soon as
possible the excitation raised above the natural standard; when this
is appeased, if  the depurations be necessary, they will very easily 
OF THE SECRETIONS.
417
take place without any violent efforts:  none such are required for
eliminating the matters badly assimilated,  which are so abundant
in the system  suffering  under scurvy  and chronic phlegmasiae,
constituting what is called a cacochymia.  So soon  as we have
succeeded in quieting the irritation of the part opposed to assimila-
tion, this last is accomplished with regularity, and all the depraved
juices are eliminated without the supervention of new disturbances.
  To conclude now by a more immediate recurrence to our subject,
we will say, that diseases are  never the effect of a want of power
in the eliminators,  excepting always those of the lungs, but rather
proceed from  an abnormal or morbid irritation  of the  viscera,
which deranges the action of the  eliminators;  and that the danger
resulting is  less owing to the retention of the substances to be elimi-
nated, than to the consequences of visceral irritation.  If we admit
an exception to this rule, in favour of pulmonary elimination, it is
because there the danger is  in consequence of the privation of a
stimulus,—oxygen, indispensable to the well-being of the animal
economy; and  not as the result of an excitation tending to an  in-
flammatory state.
   I have been compelled always to associate the secreting organs
with  the  deranged function of the eliminating ones; but  when
studying  the  former in  a more  particular  manner, we shall  find
that they  have their peculiar causes of  disease.   Be this as it may,
we cannot deny,  that the history of the eliminating will naturally
prepare us for  that of the secreting organs.
                       CHAPTER IV

                     OF THE SECRETIONS.

  The secretions consist in the formation of certain humours, which
are to concur to the performance of many functions.   The organs
which are charged  with  them  are  designated under the general
name of glands.   These are more or less regularly spherical; some
presenting but one body of  varying volume,  others an  assem-
blage of glandular grains, united by cellular or laminar tissues, form-
                             53 
41S
OF THE SECRETIONS.
ing a complex gland.  All glandular structures, wliether  large or
small, receive an artery proportioned to their volume, with a cor-
responding vein, and nerves, of which some come  from the great
sympathetic, and others emanate  from the brain, or its spinal pro-
longation.
   For the convenient study of  the secretions, it is necessary to as-
sociate them with the functions of which they  are the completion.
Let us see then  what are the offices to which the secreting glands
are annexed.
   In taking a retrospective view, we find  first the sebaceous and
oily secretions,  which concur both to sensitive and  to eliminative
functions; after that, we  see the mucous secretions, which are con-
nected with the  internal senses, and depurative eliminations, and
the lachrymal secretion, which appears very analagous to the mucous.
   Passing afterwards to the digestive function,  we shall there find
secretions that are destined to assimilation, and we shall study them,
commencing with  the sense which begins  the task of this very
important function. Such is the order that we propose following in
this chapter, reserving for that of  generation the secretions which
serve for reproduction and the  nourishment of  the new being.

          Section I.—Of the Cutaneous Secretions.

   They are confided to the glands situated in the very tissue of the
skin itself, of which they are folds, inform of a cul-de-sac, and in
which the epidermis appears to dip down to form a canal whereby
the humour reaches the cutaneous surface.   Those  glands, which
are called sebaceous, because their unctuous product is compared
to fat, are very apparent on the nose, forehead, scalp, about  the
lips,  and especially at their angles, in the hollow of the arm-pits,
on the groins, in the vicinity of the nipple, and around  the anus;
although they are not found in the other regions of the skin, analogy
leads us to place them there: sometimes,  indeed, they can be dis-
tinguished in certain individuals in some places where the)' do  not
appear in many  others; often also irritation suddenly renders them
sensible in places where before it was impossible to perceive them.
Finally, the presence of the sebaceous matter itself over the whole
cutaneous surface,  appears to  leave  no doubt of the existence oi
organs charged with effecting its secretion; but it remains however
to be ascertained, whether, the portions of animal matter which pro- 
OF THE SECRETIONS.
419
riuce the humour in question must necessarily be disposed in round-
ed corpuseules, and in a glandular form, in order to be able to fulfil
their functions.
  The sebaceous fluids consist of a mucous or albuminous  matter,
connected with an odorous and  volatile principle, which varies
according to the particular region of the body.   The fluid called
cerumen, which is secreted by the external  meatus auditorius,  is
regarded  by M.  Vauquelin  as  a compound of albumen,  and  of
thick oil, and a colouring matter.

             Skction II.—Of the Mucous  Glands.

   The mucous glands, called also follicles or cryptae mucosae, are
to the membranes of that name what the sebaceous follicles are  to
the skin, that is to say, folds of the mucous membrane in form of
a cul-de-sac, whose orifices open upon  that membrane.  These fol-
licles have not yet been discovered over the whole surface of the
mucous membrane; but here, as  with the skin, analogy leads us to
admit them.  It is not long since they have been discovered in the
pituitary membrane, where their existence  had been denied.  Be
this as it may, we shall make  the  same observation  upon these
glands that was made on the  sebaceous, viz.: the impossibility of
making an exact dissection of the capillary tissues does not allow
us to discover all the  forms of animal matter; but wherever a par-
ticular humour is found in a tissue, we are forced to conclude that
this latter is organised in such a  manner as to be able to produce it;
and when in place of one  humour we meet with many, we  must
acknowledge that the tissue is complex.  Such is precisely the case
 with the mucous membrane of  the digestive canal, and especially
of the stomach, which could have a form of animal  matter calcu-
 lated to  furnish digestive juices, although no gland destined to that
 purpose is discoverable.  Nature has made no engagement with us
 to give the  glandular form to all that can impress particular charac-
 ters  on  the mobile  and  circulating animal matter.   It  is in  the
 glands called amygdalae, that we find  collected in greatest number
 the tissues secreting mucus: they are, as we  know,  situated  be-
 tween the pillars of the arch of  the palate, and the  glandular acini
 which compose them are united by means of an areolar tissue, and
 covered bv a mucous membrane,  which bears the same relation to
 them that it does elsewhere to tissues of a similar nature. Generally, 
420
or THE SECRETIONS.
 in all points where the hollow organs which contain mucoufl mem*
 branes are contracted, the follicles are much more numerous.
   The mucus is analagous to vegetable mucilage, and contains in
 addition azote.


 Section  III.—Of the Lachrymal Gland and its Dependencies.

   The lachrymal gland  secretes the tears, which arc carried by
 the alternate movements of the depression and elevation of the su-
 perior eyelid over the whole surface of the eye, and afterwards con-
 ducted towards the great angle by the contractions of the orbicular
 muscle,  which has a tendency to approach towards its fixed point
 of attachment.   The tears are pumped up by the puncta lachry-
 malia, introduced into the ducts of the same name, then into the
 lachrymal sac, and  the  nasal canal, and finally into the  nasal
fossae.
   The lachrymal gland is  situated at the anterior, external, and
 superior region of the orbit, in a slight excavation of the os frontis;
 it is of an oval form, of  the size of a small  bean, and  composed
 of rounded granulations of a whitish colour,  lightly tinged with
 red; it is enveloped by a cellular capsule, which  furnishes to its in-
 terior numerous processes that serve to separate the globules  from
 each other.   This gland  has excretory  ducts which open on the
 internal face of the superior eyelid; these are difficult to be seen in
 the human subject, but are  distinguishable with but little trouble
 in the large quadrupeds: lastly, it receives a nerve of the fifth pair,
 and an artery, and gives origin to a vein.
   The  ocular orifices of the lachrymal ducts are called puncta
 lachrymalia; they are in number two to each side, situated  at the
 great angle of the eye, on a small tubercle of the internal extremi-
 ties of the eyelids, and consequently are divided  into superior and
 inferior.
  The lachrymal ducts, which are continuous with them, have a
 direction  at first  the superior upwards, the inferior downwards;
afterwards they both  incline inwards,  approaching and coming
together, or isolated, open into the lachrymal sac.
  The lachrymal sac is a small, membranous, oblong pouch, situa-
ted at the great angle of the eye; its internal wall is formed by the
lachrymal gutter, hollowed out of the ascending apophysis of the
•niperior  maxillary and lachrymal  bones,  and the external by an 
OF THE SECRETIONS.
421
aponeurosis;  the  inferior  presents an opening of communication
with the nasal canal.   This latter, situated behind the ascending
apophysis of the superior maxillary bone, descends backwards and
inwards, and  opens into the inferior meatus of the nasal fossa, be-
low the anterior extremity of the inferior cornet
  The puncta lachrymalia and ducts, the lachrymal sac and nasal
canal, are  lined by a mucous membrane which is continuous with
the conjunctiva and the pituitary membrane.
  The caruncula lachrymalis is a reddish tubercle placed at the
threat angle of the eye,  behind the internal commissure of the eye
lids; it approaches in its functions to the glands of Meibomius, a
species of follicles situated on the border of the eyelids,  and des-
tined to s.-erete a particular kind of mucus.
   The tears are saline; they turn vegetable blues green, contain a
large quantity of water, hold in solution a gelatinous animal muci-
lage, and  possess a small quantity of the  muriate and phosphate of
soda, pure soda,  and phosphate of lime.

             Section IV.—Secretors for Digestion.

   Of the Parotid Gland.—This  gland is  situated beneath the
concha of the ear, in a deep excavation which exists on the side of
the face, between the posterior edge of the ramus of the lower jaw,
the external  meatus auditorius, and the  mastoid apophysis of the
temporal bone, from thezigomatic arch to the angle of the jaw; its
form is that  of an irregular pyramid, the base of which  is turned
outwards.  This gland is composed of  granulations united  by a
compact cellular tissue, each of which  gives origin to a small ex-
cretory canal, which unites to the neighbouring ones to form a lar-
ger branch; these again unite with others, and terminate  all in one
trunk, of about a line in diameter, which is called the parotid duct
or duct of Steno.  This duct leaves the gland to pass over  the
masseter muscle, which it traverses transversely, and opens in  the
mouth, on a  level with the second superior molar tooth; its interi-
or is lined by a mucous membrane.
   The parotid gland receives nerves from the facial, the  fifth pair,
and the cervical plexus, and arteries which are  detached from  the
surrounding  branches.
   Of the Sub-maxillary Gland.—This is situated at the internal
side of the ramus and bodv of the inferior maxillary bone, in  the 
422
OF THE SECRETIONS.
 space left between the two bellies of the digastric muscle; it is some-
 times elongated in an outward direction as far as the parotid, with
 which in this case it communicates.  Its tissue is similar to that of the
 latter.   It has  an excretory canal called the duct  of fVarthon,
 which opens on the sides of the frcnum of the tongue;  its nerves
 come from the  fifth pair and the sub-maxillary ganglion.
   Of the Sublingual Gland.—This is placed in the thickness of
 the inferior part of the mouth, beneath the anterior wall of the tongue;
 it is of an oblong form before  backwards, in a direction parallel to
 that of the opposite  side.  Its organization is like that of the for-
 mer gland; it has no common excretory duct,  but  many  small ones
 which open separately in the mucous lining of the mouth.   Its
 nerves are furnished by the fifth and ninth (hypoglossa?) pair.
   Anatomists  do not say that the  salivary glands  receive  nerves
 from the ganglion of the great sympathetic; it is however evident,
 that these nerves pass to them, in company with the arteries, hav-
 ing the same destination.
   The saliva is composed, according to M. Berzelius, of water, a
 peculiar animal matter, mucus, the alkaline hydrochlorates, acetate
 of soda, and pure soda.
   Of the Liver.—This  gland is situated in  the  right hypochon-
 drium, which it entirely fills, and in the right  part of the epigas-
 trium, below the diaphragm, and above the stomach and  the trans-
 verse colon; it is elongated transversely, is thick and voluminous
 at the right extremity, but thin and elongated  at  the left.  The
 diaphragmatic surface is  smooth and  convex,  divided into  two
 parts, of which the left is  the smaller, by  a duplicature of the peri-
 toneum called the suspensory ligament.  The abdominal surface
 is irregularly concave, and presents three lobes separated  by fis-
 sures; the right, or great lobe,  which lodges the  gall-bladder in a
 slight excavation; the small lobe, lobulus spigelii,  situated behind;
 the left lobe, of a middle size, placed entirely  to the left, and more
 or less extended towards the spleen.   These different parts are
 separated,  1st, by an antero-posterior fissure in which is lodged the
umbilical vein, and  which separates the  left from the  right lobe;
 2d, by a transverse furrow through which passes  the vena porta-
rum, and behind which to the left  is placed the lobulus spigelii.
The vessels of the liver are the hepatic  artery, a considerable vessel
which is detached from the aorta; the vena portarum, which dips
down between the two eminences of the concave face, called por tie, 
OF THE SECRETIONS.
423
and the hepatic veins.  These latter open by many separate trunks
into  the vena cava ascendens, immediately below the diaphragm;
they carry back the  blood of the hepatic arteries and of the vena
portarum.  Its nerves arc furnished by the pneumo-gastric, or eighth
pair, by the phrenic, and by the great sympathetic.
  The proper tissue of the liver is composed of granulations of the
size of a millet seed, of a dull red hue, and of a soft consistence.
  In the middle of these granulations wind the ramifications of the
vena portarum, and of the hepatic artery and duct,—the whole en-
veloped by a cellular  membrane,  called the capsule of Glisson,
which is but the continuation of that immediately  covering the
exterior surface of the liver, and separates it from the peritoneum.
The excretory ducts of the liver, after being detached  from  each
granulation, are united to form the hepatic duct,  which is directed
towards the duodenum; before it arrives there, it is met at a right
angle by the cystic duct which comes from the gall bladder.   The
two unite to form one, which bears the name of ductus commu-
nis choledochus, and  opens  into the duodenum with that which
comes from the pancreas.  The bile does not get into the gall-blad-
der until after the union of the two canals, that is  to say, by as-
cending against its own weight.   The ductus communis choledo-
chus does not penetrate the duodenum before its having passed for
some time between its mucous and  muscular coats.   The perito-
neum covers the liver at all parts, except at the excavation of the
gall-bladder, the two inferior fissures, and the posterior edge.
  The bile is formed of water, albumen, mucus, picromel, a  kind
of resin, or of a substance that Berzelius considers as a compound
of an acid and of picromel, hydrochlorate of soda, phosphate and
sulphate of soda,  and lastly, phosphate of lime and oxide of iron.
It is only from recent experiments that picromel has been admitted,
for its existence in the bile had been denied by M. Thenard.
  Of the  Pancreas.—This  gland is situated at the posterior part
of the  epigastric region, upon the  vertebral  column, behind the
.stomach, and to the right of the spleen; it is elongated transverse-
ly, and is thinner at its left extremity than at its right or head,
called also  small pancreas.   Its tissue is analogous  to that of the
salivary glands; being of a whitish gray colour,  and composed of
granulations which are very visible to the eye.   We see in it the
ramifications and branches  of the  excretory ducts  which open
iqto the duodenum separately, or united to the ductus choledochus. 
424
Wk THE SECRETION >
 The nerves, that are distinguishable, are branches of the great sym-
 pathetic.

   Section V.—Of the Functions of the Organs of Secretion.

   The  word secretion  means a separation.  Indeed, the general
 opinion at first was, that the molecules of  the humours which are
 furnished  by  the glands exist in the blood,  and  that they  are se-
 parated therefrom  by  vessels for the purpose, which proceed  from
 the arteries, and which are called  collateral, or secerning.  The
 glands were considered as congeries, formed by the capillary  arte-
 ries which are continuous with veins of the  same kind, and by the
 collateral  canals.   It was thought that these last afterwards united
 to form canals of more considerable size, called  excretors, which
 conveyed  the secreted humour to its place  of destination.
   This is, doubtless, a very simple explanation of the  phenomena
 of secretion; but is it corroborated  by dissection and by chemistry?
 To this question it is  impossible to answer in the affirmative.  It
 is not by dissection: for, although  we can find in  a gland, vessels
 charged with the humour which it elaborates, we cannot be certain
 that these  vessels have extracted it from the sanguineous capillaries,
 since the extreme thinness of both sets does not admit of  our de-
 monstrating these anastomoses.   We cannot say,  that  the blood
 is not extravasated, and does not pass molecule by molecule through
 the parenchyma of the  gland, instead of traversing  it in small
 columns in vessels,  such as  those  of which our senses give us an
 idea.
   Secretion by means of collateral vessels is not demonstrated by
 chemistry,  since the  analysis which has  been made of the blood
 does not lead  to the discovery of all the  principles that are found
 in the products of the glands.  The bile and the  semen (I might
 also say the urine,  for the kidneys  are ranked with the  glands) are
 humours which do  not exist in the  blood, if they have not first been
 formed by  their respective glands.  It is the same with certain  very
 odorous humours that are met with in many animals, as the  civet
 eat, the beaver,  the black liquor  of the cuttle-fish, and the poi-
 sons that are furnished by the viper and other venomous animals.
The same  fact is met with in vegetables;  but I shall not apply it
to animals, though  I might be justified in doing so.
  Since we do not  find in the blood the principles constituting thi
essential character of the humours furnished by the glands,  it is 
                      OF THE SECRETIONS.                  425

impossible to admit merely a simple selection in their  tissue, or a
simple separation of molecules, which were previously disseminated
through the circulating fluids, and which require only  to be united
in order to form a peculiar matter.
   Modern physiologists, sensible of the full force of this objection,
which they themselves started, have  not hesitated to  abandon the
theory founded on  the use of  the word secretion.   It  will then be
useless to  refute the opinions of those who explain secretion by the
affinities of form and volumes, between the molecules to be secreted
and the mouths of the secreting vessels; and likewise of those who
think to give an explanation by supposing in these vessels the pre-
existenee  of the humour,  which attracts the molecules that resem-
ble it, at  the time of their passing over their orifices.   These  hy-
potheses have fallen into the discredit they merited,  and simple se-
cretion  is no  longer  admitted: the word alone remains in the  sci-
ence, though  it has changed its meaning.  The existence  of  the
proper  vessels is still admitted—but they are charged  with  the
office of preparing  the fluid of each part out of the  materials they
derive from the blood.  It is then a new composition, a transforma-
tion of fluids,  that the word  secretion represents  to the physiolo-
gists of our day.  Let us examine this opinion.
   This  transformation, or this new composition,  cannot be ques-
tioned:  it is one of the operations of organic chemistry:  but if  dis-
section does not show the direct opening  of the vessels (in which
the small  masses  of  the proper humours are detected) into  the
blood-vessels,  if this  opening is a hypothesis, the formation of  the
humour by secreting vessels cannot but be equally so.   I have al-
ready said, when speaking of the capillary circulation,  that we can-
not believe the fluids  to  be always contained in vessels, having
other vessels  within  their parietes,  and  that it was absolutely
necessary  to admit an extravasation of the molecules of mobile
between those of fixed animal matter.  Well: I think that it is in
that  extravasation  and  filtration  of  blood,  particle  by particle,
through the glandular parenchyma?,  that these  separations  and
transformations of circulating matter take place, byT which a portion
of it is made  to  appear with  attributes that it did not before pos-
sess.
   To this it may  perhaps be replied,  that this assertion is hypo-
thetical.   I regard  it  as an  inference much  better  founded than
that which had been proposed, since it rests  upon an incontestable
                              54 
426                  OF THE  SECRETIONS..

fact, the absolute necessity of the extravasation of fluids at the ex-
tremities  of the  blood-vessels.   Indeed, this necessity is demon-
strated  by  the nutrition of all the tissues; for it is not possible to
suppose secreting vessels, on account of the fixation of albumen, gela-
tine, fibrine, and the salts, in the different tissues which they form.
But if extravasation is necessary for  nutrition,  why should it not
be so for the formation of fluids?  It will  doubtless be replied,
" Why should it be so?  Could it not so happen, that the transfor-
mation of the fluids should  take place in a portion of mobile matter,
isolated from the general circulating current,  in the interior of the
secreting vessels ?"
   I think it impossible  formally  to  deny this other mode; but it
 is a hypothesis,  and I regard it as less probable than the inference
 that I have laid down,  because the changes of form in  the mobile
 matter, and the chemical compositions of the living body, must be
accomplished with a facility  proportioned  to the smallness of the
 filiform  structure,  and  because the most minute portions of this
 latter are precisely those in which the fluids are no longer collected
 in masses and contained in vessels.
   The grounds of my opinion are these. The free particles, when
 extravasated, are in more complete contact with the primitive fibre,
 and can receive  the transforming vital influence more readily, than
 when they are collected in compact masses  in the vessels.  I have
 another  reason  to  offer on this  subject: it  is, that a  certain  re-
pose is necessary to the  play of chemical affinities: now, that re-
pose, or  at least  that retardation of progress, is  more considerable
in the  extravasated fluids than in those circulating in the vessels.
The vessels, according to my view,  are destined  to  conduct the
fluids,  and  not to change their form. I think, on the contrary, that
 they must, to a certain degree,  preserve their peculiar qualities; for
 absorption, which could alter them,  is scarcely performed in the
 excreting vessels.  Whenever nature wishes to concentrate a fluid,
 she deposits it in a reservoir,  and there removes from it whatever
is superfluous, whilst the residue combines and  acquires by repose
the qualities necessary to the performance of the function for which
it is destined.
   Let us examine now the glands when in  a state of action, and
see  in what manner they concur to the completion of the functions
 to which they are annexed. 
OF THE SECRETIONS.
427
Section IV.—Of the Action and Use of the Sebaceous Follicles.

  The sebaceous glands act in an uninterrupted manner; but their
action increases whenever the skin is stimulated by friction, and
when the circulation is increased.  The humour that they furnish
serves to render the skin unctuous, whereby the impression of ex-
ternal bodies is more  easily tolerated,  and the preservation of the
temperature of the  living body  aided; since  all fat  substances are
known to be bad conductors of caloric.   It is by it that the epider-
mis is impermeable by water, which collects into drops in place of
first soaking the cuticle.  This humour  in condensing forms a kind
of layer,  so that, when we wish to  clean the  skin, we use warm
water and a soapy or  alkaline substance, which dissolves this fatty
matter. Notwithstanding this, when the skin remains a long time im-
mersed in cold water, the sebaceous humour is finally dissolved, in
consequence of the salts which that liquid contains, and the epider-
mis is allowed to imbibe the latter, and swells, whereby the  cutis is
placed in  contact with the water, which is absorbed  and enters into
the circulation   This solution does not take place with  amphibious
animals,  aquatic birds, &c. because the cutaneous oil is with them
more abundant,  and more decidedly fatty, than in the  human spe-
cies.

Section V.—Of the Action  and Uses of the Mucous Glands.

   The mucous  glands  are likewise in continual action, which is
increased by the stimulation  of the membrane to which  they  apper-
tain, much  more than by the accelerated circulation of the  blood,
though they receive  from it  also, at least in  its normal state, an
increase of  secretory impulse.  The mucus which they  furnish pre-
sents itself  to mitigate the hardness of contact of external  bodies,
and combines with them when they are liquid.  The  mucus is of
such a nature that it can be absorbed and assimilated;  it is discharged
only when  superabundant,  but is always mixed to a  certain ex-
tent with the fa?ces and urine.  It also comes off with the blood in
the ha?morrhagies of the mucous membrane; in the bronchial vesi-
 cles; it is partly dissolved in the expired air; in fine, it is a humour
having multiplied and very important uses.   It is  found in great
abundance in waters which are on the surface of the soil, on account
of the  numerous  animals  that inhabit them.   The mucus  collects 
426
OF THE
SECRETIONS.
after the evaporation of these waters, during the application of heal;
it afterwards putrefies,  and affords emanations  which  blend  and
combine with those of animal and  vegetable  substances deprived
of life.  This is a circumstance which should never be lost sight of
by those physicians who direct their attention to the study of  epi-
demics, and of medical topography.

           Section VI.—Of the Secretion of  Tears.

  The lachrymal gland is in continual action; but this is augmented
under two circumstances worthy of notice: 1. when the conjunc-
tiva is inflamed or irritated by a foreign body, a mode of increased
action  common to  it,  with  all  the other glands  obedient to  the
stimulation of the surfaces of relation  on which their excretory ca-
nals open: it is necessary to remark, that the excitement of the re-
tina, by the rays of  light, communicates to the conjunctiva an irri-
tation, of which the lachrymal gland partakes;  2. when man  is a
prey to the depressing  or commiserating  affections, the  lachrymal
secretion  is increased.   If we judge from the observation of  that
which can be appreciated by our senses, I think it will be admit-
ted, that the  irritation can arrive at the gland by  pervading the  mu-
cous surface  from the throat to the eyes.  Upon reflection, I think
I can affirm,  that in many cases the irritation pervades the sensitive
surfaces of the  mucous membranes, in the  same way that horripila-   '
tion does  that of the skin.  The contraction of the muscular tissue
adhering to these membranes always follows, and the  blood accom-
panies it.   It is thus that in the depressing passions an irritation is
generated in the epigastric centre, which spreads  to the pharynx,
and causes the blood to flow, with an increase of sensibility, toward
the portions  of mucous membrane which  line the  nasal fossae, the
lachrymal duct, and the surface  of the orbit of  the eye.  I know
that in these  kinds of painful paroxysms, the depression of the dia-
phragm is incomplete, that the blood retained in the breast is op-
posed to the return of that brought back by the  jugular veins, and
that an engorgement of blood must consequently be formed in the
brain.  But how is it  that these efforts,  which produce the same
stagnation in the encephalon, will not give rise  to a flow of tears?
It is, doubtless, because there is  in the depressing passions another
modification  than that of the violent efforts, which we know to be
purely mechanical.   Now, this  other modification appears to me 
OF THE SECRETIONS.
429
to be the irritation of the mucous surfaces of the pharynx, of the
nasal fossae, and of the eyes; it is it which causes the afflux of blood
into  those  tissues; which engorges them, as the augmentation of
their secretory action proves; which produces the same effect upon
the lachrymal  glands, and determines their super-secretion.  When-
ever this takes place, the absorbent action of the puncta lachryma-
lia is increased, and the tears flow in abundance into the nasal fossa?;
hence the frequent necessity of blowing the nose when one cries;
but that does not prevent the increase of the mucus by an influence
peculiar  to  the  pituitary membrane.   It is an  opinion  generally
adopted, that the flow of tears  is a solace to the unfortunate;  this
depends upon the visceral irritations of the passions subsiding,  like
other irritations,  by  a humoral evacuation.   Tears would, then, be
the natural crisis of the affections which excite them.   This opinion
was sustained  by one of my pupils, in a memoir ex professo, but
he had no idea of the progression of irritation along  mucous surfa-
ces.   I think  it very useful in  the explanation of many physiolo-
gical  and pathological phenomena, and hope that it may be ap-
proved of by physiologists.

 Section VII.—Of the Physiological Action of the Salivary
                            Glands.

   The salivary glands secrete very little when  the mucous lining
of the mouth is not irritated, and the small quantity  of saliva that
they furnish descends insensibly  by the oesophagus into the sto-
mach.  But, whenever mastication is exercised, or the interior oi
the mouth is in  any manner excited, the stimulation is communi-
cated to the salivary glands, and the saliva is poured out in abun-
dance by the organic action, or the contractility of the  excretory
ducts.  To this, without doubt,  the action of the muscles of the
jaw contributes, either by the pressure that they exercise upon the
glands, or by the uncommon flow of blood which they produce, in
all the vessels of the face: but this cause is far from having all that
influence which has  been attributed to it; for when the lining mem-
brane of the mouth is irritated, without mastication being exercised,
the saliva does not cease to flow in great quantity. This may readily
be observed in smokers, and all those who have  an inflammation it;
the cavity of  the mouth.
   We know that the sight or recollection, or, in other words, the
idea of dishes which please the sense of taste, likewise determines 
t30
OF THE SECRETIONS..
'he superseciet.ion of the saliva, which is then, as it were, injected
into the mouth; I think that the irritation which produces this effect
is communicated  by the brain to the organ of taste, which conveys
it into the salivary  glands,  making it to  pervade the interior of
their excretory canals.  This mechanism then appears to me analo-
gous to that of the flow of tears by a moral cause.
  Iu transports of anger, the saliva is secreted in abundance, and
remarkably altered; it is  poured into the mouth, where it appears
thick and frothy; at the same time the muscles of the  inferior max-
illa are convulsed, which produces the gnashing of the teeth.  Now
the first impulse of this singular mode of irritation appears to me to
come from the brain,  which acts  upon the pharynx  and palatum
molle.  It is from these parts,  according to my view, that the irri-
tation is propagated to the salivary glands; and if it be true, which
we cannot doubt, that hydrophobia may be produced by violent an-
ger, and communicated by the bite of the infuriated individual,  we
must believe that the saliva is then converted into venomous matter.
   The salivary secretion  is likewise much augmented during  the
venereal orgasm, especially in man, and this fact agrees with  the
observation of pathologists, who have proved that inflammation is
readily transported  from the testicles to the salivary glands, and
vice versa.  Hence it has been remarked, that the kind of anger ac-
companying violent desires for coition, which cannot  be  grati-
fied, has sometimes  been  productive of spontaneous  hydrophobia,
susceptible of communication by the bite.
   The use of  the saliva is very evident:  it mixes and  combines
with the food, by the assistance of the action of the teeth, and gives
it its first  degree of assimilation.   I  think also, that, during diges-
tion, the secretion of that  humour is augmented to a certain extent,
by the irritation which is propagated into the mouth from the lining
membrane of  the stomach.
  If the digestion be natural, the saliva is drawn into the stomach;
but when that organ  is  disagreeably affected  by an aliment,  the
saliva which the gastric irritation causes to be secreted is not swal-
lowed,  it acquires  qualities which render  it  unpleasant to  the
sense  of taste,  and we are forced to reject it  Why then  may  we
not believe, that certain well-marked shades of gastric and  pha-
ryngeal derangements can render it sufficiently irritating to  pro-
duce,  by its inoculation upon another person,  the phenomena of
hydrophobia. 
OF THE SECRETIONS.
431
  The saliva has all the qualities necessary to serve for the solution
ofalime is; it is alkaline and soapy, which renders it miscible with
greasy substances; it is  watery  and mucilaginous for those which
only  require  water and  mucus  to be divided and held in a state
of solution; but whenever inflammation of  the mucous surface of
the stomach has deranged  the mode of action of the secretors, it
ceases to be calculated to fulfil these  purposes, and the most cer-
tain  index of this is the unpleasant impression it makes upon the
taste.

 Section  VIII.—Of the Physiological Action of the  Liver.

  We have recognised in the liver two functions.   The first,  that
is to say the one first exercised, relates to the circulation; the se-
cond is that of the secretion of bile.  It is probable that the blood
conveyed in the vena portarum  is not foreign to the  formation of
the bile, since it is confounded with that of the hepatic artery in
the parenchyma of the liver; but to say with the older writers that
the bile cannot be formed but by venous blood, is,  in our opinion,
to advance too bold  a  position,  since the hepatic  artery sends
branches to each of the glandular acini that compose the liver.
  The secretion of bile is an uninterrupted  process, and a portion
of that humour, after having traversed the hepatic canal  to even be-
yond its middle, flows back into the gall-bladder.
  Arrived in the vesicle, the bile  remains and  undergoes a con-
centration  that is attributed to the absorption of a part of the se-
rum,  albumen,  and mucus that it contains.   This concentrative
absorption is analogous to that observed in all the reservoirs which
receive the product of secretion.  The cystic  bile is then strong-
er than that which comes immediately from the liver, so that the
name of gall has been applied to it, and serves to distinguish it
from the former.   The stimulation of the digestive passages great-
ly augments the formation of bile, and, moreover, determines its
evacuation from the gall-bladder.  This double influence takes place
by the irritation of the mucous lining of the digestive organs being
propagated  to that which lines  the interior of the biliary canals.
We  have already observed  that the bile was attracted to that por-
tion of the digestive canal where irritation  existed; and hence we
are led to believe, that the internal surface of the duodenum is not the
only part of the mucous membrane which solicits the secretion and 
4i*2                  OF THE SECRETIONS.

excretion of the bile. Thus, whatever be the point irritated in the
whole extent of the  digestive canal, the irritation spreads over all
the remainder, penetrates into the liver and gall-bladder,  and pro-
duces the effect  above indicated.
   Formerly the emptying of the gall-bladder was attributed to the
pressure exercised upon it by the stomach; but this mode, altoge-
ther mechanical, cannot now be admitted.  We  must  conceive.
the proper tunic of the gall-bladder to be contractile, and imagine
it obeying the  stimulation  of its mucous  membrane.  The  same
effect must take place in each glandular acinus of the liver, which
receives the  stimulation  propagated along the  excretory canals.
The blood  must then flow in a great quantity into the parenchy-
ma,  in order that the bile which is evacuated be replaced by a fresh
portion; whence it results that the more the digestive canal is sti-
mulated, the more abundant does the secretion of bile become.
   We must always establish a difference in  the action of stimulants.
All rubefacients, (as they may here be called,) such as bitters, acid
or saponaceous substances, &c. augment the biliary secretion; it is
the same case  with those medicines which  solicit the contraction of
the canal and provoke evacuations, whether by vomiting or by
stool; but  those which are astringent, and contract  the  vascular
system,  producing a permanent contraction, arrest to a certain de-
gree  this secretion, diminishing at the  same time that of the
mucus,   and relax the peristaltic and anti-peristaltic movements  of
the muscular tunic.
   In general,  a stronger and more frequently repeated stimulation
is required  to  excite the gall-bladder to evacuate its contents.   It
is thought,  in  consequence,  that the irritation of the duodenum  is
the most efficacious, and that, in ordinary digestion,  it  is at the
moment when the chyme traverses that intestine, that the bile  is
brought to  mingle with it.   Yet we may observe that it is not un-
til after violent  and  repeated efforts to vomit, that  the bile is cast
up, which  is always recognizable by its being of a deeper colour
and more bitter taste than that which comes immediately  from the
liver.
   The bile unites to the property of dissolving and assimilating
chyme,  that of being a very efficacious stimulant to the  muscular
membrane of  the canal.   It must then favour the progression and
evacuation  of  the residue of digestion.   The pancreas receives 
OF THE SECRETIONS.
433
the stimulation in the same manner and  time with the liver; and
its fluid, which is compared to that of the salivary glands, concurs
to render perfect the assimilation of the chymous matter.

Section IX.—In what manner  the  Secretions become Causes
                          of Disease.

   The sebaceous follicles,  excited by the stimulation of the skin,
contract an  irritation which converts them into so many seats of
phlegmasia.   The irritation is at first often general in the skin, and
truly sanguine; afterwards, the erysipelas becoming appeased, the
irritation persists only in the follicles, which furnish an excretion
convertible into scabs.   At other times, the disease ends in light
reddish pustules, running more or less into each other, crowned at
top by a vesicle which bursts, and the subjacent humour discharging
itself takes on also the scabby form.
   When once the irritation is established in the  sebaceous follicles,
it persists,  in common with all  others,  by an organic habit, and
spreads itself into the different regions of the skin.  This is what is
generally known under the names of herpes, tinea, &c, kinds of
sub-inflammations which vary according to the temperament,  the
degree of irritation, the region  of the skin affected, and the shade
of the phlegmasia  or sanguine inflammation in  combination with
 it, but which are ail essentially of the same nature.
   Sometimes these sub-inflammations are the consequence of irrita-
 tion in the mucous follicles of the genital  organs, and  then they
 are  termed syphilitic.   They are more especially attributed to
 the introduction of a virus following inoculation- of these  organs;
 but genital phlegmasia? are so often presented under the  sole influ-
 ence of irritation, as for example, in the  cohabitation of two healthy
 persons, the consequences of masturbation, &c, that it  is difficult
 to admit the necessary  existence of a  special  poison to provoke
 them, and that, consequently, the cutaneous affection which follows
 them, cannot be considered as dependent on that cause.  The cuta-
 neous scabby affections have, from the most remote antiquity, been
 attributed  to virus; but  herpes  and tinea have been exempted
 from such causes, and referred to an inflammatory irritation.  The
 only ones  any  longer considered virulent, are  the pustules conse-
 cutive to the phlegmasiae  of the sexual  organs, and there even al-
                               55 
4..1
OF THE SECRETION^
ready exists among physicians a numerous party who, even in all
these cases, can see nothing but irritation.
  It has been well ascertained that all the diseases of the sebaceous
follicles, which I rank as sub-inflammations, are more common and
more tenacious in certain subjects than in others;  which supposes
an innate predisposition of these  follicles to irritation.  Now, this
predisposition coincides with that in the cryptae mucosae, the lym-
phatic ganglions, and the tissues in general, which are destined to
the white fluids, or lymphatic part of our humours; hence have we
described all these irritations collectively under the title of sub-in-
flammations.
  The  mucous follicles, or  cryptae mucosae, are,  more rarely than
the sebaceous, irritated  independently of the membrane  to which
they belong; most-commonly it is that membrane  which contracts
irritation under the influence of stimulating causes, and the mucous
glands which pervade it furnish a morbid secretion, called  muco-
sity.   Indeed, this humour ceases to  have the characteristics of
simple mucus: it  is mucoso-albuminous, and very often presents all
the appearances of phlegmonous pus; at other times  it concretes,
forming membranous  productions.   Finally, there  are cases in
which the inflammation appears to have subsided in the membrane,
and to persist only in the follicles under consideration, which furnish
a very  abundant  mucosity,  and are  converted into supplementary
depurators of the skin and the kidneys.
  It is very rare  that irritation is thus circumscribed in the mucous
follicles.  It is more common  to see it harden the mucous mem-
branes  and  their  follicles, afterwards to soften the whole, and to
convert it into a  suppurating  surface which  is dissolved and de-
stroyed, and occasions a loss of substance in the whole thickness of
the mucous membrane.   Of this nature are aphtha?, chancres, and
the affections called chancrous, which are observed upon external
as well  as internal mucous membranes.  In truth, the name of chan-
cre is only applicable to ulcerations of the openings of the  mucous
membrane;  but let us  be told wherein do they  differ from  those
ulcerations which corrode the interior of the trachea,  of the  bron-
chia?, of the bladder, and of the mucous lining of the digestive or-
gans? Doubtless the difference can only be in their seat: we every-
where  see the cellular tissue swell and  harden,  when  the  ulce-
ration is chronic.    Such is the origin of schirrus, which, like the 
UF THE SECRETIONS.
435
ulcerations in question,  should be referred to the series of sub-in-
flammations,—always bearing in mind that, in most cases, it com-
mences by an acute sanguine inflammation, more or less diffused,
which, in a more advanced stage, losing its intensity,  becomes
chronic,  and is finally  reduced to a sub-inflammation of varying
extent Thus, sub-inflammation succeeds to phlegmasia in the mu-
cous membranes as well as in the skin;  but  that does not prevent
the former at times partially developing  itself, by a small pustule
upon the surface of the mucous membranes,  as  is observed  upon
that of the skin.                                          '
   Keeping in view the causes which call into play the action of the
follicles secreting mucus, we shall conceive how their morbid irri-
tation must occasionally succeed the stimulation of foreign bodies,
placed in contact with the mucous membranes,  and at other times to
the  influence  sympathetically exercised  by  another organ  upOn
these tissues.   From  this it is seen that the mucous sub-inflamma-
tions will sometimes result from the cessation of the perspiratory
action  of the skin, and  that, in other cases,  it will come on con-
secutively to the irritation of another  mucous  membrane.   It  is
thus that the mucous lining of the lungs or mouth, is affected by the
irritation of that of the  stomach;  the covering of the glans penisby
that'of the bladder or vesicula? seminales; and the mucous tissue of
the velum palati and tonsils consecutively to that of the sexual organs.
The supposition of the existence of virus  being essential  to the
development of sub-inflammations is then altogether gratuitous.  It
is, however, important to enter into an explanation of this subject:
if  by virus is understood a matter  applied to the  surface of a mu-
cous membrane, it certainly is impossible to deny the irritating in-
fluence of such a  cause.  It is thus that, in  the connexion of the
sexes, and all direct applications of the same nature, an acrid
and sanious suppuration,  the  effect  of an acute inflammation,
will inflame, excoriate, and ulcerate the mucous surface with which
it is in direct contact   But all  irritating corpuscules produce the
same effect: the concentrated acids, saline  substances,  corrosive
poisons, and the acrid juices of vegetables, inflame and ulcerate the
mucous  membranes by carrying  the  irritation into their  follicles
and entire tissue without exception; but when, as a consequence
of this primitive affection,  we see  another developed in a mucous
 membrane at  a greater or  less distance, it is not necessary with
manv  authors to admit,  for the production of this last, the absorp- 
43b
of the >r.c he nova-
tion of a virus taken  up in the first stage of the disease, and de-
posited by the circulation in the second.   Sympathy, or the simple
vital influence of an inflamed mucous membrane, is perfectly suffi-
cient to explain this transmission.   Why, indeed, should wc admit
it in certain cases and not in others,  since they  are precisely analo-
gous?  For example, when aphtha? in the mouth is produced as an
effect of gastritis, is it attributed to a virus? When that disease oc-
casions  irritation  in  the bronchia?,  whicli ulcerate and produce
phthisis pulmonalis, do we then speak of virus? The kind of phthi-
sis that I  have noticed in the Histoire des Phlegmasies has  since
then been described by the English, who have never had an ide;«
of attributing it to a virus circulating in the blood-vessels.  In those
persons who have an affection  of the liver, the skin often becomeH
herpetic; but no one  attributes these herpes, which are termed he-
patic, to a virus proceeding from the liver.  I regard them as a re-
petition,  not of the irritation of that viscus, but of one which exists
in the mucous lining of the  digestive organs, and this is a fact
which appears to me to be analogous to the  preceding.   Now,  if
the existence of a virus circulating in the humours is not insisted
on for the production of these mucous or cutaneous sub-inflamma-
tions, we cannot see, with the same authors,  why we  should  lie
forced to admit one for the repetition of the irritation of the sexual
organs in the mouth, and different regions of the skin.
   But, reply others, how many suppositions equally gratuitous will
not the  admission of such a virus exact!  It must be asserted that
it has an affinity only for a particular tissue, in order to explain why
it does  not  affect the cerebral substance,  and why it is not propa-
gated and multiplied in the  cellular and serous tissues, which are
at the same  time very  sanguineous  and lymphatic.  It is further
necessary to explain  how it is that we do not find it in the analysis
of the blood, and other circulating humours.
   It may perhaps be objected, that it sometimes attacks the mucous
membranes of the bronchia? and digestive organs.  I would answer,
in always taking part  with the opponents of the virus, that, in a
great number of cases, the inflammations and sub-inflammations of
the skin  are repeated in those organs without our once having a
thought of referring them to a virus; such again, are herpes,  which
no one ever dreams of attributing to this cause. Besides, ought  we.
not to bear in mind  the irritation that has been provoked in tliesc
organs by the antivenereal medicines, when syphilis is followed by 
OF THE SECRETIONS.
437
interna] affections? and when this determining cause shall not have
acted, will it not suffice here, as in herpes, for an inveterate external
sub-inflammation to explain the propagation of disease in the inter-
nal mucous membranes?
   The strongest objection perhaps is that drawn from the consecu-
tive irritation  of the  periosteum and osseous system.   But, alas!
rheumatism, which no one now thinks of attributing to virus, every
moment produces the same effects; it gives rise to exostoses, and
acute pains in the bones; and if we were unprejudiced by the idea
that these affections  always suppose the  existence of a venereal
virus,  most of those  cases  considered as indubitable proofs of sy-
philis  would  be attributed to phlegmasia.   Besides, are we well
acquainted with the sympathies of  the sexual organs and skin with
the bones? and can we not in a great measure find in them the rea-
sons of the propagation in question?  Do we not know that therirri-
tations of the  genital  organs act strongly upon  the  locomotive
apparatus?
   Finally, the last objection that can be raised in favour of the sy-
philitic virus, is the pretended necessity of mercury for its destruc-
tion; but if we consider, 1st.  that mercury does not alwa)Ts cure;
2d.  that  other stimulants as  well  as it, produce  cures;  3d. thai
we often perfectly cure by antiphlogistics,  in cases where  it ap-
peared most  indicated; 4th. that mercury  likewise cures other ir-
ritations, we  shall be forced to admit that the success of this medi-
cine, in the affections called syphilitic, is the effect of a true revul-
sion.  If, then, to this means we apply  the doctrine which directs
practitioners  in  the administration of other modifiers of the same
order (the revulsives), we shall  be able to distinguish the cases
where the antiphlogistic treatment deserves the preference over the
 mercurial, and we shall cease to administer it in those cases where
 its employment may be prejudicial.
    Such are the arguments that might be employed by the adveraries
 of a venereal  virus.  Hence it would result,  that if a virus is insisted
 on in the syphilitic affections produced  by  the contact of the ulcers
 of the genital organs,  it must be granted that the irritating pus
 which produces them,  by a true contagion, can act only locally, that
 it cannot be absorbed,  that it will  not  circulate in the blood to de-
posit elsewhere the germ of the disease, and that, if other irritations
 are manifested in different regions, they will be the effect of an in-
fluence purely sympathetic, exercised  by  the  part primitively af- 
JJfc
OF THE SECRL1 IONS.
 fected.   Such is the  species of contagion that 1 have admitted in
 many parts of my writings, in always pointing out how difficult it
 is to prove the general infection and corruption of the blood, which
 constitutes the principle dearest to the partisans of a syphilitic vi-
 rus.  Nevertheless, this kind of contagion, if admitted, will never
 prevent the phlegmasiae termed syphilitic, from being likewise pro-
 duced without inoculations, and by the  simple  effect  of friction<;
 too often repeated upon the sexual organs; which would go to prove
 that irritation, whatever be its origin, can cause them.
   I would here  terminate  the discussion of this most interesting
 subject, but there is one idea of which the partisans of virus would
 take advantage for the support of their opinion: if the lively irrita-
 tion of the secretory organs, they would say, can convert their pro-
 ducts into an irritatingpoison, transmissible by absorption, as we have
 reason to believe takes place in hydrophobia, when it is the effect of
 anger, why should not the mucous membranes of the sexual organs,
 over-irritated  by frictions too often repeated in the venereal orgasm,
 contract a mode of irritation, the excretion from which should be ca-
 pable of producing the same affection in those who would be submitted
 to its inoculation, through the pores of the mucous membrane, even
 without the long-continued friction; and why should not this poison,
 the creation of which would thus be continually kept up,  be ab-
 sorbed,  and develope in other places a particular mode of irritation?
 We do not, it is true, find it in the circulating humours; but do we
 meet with  them  in that of hydrophobia, which is here taken as the
 point of comparison? Besides, there are several viruses which can cir-
 culate in the humours without being perceived.  The miasmata of the
 plague, yellow fever, all typhous fevers, variola and measles, can no
 more be detected b)^ the chemist than that of hydrophobia, and yet
 no one hesitates  to admit them.  They are manifested by their ef-
 fects, which  are identical  in their  nature.   This is  all that we
 can know  of  them; and  if to these  notions  we join  that  of the
 most  successful  means of  attacking  them, must it not then be
 admitted,  that there  exists a syphilitic virus having  a particular
specific?
  I certainly would not venture to deny  the possibility of an exal-
tation of action in the sexual organs, capable of creating a product
very irritating to  the mucous membrane,  when inoculated by
it  1 might  perhaps admit that this  product  absorbed,  would
be susceptible of carrying the irritation to other parts;  but it is not 
                     OF  THE  SECRETIONS.                  439

khe less proved, that very often some of the grades of the irritation
which result from it can be perfectly destroyed by antiphlogistics;
that in others revulsives present more advantage; and, finally, that
mercury is of the number of those which oftenest succeed.   But
the facts  in the sequel will perhaps be able to throw a greater light
upon  this question, which I abandon to continue the exposition of
the diseases of the secretory organs.
   We have seen  by what causes the secretion of the tears can be
excited.   When that secretion is carried too far, we find phlegmasiae
supervening, of which some are peculiar to the lachrymal glands,
and others to the portion of mucous membrane which partakes of
their  irritation; for the glands cannot be affected alone in cases of
this kind.  The eyes become red, the retina engorged, the sight
diminished, and all the chronic phlegmasia? of the orbit of the eye,
not excepting cataract, are  apt to make  their attack.   The con-
junctiva contracts, together with the lachrymal sac and nasal canal,
a state of habitual congestion which narrows the lachrymal passages
and produces fistula.   The  gland  itself tumefies, and becomes so
irritable, that the slightest stimulation is sufficient to produce a flow
of tears.   Wc may readily imagine what might be the consequence
of this permanent state of irritation.  There often results from it the
total loss of sight, and even that of the organ which is its instrument;
for the other effects of the depressing passions, we refer to what has
been  said in the history of the functions of relation.
   Onions we know exhale a gas which is very irritating to the con-
junctiva and  lachrymal gland.  If persons who are exposed to  the
handling of these roots, do not become accustomed to them, there may
ensue chronic phlegmasiae, similar to those which we have just in-
dicated.   The same  effects result  from smoke, and  all  the causes
which exercise a special irritation over the ocular apparatus, and par-
ticularly on the lachrymal secretion.
   We rarely see salivation,  produced by  irritation  of the mucous
membrane of the mouth, end in  an  inflammation of the parotids
and other salivary glands; yet this termination is not impossible.
A considerable tumefaction is indeed observable about  the lower
maxilla, during the course of a  mercurial salivation; but the state of
the glands under  these circumstances, has not been sufficiently ob-
served to enable us to  determine whether or not they  undergo a
disorganising phlegmasia.  We know that they are irritated; that is
the principal  point; and hence we can conclude, that if any accidental 
440
OF THE SECRETIONS.
stimulation should supervene, for example that of cold acting upon
the surface of the skin covering the gland, they would be  able to
contract a very acute inflammation.
  All physicians know that the parotid glands often become phleg-
monous as a consequence of the gastro-enterites which  have  not
been attacked, at their commencement, by a sufficiently powerful
antiphlogistic treatment.   As the mucous membrane of the pharynx
and mouth is always first irritated in these cases, as well as in those
in which the parotids are not affected, we think that the inflamma-
tory stimulus reaches them  by the propagation of the irritation of
the membrane lining the mouth; indeed, we have seen that, during
the attack of  gastritis, the salivary humour was always depraved,
which supposes that the organs that furnish it are irritated.  We
must not then be astonished that this irritation should sometimes go
on  even to the point of inflammation.  As I have already mention-
ed the part performed  by the irritation of the salivary glands in the
phenomena of hydrophobia, I  think it useless to repeat it.
  The salivary ducts are susceptible of contracting particular in-
flammations.  Their orifices may be obliterated in consequence of
phlegmasiae of the internal membrane of the mouth, which sometimes
produces very considerable  tumours.   Thus  we  see cases where
the decomposed saliva furnishes concretions  which obliterate the
excretory canals.  It  has not yet been determined, and there is
nothing more difficult  to ascertain, in what this disposition of the
glands to secrete a saliva susceptible of furnishing concretions con-
sists: the irritation of the stomach, and that of the mouth, may with-
out doubt in some measure contribute to it, but observation has not
sufficiently cleared up  this difficulty.
  There are cases where the secretion  of saliva  becomes so easy,
from having been excited by  phlegmasia? of  the  mouth, that the
slightest suppression of perspiration produces very inconvenient
salivation.   In these  instances, the glands which furnish  it have
become vicarious to the depurative organs.  This irritation should
be placed in the number of sub-inflammations.  It is the  same case
with those habitual salivations which return periodically at certain
hours of the day, especially at that of rising.   It would  be neces-
sary to examine often  the condition of the salivary glands in those
who have been subject to this inconvenience,  in order to ascertain
if they present any traces  of jDhlegmasiae or sub-inflammations. 
OF THE SECRETIONS
441*
   The secretion of the liver, when regarded as the cause of disease
 merits a particular attention. We are aware of the importance attach-
 ed to it by physicians, in this respect, during the reign.of the humo-
 ral theories; and it is known that ontologists, in all their variations
 of language, are far from having made any change in the fundamen-
 tal ideas of their predecessors.  We are indeed no longer told of ca-
 cocholia or corruption of the bile, but we have gastric derangement,
 in which the bile furnishes the principal indications.   It  is no longer
 said  that this fluid is thrown upon such or such parts of the body,
 but we are advised to treat the gastric derangement, to which the
 affections of these parts  are made  subordinate,  by the medicines
 that  evacuate the bilious humour.   Although bile be not so power-
 ful a cause of diseases as has  been  believed,  it must however be
 admitted  that it  can give rise to some.   We shall discover them
 while examining into the manner in  which  the biliary secretion
 may produce a pathological condition.
   We  will first repeat that the secretory action of  the liver, al-
 though essentially continual, augments or diminishes according to
 the degree of stimulation of the alimentary canal, and  we will en-
 deavour to ascertain how these changes are converted   into causes
 of disease.
   Called to the stomach, in gastric  irritations suddenly developed,
 the bile there causes an unpleasant sensation which is extended into
 the mouth, where its character is recognized by the taste, and pro-
 vokes nausea or even vomiting.  The more the sensibility of the
 internal membrane of the stomach is exalted,  the more considera-
 ble is the sympathetic disturbance which results from the presence
 of bile: we may then affirm that this humour is increased by the pa-
 thological condition of the stomach; but it should be understood es-
 pecially of the cystic bile, which is incomparably more stimulating
 than  the hepatic.
  When the  irritation  occupies  the small intestine,  the  bile no
 longer  flows back into the stomach; it accumulates in the phlogosed
 points  along the intestines, as is shown  by post mortem  exami-
 nations; but the  symptoms dependent on it  are  not  sufficiently
distinguished from those which proceed from phlegmasia properly
so called, to enable us to indicate them with precision.   We have
only the yellow colour of the lingual mucous covering,  the yellow-
 ish tinge of the skin, and the bilious odour, to guide us  in the diag-
 nosis; and ever these symptoms are very fallacious.
                              56 
442                  OF THE  SECRETIONS
   It is not thus in cases where the inflammation i* developed in the
large intestines: when  the bile is poured out on them,  it i> always
attended by the colics,  tormina, and tenesmus, which  accompany
dysentery; but its stimulating influence becomes still more mani-
fest at the orifice of the rectum; for it is very evident  that the ex-
pulsion of bile produces at the anus a smarting proportioned to the
thickness and  concentration of that humour.   This is constantly
observed in dysentery, and at the conclusion of the action of dras-
tic purgatives; the stools are then always preceded  by strong tor-
mina, which always disappear after the passage of a  thick bile,
the contact of which is  very irritating to the podex.
   In some cases, of rare occurrence indeed, the bile caused by cer-
tain moral affections, such as anger, is so acrid, at the moment of
its excretion, that it irritates the  mouth, the fauces, and orifice of
the anus,—which leads  to the belief that to it may be attributed the
violent pains of the stomach  and  the  tormina  that precede and
determine its discharge.
   If we examine into the effects of bile, when secreted in  excess,
upon the ductus choledochus and gall-bladder,  we shall not obtain
such  satisfactory data.  What are  termed  hepatic colics attributed
to this cause, are far from being always  dependent on it;  they are,
in most  cases,  nothing  more than  painful spasms of the pylorus
and duodenum.   Besides, the sensibility is not considerable enough
in the biliary canals  to  cause sensations in them similar to those
kinds of colic.   The gall-bladder,  being  more susceptible of in-
flammation,  may without doubt  suffer from the  presence of the
bile, to such  a degree that  there results from it particular pains re-
ferred to the region occupied by  it:  yet these  cases must be rare,
for many persons show  after death  concretions of bile  (biliary cal-
culi) without ever having complained of what are called bilious co-
lics, or any painful sensation in the right hypochondrium.  It is then
very difficult, not to say impossible, to determine to what extent irrita-
tion is caused by the presenceof bile, in the diseaseswhich interest the
liver and its excretory apparatus. Whenthe secretion of the liver isex-
cited by a gastro-enteritic irritation, which produces at the same time a
constriction of the duodenum, the  superabundant bile, no longer
finding its ordinary passage of  elimination from the liver, remains
in it,  while at the same time that which fills  the excretory canals
reascends.  There is then a kind of retrograde motion  of this  hu-
mour, which impels  it  towards the liver, where it is  already su- 
                     OF THE SECRETION-.                  413

perabundant: anti  the ordinary result of such  a morbid condition
is the absorption of the superfluity of the secretion, and the yel-
lou colour of the skin and conjunctiva.  This is what is meant by
the terms jaundice or icterus.   This bile, diffused through the cir-
culation, communicates its colour to almost all the tissues except
the white pulp of the encephalon, and the membranes which se-
crete the humours of the eye.   It is directed towards the kidneys,
which secrete  and eliminate at least a part of it;  it impregnates
the mucus of the membranes of relation, the perspiration and se-
rum  deposited in the areolar tissues, and  the serous membranes.
It is a source of uneasiness  to all the sensible parts;  it stimulates
more particularly the  skin  in  a disagreeable  manner, often pro-
ducing on  it small pustules; it acts, in a word, as a foreign  body
whose presence is troublesome to the economy.
   Notwithstanding  all the morbid effects of the bile  properly so
called, it is not from  it that the greater number of diseases depen-
dent on the vicious secretion of the liver proceed: the most com-
mon and most violent have for their cause the organic process which
furnishes it.  Indeed, this process  when too exalted  is converted
into an acute or chronic inflammation, which, if not  arrested, de-
stroys the organization of the liver.  This is manifested in the acute
state by the phlegmonous inflammations, which are converted into
an abscess, and in the chronic by a painful tumefaction, which pro-
duces the enlarged condition and other hepatic  degenerations that
we so often meet  with in persons who have long suffered from
chronic gastritis and  enteritis.   Post mortem examinations have
indeed apprised us that these kinds of degeneration correspond par-
ticularly with  the inflammation of the stomach, small intestines,
and especially of the duodenum; and since experience  has taught us
that  in  removing these phlegmasia? we cure the hepatic affections,
whilst  they are  exasperated  by purgatives,  it becomes evident,
for every man who wishes to reason, that the disease here proceeds
from irritation of the digestive  canal, communicated to the paren-
chyma of  the  liver, and  not to the influence of what is  properly
called bile.   I constantly find that, whatever be  the intensity of
 the phenomena attributed to bile, the alteration  and acrimony of
that humour, calmness is re-established so soon as a cessation of the
 gastro-enteritis is effected? and the bile resumes its ordinary course,
 ceasing to be an inconvenience in the interior of the digestive canal
 The indications furnished by the bile as a  foreign body necessita- 
144
Of THE Sl( RETION?.
 ting the use of  evacuants, are, however, not always  illusory; bul
 they should be restricted to a small number of cases, the pointing
 out of which I will dispense with here, since they are in the cogni-
 zance of pathology.
   It has been thought that when  the secretors were in  extraor-
 dinary action, there was a number of organic movements directed
 towards their tissues, and that they thus become the point to which
 the efforts of the vital powers arc directed.   This theory is inex-
 act.   The secretors, as has been observed  by  Bichat, are obedi-
 ent to the stimulation of the membrane of relation, upon which is
 deposited the product of their organic actions;  when  they receive
 too lively a stimulation, they indeed become  the centre of  inflam-
 mation, but it is not because the vital  power propels  the fluids to-
 wards them, but because they attract them; and, as soon as their
 vital erection is made to cease,  or rather reduced to its natural state,
 the fluxion ceases, which would not happen if the intention of the
 vital principle was to engorge them.  In admitting this mechanism,
 it is not necessary that it should act upon  the irritated  secretors,
 but rather upon the vital  principle itself.  But where does this
 principle  reside, and what are the means  of which  we are pos-
 sessed for correcting the derangements under which we suppose H
 to labour?  The seat that may, with most reason, be assigned to it,
 is, without doubt, the brain.   It  would be then necessary,  in the
 super-secretions of the liver, for example, to address our remedies
 to the brain, to cure bilious diseases.  But, except these cases where
 it is itself in a state of phlegmasia,  this practice would have no ef-
 fect.  It is, therefore, to the secretors themselves, and generally to
the neighbouring mucous surfaces, that we should address the mean*
 calculated to moderate the secretions; and these means  ought #■
 nerally to be selected, not from the evacuants, but rather from the
 antiphlogistics.
   The secretion of the pancreatic juice is obedient to the stimula-
tions which act upon that of the bile.  It is certain, that inflamma-
tion of the pancreas is less common than that of the liver; and we
have no distinct idea of the disorders which may correspond either
to the superabundance and alteration of the pancreatic juice, or to
the irritation of the gland itself,  except the inflammation  has at-
tained  the degree which corresponds  to the  phlegjiionous.  The
 fluid of the  pancreas is susceptible, like all the other products of
 the secretors, of being decomposed, and of forming  concretions, 
                     OF  THE  SECRETION?.                 445
which arise in its parenchyma or obliterate its canals; but upon this
point semeiology is not less obscure than in those of the diminu-
tion  and augmentation of the secretory action of this gland: the
painful  tumefactions of the lower region of the epigastrium "may
depend  on so many different tissues, that, according  to all appear-
ance, it will be, for a long time, difficult to raise the veil by which
the real affections of the pancreas are obscured."
  We may say of the liver and of the pancreas, what we have said
of perspiration and the tears: the lively  irritations  of the animal
economy, and that excitation of the heart which constitutes the
fundamental phenomenon of the febrile condition, sometimes ter-
minate by abundant  evacuations  of  the digestive  canal,  of which
these glands furnish the principal materials.  These  kinds of eva-
cuations likewise dissipate  the  super-irritations of the alimentary
canal produced by emetics and  purgatives; for  whenever  these
medicines do not occasion a bilious or mucous super-secretion, they
create gastritis or enteritis;  it is then a general  rule,  that all irrita-
tions have a tendency to  terminate by the elimination  of fluids.
The secretors of bile and of the pancreatic juice can,  like all those that
we have examined, contract a habit of action which  renders  them,
to a  certain degree, supplementary to the ordinary depurators: and
when they  have for a long time fulfilled  this function, they are
altered, and the glands experience a degeneration, which, when it
does not extend to the formation of purulent collections, can only
be referred to sub-inflammations.
  When the action of a secretor,  for instance that  of the  liver, has
for a long time been excited in a moderate degree,  and has pro-
duced a tumefaction with stagnation of the blood,  and fluids secre-
ted in  their respective cavities,  art sometimes succeeds in  dissi-
pating this engorgement, by exciting suddenly, and in a more ener-
getic manner, the secretory action; but this method, too often re-
peated, never fails to augment the disease  of which it is thought to
be the remedy;  we may then  rank it  among  the most  powerful
causes of the affections of the secretory  system.
  Such  are  the  different ways in  which  the  secretory  functions
may act in the production of diseases; they concur to prove that all
the vital excretions which  are  raised above the natural type, tend
to inflammation or sub-inflammation, and produce neuroses, by  react-
ing upon  the nervous apparatus, the sole conductor of stimulation<-
developed in any point whatever of the living animal economy. 
416
                        CHAPTER X.

               OF  THE  INTERNAL EXHALATIONS

   There are many  thousand outlets to the fluids which circulate in
 the vascular apparatus.  We have just examined the principal ones,
 those which give issue to the superfluous fluids, and those which
 permit the humours  destined to the  performance  of certain func-
 tions, to pass out, after being moulded^n a particular manner. There
 are others more numerous still, which favour the extravasation of a
 part of the mobile animal matter, and place it as a deposit, for some
 time, upon surfaces of greater or  less extent, whence it re-enters
 into the circulatory current
   When we reflect on those numerous outlets which  present them-
 selves in the round of the circulating fluids, we have reason to be
 astonished how there can remain sufficient blood in the vascular ap-
 paratus to furnish  nutriment  to all the  tissues.  We ask by what
 power  it  is that this fluid is retained in its vessels, and we find it
 to be none other than the elective affinity which draws certain mo-
 lecules of mobile animal matter towards  other molecules of fixed
 matter;  that is to say, this internal chemistry wholly submitted to
 the vital power which constitutes  the fundamental  phenomenon of
 the organic  functions.    Those  who have been opposed  to the
 expression vital chemistry, have  alleged  no other reason,  except
 that this chemistry  is not subservient to the same laws with that of
 inert  bodies.  But  has  this difference  ever been  contested  with
 them?  Is it not rather upon  this that I have  established the cha-
 racteristics of the chemistry of organic bodies?   Have I not repeat-
 ed to  them that it was under the direction of the power presiding
 over life, and that it could have nothing in common with the chenus-
 try of unorganized  bodies, except the changes of composition, and
 transformations of matter founded upon the play of molecular affini-
 ties.   This, then,  is what constitutes this kind of chemistry.  Is
there  any thing more-clear? or  is it the word chemistry which is
so displeasing to our opponents?   But is this word, then, only ap-
plicable to the molecular affinities of inert bodies? They wish those
of living bodies to be  designated by the  term vital phenomena: but
this term  is not sufficient to distinguish them; it confounds them 
OF THE INTERNAL  EXHALATIONS.
147
*'ith the exercise of contractility, with sensibility, and with all the
prodigies of the intellect, which are, as well as that chemistry, phe
nomena appertaining to life.  If those  gentlemen reject the  term
vital chemistry, what will  they adopt in its place,  in the state in
which the nicety of our distinctions upon physiological phenomena
place the science?  Circumlocutions  alone will be left  them.  It
will then every instant be necessary, in order to designate the phe-
nomena to which we consecrate the word employed, to use some of
the following:—vital molecular affinities;  vital  compositions
and decompositions; vital appropriation of mobile molecules by
fixed  molecules; vital disorganizations and decompositions of
the tissues, etc. etc.:  but these different modes of expression would
seem to designate  facts  altogether different, whilst they in  truth
mean the same thing, diversified by causes which we are unable to
specify.   Would it not be better to express these facts by a single
term? and does not that of vital chemistry present itself as the only
one suitable?   Indeed I cannot conceive why this opposition to the
perfecting of language so imperiously demanded by the progress of
the science.  They assume an imposing and dictatorial air, in  order
to tell us that the vital transformations do not resemble those in the
crucibles of our chemists.   They would appear to teach  us this dif-
ference, whilst it is upon it that we rest for the adoption of the
term vital chemistry: but it would be in vain,—it will ever be im-
possible to dispense with it, in our efforts to establish a classifica-
tion of physiological phenomena, without the risk of diffuseness of
language, and throwing the subject into  confusion and obscurity.
Invent another word,—it is to  me  immaterial: take it from the
Greek, though the Greeks knew nothing of chemistry; still it must
always express the same fact, the play of the molecular affinities,
under the influence of life: or, if you  do not wish  to distinguish the
life  from matter, it consists in a play of molecular  affinities, ma-
king part of the phenomena which distinguish living bodies.   AH
these petty cavils do  but little honour to these gentlemen, for they
only  announce their superficial  views,  and a want of attention in
reading new works, even though they should not  proceed from less
excusable motives.   The term vital chemistry is not of my own in-
vention, but I  have adopted it  from  Fourcroy, by  whom I have
often heard it used, as necessary to the distinctions I am forced to
establish between the organic phenomena, which the  celebrated Bi-
chat has considered in such a summary manner  that they  are still 
448
OF THE INTERNAL EXHALATIONS.
 involved in much obscurity.   When  the futility of these distinc-
 tions shall be demonstrated, I will abandon the term vital chemis-
 try; until then I will continue to employ it, and I now proceed to
 use it for elucidating  the phenomena of what is designated under
 the head of internal exhalations.

 Section I.—Of the Tissues charged with the Internal Ex-
                           halations.

   These tissues are very numerous: among the first is ranked the
 areolar, which is always moistened by  a lymphatic vapour, and a
 peculiar cellular tissue which exhales an animal oil, termed in some
 parts the fat, and in others the medulla.   These  tissues are not
 limited to the superficies of the body,  interstices of the  muscles,
 and spaces left between the many contiguous viscera: they insinu-
 ate themselves between the fasciculi of the muscle  itself,  imme-
 diately envelop certain viscera, as the heart, surround the vessels,
 to which they furnish a sheath, and with them are insinuated into
 the different parenchyma?, and even penetrate  into the interior of
 the bones.
   If we examine the cellulo-areolar tissue  in the different organs,
 we shall find that in certain regions it is filled  with fat,  whilst in
 many others it is only moistened by a lymphatic vapour; in gene-
 ral, whenever the fat might prove injurious, either  by exercising
 too great a compression, or  in  giving  to  the part  an increased
 volume, or finally, by opposing the necessary evolution of calorie^
 this substance does not exist; whilst the  lymphatic  vapour,  which
 is essentially necessary to  facilitate motion, is every  where met
 with.
  In the bones we observe two kinds of oily humour:  the central
 cavities of the long and  cylindrical  bones  are  lined  by a cellular
 membrane, which furnishes what is called the medulla; the flat
 bones have, in the intervals which separate their  two plates, an
 osseous areolar tissue called  diploe, which contains a membrane ex-
 haling  an animal oil more fluid than the medulla properly so called.
 These membranes communicate with the general cellular  tissue by
that which accompanies the vessels distributed to them, after having
pierced the external osseous stratum, always more  condensed and
harder than the internal laminae. 
OF THE INTERNAL EXHALATIONS.
449
  The fat likewise varies in density in the cellular net-work inter-
posed between the organs; it  is more concentrated about the kid-
neys, and in the sub-cutaneous cellular tissue, but is found of less
consistence  between  the coats of those  viscera that are supplied
with it.
  Next to the lymphatic and unctuous cellular tissues, we have the
membranes called by Bichat serous.  They have, we know, beencom-
pared by him to sacs without apertures, the internal surface corres-
ponding to itself, and the external being adherent to the surrounding
parts, by means of cellular filaments.  On  the same line with those
membranes  appertaining to the great viscera, such as the brain, the
lungs, the heart, the abdominal cavity, are classed the synovial and
tendinous capsules, whose free surfaces are likewise in relation with
themselves;  and the external, which correspond to cartilages, liga-
ments, or tendons, are united to these latter by a very strong and
compact cellular tissue. The vapour which moistens the first is called
serum or serosity; that  furnishing the second is  called  synovia.
These two humours, formed however of identical  elements, differ
as well as the fatty ones 4n their degree of concentration, the sero-
sity being always  more watery, and the  synovia  more  lymphatic
and albuminous; as to the areolar tissue by which  the membranes
adhere to the parts covered by them, we find in it either  lymph or
fat according to the wants of the organs.  It is thus that the exterior
of the  epiploon and  the mediastinum corresponds to an abundant
adipose tissue,  whilst the cellular  filaments  by which the perito-
neum adheres to the anterior portion of the intestines, uterus, liver,
and the greater part of the spleen, only contain general  lymphatic
vapour. There is the same arrangement in thepleuras, which have
no fat  behind  them except at the mediastinum, and in the serous
membrane of the  pericardium, which only  presents some at the
surface of the heart, and which does not off?r any between it and
the pericardiac sac, &c.   The arachnoid is the only serous mem-,
brane the external  surface of which  never generates adipose matter..
Fat is never admitted in  the cranial cavity,  and the  reason is too
evident to require  its annunciation: as to the synovial membranes,
their external surface  never corresponds to  fatty matter, except
when it no longer  lines  the articular cartilages,'and fibrous mem-
branes  called lateral  ligaments, &c.; but there are met  with cer-
tain free spaces between  these latter, as we see in the popliteal re-
                              57 
430
OF THE 1KTLKNAL EXU A I..VI KKN >.
gions, which are filled with a tolerably large quantity ot fatty cellu-
lar tissue.
   Such are the principal tissues on which the internal exhalations
are performed; we must place on the next line some  membranes
which their resemblance, as respects exhalations, has led to be ap-
proximated to the preceding ones: such in the first place are the mem-
branes that secrete the humours of the eye, and that which furnish-
es the lymphatic humour in which is bathed  the portio  mollis of
the auditory nerve.

  Section II.—Of the Physiological Action and Uses of the
           Serous, Adipose, and Medullary Tissues.

   All these tissues are to appearance of a very simple  organiza-
tion.   Notwithstanding which, the sanguineous capillary system,
some lymphatic vessels and nervous extremities are  lost  in them,
and  seem to constitute in conjunction with the cellular  lamina? a
homogeneous tissue, the dissection of which is impossible; but this
form of fixed animal matter performs certain functions which we
have it in our power to notice. It furnishes humours which are de-
posited in its interstices, and which remain there for a certain time.
Many hypotheses have been advanced  respecting the manner in
which these  humours are formed;  some have thought they were
merely separated from the blood, that is to say, secreted by colla-
teral  vessels;  others, modifying this explanation, have pretended
that  there are no peculiar canals charged with the office of select-
ing them from the blood  in virtue of an elective sensibility, but
that  they were merely exsuded by the porosities and perforations
of the arterial capillaries.
   We may readily suppose that explanations have been carried too
far.  Indeed, the collateral and excretory vessels cannot be demon-
strated in the tissues, in which we are unable even to perceive the
termination  of  the  sanguineous capillaries of  the lymphatics  or
nerves.  It  was useless then to descant on the mode of vitality of
these pretended collateral vessels, or on the perforations and po-
rosities of the arterial ones.   Besides, how can we explain by the
simple transudation through the arteries, the formation of humours
which  moisten the areola? of the laminated or serous tissue, when
we find such notable differences among these fluids?  Does not the
serosity of the arachnoid  differ from that of the pleura, and this 
OF THE INTERNAL  EXHALATIONS.
451
 I.ittcr  from the vapour of the peritoneum?   Can we compare any
 of these humours to those of  the articular and tendinous capsules?
 Are not the latter incomparably more dense and resisting, as being
 destined to moderate the efleets of a much more considerable  pres-
 sure?  The synovia  ought to be composed of rounded globules of
 extreme tenacity, and intended to roll between the smooth surfaces
 which clothe the articular cartilages, in order to prevent their im-
 mediate contact, which would produce laceration and inflammation;
 but  would not such globules be hurtful  between the  free surfaces
 of the  arachnoid, where the pressure is incomparably less  strong;
 and  reciprocally, of what avail would be a vapour of  such  tenuity
 as that of the arachnoid between the cartilages and tendons?  Each
 serous and synovial surface being subjected to very different de-
 grees of pressure, it was necessary that the composition of the
 humours  should  be  adapted to this pressure.  There is then be-
 tween  the serous,  synovial, and capsular membranes differences
 of organization which we cannot  explain, but  of which  we are
 allowed to have a conception by means  of reasoning, and on  these
 differences  depend  those of the interposed  humours.    Hence,
 the explanation by which the formation of these fluids is attributed
 to simple arterial porosities falls of itself, and requires no other kind
of refutation.
  It is still more difficult to explain by such a mechanism the pro-
 duction of fatty and  oily humours, for  they  do not exist in the
 blood:   we  are then compelled to allow that  the cells,  which
 contain these  kinds of humours,  fabricate  them immediately at
the expense of the fluids in  circulation; and  since dissection can-
 not  show us organized ducts in the form of vessels which may be
 entrusted with  bringing  about this  transformation, we are  com-
 pelled to refer it to an inexplicable kind of organic action residing
 in the walls of the adipose cells, and which, as well as the formation
 of serous and synovial fluids, can only be considered as purely a phe-
 nomenon of vital  chemistry.  In fact, even though we should  refer
 these combinations to the movements of contractility, it would al-
ways be incumbent on us to explain how the alternate condensa-
tion  and relaxation of living  fibre  can  bring  about combinations
which had no existence in the circulating fluids.   All that can be
said, in setting out from these data, is, that the movements of con-
tractility in fixed animal  matter agitate the fluids, propel them in
directions determined  by that of the vessels, force them to delay
in certain parts, and,  finally, conduct to the same place, and put in
relation with them,  certain  fluids already different in  their nature 
452
OF THE INTERNAL  EXHALATIONS.
from each other.   To this, in fact, is reduced the part ot  eontrm
tility; but whilst it gives motion to or retains the fluids,  chemical
affinities are in action, which change the combinations of the circu-
lating molecules, by drawing some of them towards the fixed ani-
mal  matter,  whence  results nutrition; and by detaching others
from this latter to restore them to the mobile animal matter, which
constitutes decomposition; finally, by producing, at the expense of
this mobile animal matter, fluids more or less differing from blood,
which gives the secretions, and forms thereby the  different serous
or synovial fluids,  which we would in vain attribute to the too sim-
ple mechanism of exhalation.
   Internal exhalation and  secretion are  then  nothing more than
two general varieties  of a phenomenon fundamentally the  same,
that is to say, the  operations of  vital chemistry, the specific diffe-
rences of which elude our view.  Now all this  being applicable to
the formation of the humours of the eye,  and that  of the  fluid  in
which the acoustic nerve  i3 immersed, I believe that it would be
very useless to be  detained with them.
   Generally speaking, there is an agreement of opinion on the uses
of the fluids deposited in the tissues which have just been examined.
The serosity of the laminated tissues and serous membranes can
answer no other purpose but that of giving suppleness to the differ-
ent organs, and of facilitating their movements of condensation,
expansion, and separation.   As it must be absorbed in a proportion
corresponding to its exhalation, it cannot contain any thing hetero-
geneous to the most healthy and nutritive humours;  and of course it
is  not stimulating in its normal state.  The  mechanism by which
it is made to  enter into the circulating  current is analogous to that
of its formation; since we must suppose a  play of molecular affini-
ties between this humour and the porosities by which its  suction is
accomplished.  Vainly will it be attempted  to weaken this propo-
sition by alleging the absorption of a number of liquids foreign to
the animal economy.   I would reply,  that these latter are often
united by affinities with living matter.   This question will receive
development when we treat of general absorption.
   The uses of the adipose matter are more numerous than those ot
the serous and synovial humours. It has in the  first place, in com-
mon with these latter, the  office of facilitating the motion of one
part  on another; but, in  addition to  this, we  attribute  to  it  the
faculty of aiding in the preservation of the temperature suitable to 
OF THE INTERNAL EXHALATIONS.
453
the human body, by opposing in its character of bad conductor the
too rapid evaporation of caloric.   Experience is conclusive on this
point: we know that the fat abounds around  the principal organs,
that it protects them all by being  accumulated under the skin, that
persons who are deprived of it support the cold worse than those
who are abundantly supplied with it, and that  these latter cannot
be acclimated  in arid regions without losing a great part of their
fat.  Finally, we have observed that the warm-blooded animals of
cold  countries are fatter  than those which inhabit the equatorial
climates.
   The third use of fat is relative to nutrition.  In fact, though we
find  none in the blood, at least during the state of perfect health,
we observe  that this matter is only accumulated when the wants of
nutrition are gratified, and  that it disappears whenever  the body
does not find in digestion nutritive  materials sufficient for its sup-
port.   But  1 am encroaching on this question, which ought to be
brought forward in the pathology of internal exhalations.
   The  fat is  likewise considered, and with  much reason, as con-
curring to beauty and the voluptuous sensations attached to the ap-
proach  of the two sexes; it gives, in  fact, roundness  to the figure,
softness to the contours, and to it more especially do women owe
their most winning charms.  In the female sex, we find it. accumu-
lated, at the age of puberty, about  the organs  which are to serve
for generation, and"rendering them more prominent,  as if to indi-
cate  the predominance of action which they have just acquired, and
to reveal  their uses.  It is to the fat that youth  owes its beauty and
freshness; it is the  index of strength and health: it announces a ful-
ness of life; and nature,  by placing it in man  around the muscles
the best defined, makes use of it as a  means of indicating their
energy, and the ability to support  labour and  privations.   In ge-
neral, we hold animals  in  estimation proportionate  to the fat by
which they are  embellished.  In a word, this  matter is the orna-
ment of animated nature, whilst the want of it  inspires us with the
ideas of weakness,  poverty, and death.
   The  quantity of marrow is, generally, proportionate to that of
the fat; and hence,  like this latter, it  abounds in a state of health,
and,  like it, disappears  in  disease.   Its use is supposed to be to
render  the bones more flexible and more difficult to  break, and to
favour their consolidation after fracture".   Might  it not be for the 
451
OF THE INTERNAL KXHALATIONS.
bones what fat is for the soft parts, a kind of deposit of the superflu-
ity of nutrition, destined to aid in their restoration in case of need?
  The fat  and marrow are,  undoubtedly, continually  renewed,
though still this change is far from being as easy and as prompt as
that of the serous vapours.  The fatty humours are  almost always
decomposed, and lose their distinctive characters, after penetrating
into the circulating current.  There are,  however, cases in which
their properties are retained, but these are more frequently within
the province of pathology.
  The tissues in which the internal exhalations are performed, con-
sist of gelatine, and enjoy contractility in a degree faintly defined,
but not the less existing, since they can return upon themselves in
a great number of cases.   They are not in  a normal state productive
of any sensation.
  As to the humours of the eye,  their use is most evident; so also
of the  liquid which bathes the pulpy expansion of the acoustic
nerve: they are destined to aid in the exercise of these  senses, and
their renewal must be much prompter than that of the oily humours.

Section III.—In  what manner the Internal Exhalations be-
                   come Causes of Disease.

  The internal exhalations are  brought about in an uniform manner,
and do  not seem to be sensibly augmented in the normal state, by
the stimulations of the organs of relation, which vibrate the nervous
system, and act so powerfully on the heart, and vascular and secre-
ting systems.  Were it otherwise, the health would never have any
stability.   Nature has therefore so ordered it, that the tissues for
exhalation  should remain  alien to the daily sympathies inseparable
from the exercise of the functions; and it  is from  not having  pro-
perly understood this truth, that physicians have admitted  so many
general diseases.  When an inflammation is developed in the mu-
cous membranes, and in the parenchymatous and secreting organs,
the cellular tissue the  nearest to the seat  of disease participates in
it, and the nature and the quantity of the  fluids which  are exhaled
in it undergo changes;  but in  the other regions  these tissues arc
not directly  affected, they  only undergo  increase or  decrease in
the quantity of their  fluids,  according as the circulation is  per-
formed with  more  or less  rapidity, or as the mobile animal mat-
ter is diverted towards another organ, or evacuated in larger quan- 
01 THE INTERNAL EXHALATIONS.
155
lily than usual.   It is in thin way that an excess of exhalation tikes
place in all the cellular tissues adjoining the seat of the inflamma-
tion, and that those which  are  remote are nearly dried up.   The
cells containing fat are then deprived of it by absorption, and the
body in general becomes thinner, whilst the parts adjoining the in-
flammation are hypertrophied.   Generally speaking, we discover
that, in this case,  it is not to the primitive affection of these tissues
that the disorder in the animal economy can be referred; in other
words, they are not affected in a primary or idiopathic manner.
  In chronic irritations of the mucous membranes, parenchyma?,
and secretory glands, when the inflammation has lasted for a length
of time, the nutrition of the cellular tissues surrounding them is
remarkably deranged.  They become swelled, and  engorged  with
lymph and a serosity of  varying thickness and deviation  from its
natural composition.  At this time, the equilibrium  between exha-
lation and absorption is destroyed in the analagous tissues of other
parts of the body; and if the inflammation of that  primitively af-
fected be not acute, if it be not sufficiently strong to accelerate the
circulation and keep up fever, if it be limited to producing an afflux
of lymph,—in a word, if it do not exceed the degree of sub-inflam-
mation, the general derangement of exhalation and absorption ends
in dropsy.   There is, in this case, a cause of disorder proceeding
from the irregularity in the internal exhalations; for the accumula-
tions of serosity are a cause of particular  derangement of the func-
tions; but,  under  such circumstances, we always find, that the dis-
ease of the internal exhalent tissues is but consecutive, and that the
derangement in the health always  commenced by  an affection of
other tissues.
  Thus, to recapitulate, the tissues on which  internal exhalation.^
are performed, become secondary causes of disease,  either by wast-
ing, as in marasmus, or by acquiring,  as  in hypertrophies and
dropsies, whenever irritation has been fixed for any  time in the or-
gans of relation.   Let us next inquire in what cases the exhalent
tissues are  primarily affected.
  The most powerful and usual causes of the primitive affections
of the tissues are external injuries; in fact, commotions, contusions,
and wounds, affect at the very instant the cellular, serous, and me-
dullary tissues; in them take place the lacerations and  ruptures which
are  attended with ecchymoses and frequent phlegmons, as we se<
after falls, shocks of the limbs produced by fire-arms, explosions « 
450'            OP THE INTERNAL  EXHALATION*.
gunpowder: to their inflammation do we refer all the phlegmons of
which surgeons usually take charge.   The tissues of relation and
the secreting organs are not, however, always exempt from irrita-
tion in such cases; but whenever they are so affected, that does not
prevent  the  cellular tissue  from suffering at the same time; and
even when the former are exempt from any lesion, as always hap-
pens in the traumatic affections of the exterior of the body,  the cel-
lular tissues are still affected.  It is, likewise, to the inflammation
of the cellular tissue we refer that met with in all wounds; on it
depend vegetations and fleshy excresences, the  growth of fungous.
flesh to excess, the generation of pus and the various aspects which it
may present, schirri,  and,  in fine, the  formation of cicatrices in
which the cellular tissue is more or less condensed and altered in its
organization.
   It is therefore in a more peculiar manner, as we have already
said, in cellular inflammation and  its various modifications of phleg-
mon, that  surgery is engaged.   As,  however,  the  phenomenon,
though local, exerts powerful effects over the  animal economy, and
is susceptible of propagation and transmission, it  often happens
that cellular inflammation of wounds and contusions calls into play
that of the tissues of relation, which had not been primitively inte-
rested; hence traumatic fevers, which depend on the secondary in-
flammation of the mucous membrane of the digestive canal and brain,
and which may be converted into alarming diseases;  hence the con-
vulsions  which an over-irritated  brain often produces; hence, like-
wise, the derangement of the secreting organs brought on by pre-
ceding irritations.  It is thus that the primary irritation of the in-
ternal  exhaling tissues becomes  a very potent cause of  disease in
the animal economy.
  We must not, however, imagine that wounds can produce irritation
only in the mucous and secreting tissues of the viscera.   It often
happens that the traumatic  inflammation of the cellular tissues is
transferred to the serous membranes of the same viscera; proofs of
which are found in the pleurisies, pericardites, arachnites, and peri-
tonites, which we see all of a sudden supervene on the suppuration „
of an external wound, and  which seem to be  excited by similarity
of structure; for the closest connexion is observed between the cel-
lular tissues and the  serous membranes.
   Next to wounds, the most frequent cause of irritation in the in-
ternal exhalent tissues, is the suppression of  the secreting and de- 
         OK  THE  DISOROERED 1XTLHNAL EXHALATIONS.      457

 purating function of the skin.  This, which gives origin to so ma»
 ny affections of  the mucous  membranes and  the  secreting organs
 annexed to  them, may also exercise a direct influence on the lym-
 phatic and adipose cells.   It  is by this means that cold, in retard-
 ing the action of the skin, suddenly gives origin to phlegmons, ar-
 ticular rheumatisms, pleurisies,  and peritonites.   Sometimes, in-
 deed, the  first irritation, supplementary and abnormal, which suc-
 ceeds to the impression of cold, is manifested on the  mucous tis-
 sues and secreting glands, which it traverses in order afterwards to
 be fixed on  the serous membranes enveloping them, or in the cel-
 lular tissue  in which they are imbedded: we have proofs of this in
 the catarrhs, colics, diarrhoea, and nephritic pains, which precede by
 some hours  and even some days, pleurisies, peritonites, and phleg-
 monous inflammations of the kidneys; but there are other cases in
 which the inflammation caused by the cold, is evidenced from the
 very commencement in  these  last tissues; and  when it suddenly
" breaks out in the articular capsules, ligaments, cellular and aponeuro-
 tic tissues, interposed between the muscles, it is impossible to say that
 it at first  existed in the mucous membranes and secreting organs.
 It is therefore evident, that the cause of which we speak, the sup-
 pression of  external exhalation, may bear directly on the internal
 exhaling  tissues, and that the disturbances, that supervene in the
 functions, owe  their  origin  to the primitive irritation  of  these
 parts.  It  is  not always acute inflammations which succeed the sup-
 pression of cutaneous depuration.  In cold and temperate climates,
 in which  the atmospherical vicissitudes are very frequent, there  is
 often developed lardaceous and  sehirrous masses, kinds of abnor-
 mal  hypertrophies, and sub-inflammations, in various regions of the
 body.   On  this  account the  post mortem alterations of  this na-
 ture are incomparably more frequent in the north than to the south.
 These facts  prove that the internal exhalations, having become pre-
 dominant, in consequence of the diminished stimulation of the ex-
 terior,  arc converted, in the tissues entrusted with  their perfor-
 mance,  into an irritation which rouses them from the torpor in
 which they  had  been accustomed to live, and places them in con-
 nexion with the organs which transmit to them inflammation and
 sub-inflammation.
   Suppressed cutaneous  transpiration exercises likewise an irrita-
 tive influence over these tissues, which follows immediately after
 sub-inflammation: I now allude to oedemas and dropsies of the se-
                                58 
458      OF THE DISORDERED  INTERNAL EXHALATIONS.
rous membranes, which we at times observe succeeding the im-
pression of cold, swellings of the  body, impeded movements, and
feeling of suffocation, which afterwards come on, as also the obsta-
cles  to the circulation and  respiration,  are here the  effects of the
primary affection of the internal exhalations.
  The same kind of alteration may be met with after the abundant
absorption of liquids, whenever the eliminators of the superfluous
serosity are not inclined to action; in such cases the internal exha-
lations become all of a sudden their substitutes.   Do  we not, in
fact,  meet with  ascites and  general  eedemas which  recognise  no
other cause than the excessive drinking of water, soups, wine, &c.
which the kidneys, skin, and other outlets for depuration, have re-
fused to eliminate.
  Heat directed to a part of the body, and the vivid and local im-
pression of intense cold, sometimes give rise in the skin to an irri-
tation, which extends to the sub-cutaneous tissue and there becomes
predominant; whence still result phlegmons.
  Mental emotions do not seem to exert a direct morbid  effect on
the  tissues for internal exhalation; but such may result by the
transmission  of that  which the passions have given  rise  to in the
tissues of relation.
  There  are  cases in which the  cellular  tissue is predisposed
in  such   an  extraordinary  manner to  inflammation, without  its
being always  in our power to give a satisfactory  explanation.
Depurations of matter are then multiplied after the slightest irrita-
tion, as if the adipose net-work had acquired  the irritability of the
membranes of relation.  Inveterate gastro-enteritis seems  to be of-
ten the cause of this.   The  puerperal state  likewise produces this
melancholy diathesis  when  the mothers refuse to suckle their off-
spring; it seems that, in these cases, all the tissues have acquired an
extraordinary inflammatory mobility, and are disposed to  become
by the slightest irritation the rendezvous of the superabundant lym-
phatic humours, which nature had destined for the nourishment of
the child.
  Whenever  the muscles degenerate and their fibrine disappears,
in order to make way for an albuminous or lardaceous tissue, as
we  often find after  chronic rheumatisms,  which for a length of
time had prevented and forced the  limb to absolute rest, this change
is owing to the development of the cellular  tissue  interposed be-
tween the mu^Hil.T' fasciculi.  We know that  this tissue penetrates 
         OF THE DISORDERED  INTERNAL EXHALATIONS.      459

between each muscle, then between the fasciculi composing it, and
finally between each red fibre, as far as they can be divided, and
to such an extent that the last cellular filaments are of a wonderful
tenuity.   Accordingly, in the diseases under consideration, the  ir-
ritation is transmitted along these very  delicate cellular lamina?, as
well as in those  which accompany the sanguineous and lymphatic
vessels; it swells them, and bathes them in lymph and fat.  It ab-
stracts, for their profit,  the vital action which ought to be received
by the muscular fibres.   This double cause,  the  superabundant  vi-
tality of the cellular tissue and the pressure which it exerts on the
muscular,  which is no  longer kept in activity by exercise, finally
brings about the  absorption of all  the molecules of fibrine, and the
organ is lost  to  its primitive  destination.   It no  longer  receives
the same quantity of blood: it has lost its temperature, and ceases
to correspond with the  centre of perception.  The aponeuroses, ten-
dons, ligaments,  finally, all that is not fibrine, all  that is purely
gelatinous, remains, but in a more or less altered state.  The ves-
sels are not destroyed,  but, as the limb consumes very little blood,
they are diminished in size.   If  the pains are considerable, if  the
neurilema be  inflamed, the nerves remain, and may even  have ac-
quired development: but this growth is pathological; it is a gela-
tinous hypertrophy, which is not by any means  favourable to mus-
cular contraction, the instruments of which have, moreover, disap-
peared.   If there be no pains,  the nerves also are  atrophied; or if
they still seem to possess any volume,  the nervous substance, pro-
perly so called,  is no  longer met with in them.
   This degeneration is then still a disease of  the internal exhalent
 tissues,  and it is their irritation that deranges the functions of the
 body.   It would not by any means be physiological to desire to at-
 tribute their fatty  and  albuminous growths to debility, still' less to
 a rheumatismal diathesis of  a  particular kind, or to a  humour.
 Rheumatism  is  truly  a disease of the gelatinous and muscular tis-
 sues simultaneously;  but this disease,  which is only an  irritation,
 by rendering the  contraction of the muscular fibrine painful, con-
 demns it to repose, and thenceforward the entire vital action is di-
 verted from this fibrine  and fixed on  the tissues which  are inter-
 posed between the muscular fibres.  The  tendinous capsules,  and
 all  the adjacent cellular tissues,  also participate in this irritation,
 whence result fatty and  gelatinous engorgements  round the tendi-
 nous attachments as well  as around the articulations. 
1<)0      OF THE DISORDERED  INTERNAL EXHALAIION^
  In paralysis from irritation of the brain or muscular  nerves, \\t
meet  with a somewhat different degeneration;  we see  the areolar
tissues injected with a gelatino-albuminous lymph,  to such  an ex-
tent even  that the  limb seems oedematous;  but  the  lardaceous
growths are not so frequent, because the irritation is not sufficiently
intense to form them.   The fluids driven by the circulation arrive
also in the gelatinous areola?, and the diminished power of absorption
compels them to remain there, and hence  results  the  oedematous
state of which I spoke.                             •
  If the inflammations of the sanguineous vascular system, whether
in the skin, or in the mucous membranes or their appendages,  may
be transferred to the cellular tissue, that of the ganglions and lym-
phatic vessels runs into it  with still  greater facility.   It is in the
'glandular phlegmasia? of the extremities, which form a knotty  cord
along the course of the lymphatic  vessels,  that we  meet with the
most extensive phlegmasiae and most abundant suppurations; and
when these adenites pass into a chronic state, whole limbs are  seen
converted into great albuminous  or  lardaceous  masses, as in the
glandular disease of Barbadoes.  Thus the external adipose tissue
is placed  between two others from which it  may receive irritation;
the skin on one side, as we see in  the elephantiasis of the Greeks,
which  begins by the inflammation of this envelope,  and  on the
other side the  lymphatic vessels,  the neglected inflammations of
which give rise to those monstrous engorgements of which  I have
spoken above,  and to which is referred the elephantiasis  of the
Arabs.   In all these  cases there is hypertrophy and vicious irrita-
tion of the cellular tissue.  Such is also that peculiar disease of the
cellular membrane in new-born infants.
  The  medullary membrane of the  great  cylindrical  bones, and
even of those of the spongy kind, abounding in diploe,  receives ir-
ritation from  external  violence; it likewise penetrates there  after
being developed in  the articular ligaments  in the gouty and rheu-
matic, and after syphilitic  inflations which  had, commenced in the
mucous surfaces of the genital organs.  Hence those swellings of the
bones, called spina ventosa, in which enormous lardaceous  masses
are developed in  the medullary canal, cause a diluting, thinning,
and softening of  the external surfaces of these bones, formerly so
hard,  and terminate in the carcinomatous degeneration.   These
diseases are, it must be acknowledged, of rare occurrence; but they
do exist, and they furnish us, by means of the pains  that accompany 
        OF THE  DISORDERED INTERNAL EXHALATIONS.      4ul

them, a certain proof that the irritation developes the nervous mat-
ter, which was lost in the medullary tissues, rouses them from the
torpor of their normal state, and  establishes extraordinary sympa-
thies  between these same tissues  and  the organs of relation.   All
these extraordinary points of  irritation,—cellular, serous, osseous
phlegmasia?, are, in my way of thinking, accidental senses, because
it seems to me that  inflammation, by heating  and  softening them,
renders them somewhat  analogous to the senses in a normal state.
and, like these latter, places them  in relation with the centre of .per-
ception, the only  medium of the sympathies of  relation.  The
tumefaction of the spongy bones, their softening and caries, can only
be considered as an effect of the  inflammation always chronic, or
rather of the sub-inflammation that prevails in the medullary mem-
brane placed by nature in the cells of the  diploe.   It was at one
time  a matter of  serious  dispute,  to ascertain whether  or no caries
ought to be ranked among inflammatory diseases; we class it, with-
out hesitation, in the series of the phlegmasia? of the internal exha-
lent tissues.
   There is a peculiar state of the animal economy which singularly
favours the transmission of irritations,  formed primarily  in the
tissues of relation, to those destined for the internal exhalations; it
is designated by the title of scrophulous affection.   We shall meet
with  it again in the etiology of the diseases of the lymphatic system,
properly  so called, and on that occasion I propose  inquiring under
what circumstances it is established in the human  body.   I may,
however, remark by the way, that this  diathesis  is distinguished
by an extraordinary irritability  of those tissues, which act on al-
buminous and oily portion  of our humours, without even  except-
ing the most dense ones, and  which receive it while they repel
the red molecules, or which only admit them in a state of decom-
position,  and with a slowness of movement  opposed to the free
development of inflammation.   Such is, at least in my opinion.
the reason why irritations of these tissues exhibit a character totally
different from those manifested  in most others; and it is this well
marked difference which induces me to appropriate to such kind of
affections, a word, which, without erasing them from the list of irrita-
tive diseases, serves still  to distinguish them from common phlegma-
sia?: this word, asalready known,  is sub-inflammation; but as I pro-
pose  recurring to this topic. I shall not now make any efforts  to con- 
■IG2       OF THE DISORDERED INTERNAL EXHALATIONS-.
vince practitioners of the  necessity of admitting this expression,
or of finding another which shall give precisely the same idea.
  Polysarcia, or obesity, is the effect of a superabundance of nutri-
tive  materials, which are thus placed in reserve under the shape of
fat in the  cells  of the adipose tissue.   It  would be difficult to  ex-
plain, not why it is created, but rather still more,  why all  persons
who eat much and who do not use exercise proportionate  to their
locomotive powers, are not thus affected: be this as it may, this  ex-
uberant fat impedes all the functions, and constitutes a diseased state
which has its origin in the functions of the internal  exhalent tissues.
We do not find accumulations of serosity supervene in  the lami-
nated tissues and serous membranes, unless predisposed thereto by
disease: dropsy is in  fact never seen, like obesity, in the normal
state; but we find that persons who are very  fat,  are much more
liable to serous collections  than those which are lean  and haggard.
The explanation is usually given  in the relaxation  of  the fibre;  but
can such relaxation,  regarded as bordering on a pathological state,
be compatible with the exuberant ha?matosis which we always  ob-
serve in persons loaded with fat?
   The membranes secreting the humours of the eye, contract irri-
tation by  external injuries, and receive it from certain other adja-
cent tissues more susceptible than themselves: it is thus that blows
on the ball produce an excessive exhalation, which  is a real dropsy.
We  find this irritation likewise supervene on  violent cephalalgias,
which are then attended with opacity of the vitrcoushumourand crys-
talline lens.   On the other hand, ophthalmias of the conjunctiva im-
part to the membranes that exhale the above humours an irritative
impulse, by which they lose their transparency.   We meet more-
over with critical phlegmasia? of the eye, and sudden opacities, at
the termination of certain acute fevers, depending  more usually on
gastro-enteritis with  strong irritation of the brain, when  these dis-
eases have been treated by the stimulating method,  or abandoned
to nature.  The inflammations  of the retina and  iris  may like-
wise affect the internal exhalations of the eye, so that  the mem-
branes which are entrusted with them receive  irritation from all the
surrounding tissues,  and retain it in  a grade  proportioned to  the
impetus that communicated it to them.
  The arachnoid membrane, which is spread  out in  the  interior of
the petrous portion of the temporal  bone, is susceptible  of similar
legions: but we have not all thevvished-for dataas to the passages by 
OF GENERAL ABSORPTION.
463
which  they are  transmitted to it.   There is no doubt but many
cases of deafness,  the cause of which seems undiscoverable, owe
their origin to irritation of this serous tissue, the humour of which
is  thickened and  condensed, and compresses the acoustic nerve,
causing at  the same time its absorption.  Fresh  researches ought
to  be made on this point of pathology.
                        CHAPTER XI.

                   OF GENERAL  ABSORPTION.

  Absorption is that function of the animal economy which in-
troduces into the blood-vessels the  materials necessary to the per-
formance of other functions.   It is  exerted, 1. upon  the fluids as-
similated in the digestive canal; 2.  upon those which are suscepti-
ble  of admission by the other mucous surfaces; 3. upon  those
which are  exhaled  upon the serous membranes and in the areola
of the laminar tissues; 4. upon the  oily fluids deposited in the adi-
pose and in  those of the medullary and  diploic tissues; 5. upon
the humours  of the eye and of the  internal  ear; 6.  upon the inte-
rior  of  the excretory  canals; 7.  upon  the  cutaneous  surface;  8
finally,  absorption  is exercised at the expense of the proper fibres
of each organ and parenchyma.
  The first of these absorptions has been described when treating
of the digestive function.  It is performed, as we have seen, by ves-
sels  forming  a particular system, or a considerable  branch of the
general  lymphatic apparatus.   Among the other absorptions, some
take place by vessels which are distributed to this last apparatus;
others are supposed to be exercised  by very short vessels which  go
directly to  the  venous radicles, after traversing a very short space.
But  besides these, it  is suspected that  there exists an absorption
which cannot have  peculiar vessels, and which may be nothing else
but a separation  of the molecules  of the solids which would  be
drawn along by the fluids extravasated at the moment when  they
traverse the parenchyma*;  but  this  latter forms part of the pheno-
mena of nutrition, in which we meet with the composition and de- 
464
OF GENERAL AllSORPTION.
Composition of the solids.   This last will therefore be reserved for
the following chapter.
   General lymphatic absorption is the  only one, the agents of
which we can demonstrate: we proceed, therefore, to  present an
abridged description of these, proposing to treat afterwards of that
supposed to be carried on by small lymphatic vessels, which run di-
rectly into the venous radicles.

Section  I.—Summary Description of the Lymphatic or *lb-
                        sorbent System.

   The organs of absorption are divided  into two classes: 1.  lym-
phatic vessels;  2. lymphatic ganglions.   The  lymphatic vessels
are tubes entrusted with the office of transmitting  to the venous
system the fluids  absorbed at the surface  of the membranes  or in
the tissue of the organs. They form two planes;  the one  superficial,
the other deep-seated: the first  or sub-cutaneous, covering all the
body and all  the surfaces of the internal organs;  the second dips
down into the interior of the tissues, forming there a kind of fas-
ciculi that surround the blood-vessels, the direction of which they
follow.  These two planes communicate frequently with each other
by anastomosing branches, or in plexuses common to both.
   The arrangement of the absorbent radicles, or the origin of the
absorbent vessels,  is entirely unknown. When the lymphatic ves-
sels  begin to be perceptible, they are already at  a distance from
their  origin.   Their volume is  less than that of  the arteries and
veins, and their form cylindrical: but they present at different in-
tervals dilatations  of  a greater or less size, which correspond  to the
valves situated in their interior.
   These vessels originating in all parts of the body, unite, anasto-
mose, and form plexuses passing through  the lymphatic ganglions;
whence arises the  distinction of lymphatic vessels into afferentia
for those which arrive  in  the  ganglions, bringing the fluids that
they have absorbed; and into efferentia for those which go off from
these  ganglions, conducting their fluids  into the  venous  system:
finally, these vessels empty themselves  by several  trunks  into the
sub-clavian and internal jugular veins.   Two of  these trunks are
much larger than the others: these are called, the one thoracic
duct,  the other great right lymphatic vein.  This last, equalling
almost in size the thoracic duct, is extended obliquely to the  right 
OF GENERAL ABSORPTION.
465
 upon the  transverse apophysis of the  last cervical vertebra,  and
 opees at the angle formed  by the right internal jugular and sub-
 clavian  veins, after a course of about a  third or a fourth of an inch.
   The lymphatic ganglions are small bodies of a variable form,
 but in general rounded, varying in dimensions  from the tenth of a
 line  to the size of a filbert, situated here and there on the course of
 the lymphatic vessels, to the number of six or seven  hundred, but
 collected in the greatest number in the vicinity  of the  articulations,
 in those parts where the cellular tissue is most abundant, as the
 groins, the arm-pits, the lateral and inferior parts of the neck, and
 in the thoracic and abdominal cavities. They are designated by their
 situation,  according to the region which they occupy: upon one
 side they receive the  lymphatic vessels  which have  absorbed the
 lymph,  on the other they give passage to those which convey it into
 the venous system.  The texture of the vessels and lymphatic gan-
 glions has been before described, when treating of the  digestive
 function.

 Section II.—Physiological Action of the  Absorbent  System.

   Although all the absorbent vessels  communicate with each other,
 it is very evident that the lymphatic ganglions are met with more
 particularly upon the route of the absorbents which  return from
 the skin or from the internal  surfaces of relation; in fact, all those
 of the exterior terminate in the ganglions situated about the articu-
 lations, in the groins, and the cervical region.  These  last are also
 in relation with the lymphatics which arise from the salivary, ducts
 and from the mucous membrane of the mouth:  the internal surface
 of the digestive canal conveys its  own into the ganglions of the
 mesentery, and of the different omenta, and these ganglions com-
 municate with others which have received the lymphatics arising
 from  the excretory ducts of the bile,  and from those which belong
 to the pancreas.  The lymphatics of the bronchia? and  of the lungs
 terminate in the ganglions called bronchial, which are  situated, in
 part,  about the ramifications of the bronchia?,  and in  part in the
 mediastinum.   From the urinary surfaces, and  from those of the
 genital organs, the  lymphatics run either to the ganglions of the
 abdomen, or to those of the groins.  From this we see that the
ganglions are disposed  in such a  graduated manner,  that the fluids
arising from those of the exterior, in following the passage of the
                              59 
466                  OF  GENERAL ABSORPTION
1} mphatics, pass successively into others more deeply seated, until
thev have reached the central lymphatic  trunks which  are to de-
posit  them  in the veins that convey them to the right auricle,
consequently into  the current of black blood.
  The lymphatic system is then an appendage of the great general
venous system.   This arrangement was yet unknown at  the time
of the discovery of the circulation: the veins, in the opinion of all
anatomists, were entrusted  exclusively with  the different absorp-
tions: they were deprived  of this office after the labours of Mas-
cagni, Cruikshank, &c, and  all absorption was attributed to the
lymphatic system.   At  the present  time opinion begins to be di-
vided:  no  one denies to the  lymphatics  the  office  of convey-
ing and  depositing  certain fluids into  the large veins  near the
heart, after having made them traverse  a  long course;  but  it is
thought that we  ought to admit a much  shorter  passage for other
fluids, which, from the surfaces where absorption is carried on,  must
be introduced immediately into the venous radicles. Wemay express
ourselves in the manner of the ancients, by saying  that the veins
absorb.   The  experiments tending  to  prove this fact  may be
found in  the different works of M. Magendie.*  We had at first
thought that it was executed  by small canals,  which, after having
obtained  from  the  surfaces  a  fluid  different  from  the blood,
water for  example, deposit it,  after  a  passage  more  or  less
short, in the venous radicles;  which would establish two classes
of lymphatic absorbents: the first,  forming  part  of the general
system,  would  be  the   great  lymphatics;  the second,  without
any communication with this system,  would be called the  small
  * M. Magendie insulated by two ligatures a portion of intestine, dividing with
great care  all  the chyliferous and  lymphatic vessels, arteries, and veins, with
the exception of a vein and an artery; he then divided the intestine, above and
below the two ligatures, in such a manner that it had no connexion with the re-
mainder of the body, other than by  this single vein and artery ; he injected into
it a decoction of nux vomica, and, in six minutes afterwards, the effect of the poi«
son was manifested. M. Segalas, a pupil of M. Magendie, repeated this experi-
ment, but he left no communication between tlie portion of the intestine with the
remainder of the bod)', except the chyliferous vessels,—all the arteries and veins
being divided;  he injected halfa dram of the alcoholic extract of nux vomica, and
the poisoning did not take place, even after half an hour ; but when he freed one
of the veins which had been merely tied, and not divided, the poisoning took place
immediately.  Others have nevertheless discovered  (Tiedemann and Gmelin)
substances not alimentary (prussiate of potash) in the thoracic duct. 
OF GENERAL ABSORPTION.
467
lymphatics, or the short absorbents.   But to sustain this opinion,
we ought  to be assured that absorption is always performed at
its origin,  by organized canals;  which  it is impossible to affirm,
since dissection has not enabled us to distinguish the particular ab-
sorbent mouths.   It might indeed happen that the fluids, deposited
upon the surfaces, were pumped  up in virtue of the affinities of vital
chemistry, and at first,  in a true state of extravasation, introduced
molecule by molecule, between those of the fixed animal matter; and
that there,  confounded with the blood also extravasated, these mole-
cules  might be seized upon sometimes by the venous radicles, and
someti mes by those of the general lymphatic system, accord i n g as their
affinities would direct them towards one or other description of ves-
sels.   The greatest obscurity still exists on this point of physiology
which forms part of the mysteries of the capillary circulation, a cir-
culation which obeys, as we have already seen, the unexplained laws
of the molecular affinities of vital chemistry.   If the phenomena of
absorption  were performed in this manner, it would be correct to
say that the veins absorb; but it would remain  to determine what
are, among the  substances  submitted to  absorption,  those  which
ought to traverse the great lymphatic system before being admissi-
ble into the veins, and those which are privileged to penetrate im-
mediately into these vessels after they  have been  pumped up by
the animal matter of the surfaces.  The following are some data,
which,  it seems to us,  might serve as a means of leading to  thi*
discovery.
   Since the most considerable lymphatic ganglions are found in the
route of the fluids which traverse the absorbents of the surfaces of
relation, may it not be presumed that these ganglions co-operate in
assimilation?  Their structure supports this conjecture, for they do
not consist entirely of convolutions  of  lymphatic vessels, but are
also parenchyma?,   having  a  proper tissue, nerves,  and sanguine-
ous vessels, arterial and venous.    The lymph which reaches them
cannot, then, remain in  condensed columns, as  it was in the vasa
aflerentia, but must be extravasated there and submitted to the ac-
tion of the vascular affinities which modify it, so that, when taken
up by the vasa efferentia, it has made some progress in assimilation.
If the necessity or even utility of this elaboration be admitted, we
can conceive that the fluids imbibed by the different surfaces should
be divided into two kind.-: the one will be admitted directly by the
radicles of the veins: the other will be attracted towards the great 
46a
OF GENERAL ABSORPTION
lymphatic apparatus, and will have to traverse it before mixing with
the blood.  Now, our modern physiologists have admitted this di-
vision upon the surface of the digestive canal; if we believe them,
the chyle arising from compound  solid  aliments must necessarily
traverse the mesentery, and, consequently, the ganglions which it
contains; wmilst water, absorbed directly  by the veins, can enter into
the blood,  avoiding this long circuitous  route.   But if this be the
case, how would the  absorption of poisons by the venous system
be explained?
  Do the absorptions which are performed in the serous membranes,
the synovial capsules, the areolae of the  laminar tissue, the cells oi
the adipose,  medullary,  and diploic membranes,  those of  the
humours of the eye, the arachnoid, &c, terminate in lymphatic
ganglions?.  It would be rash to affirm  that this is indispensable,
for the ganglions that are rrret with in some of these tissues may be
destined for the fluids taken  up from the surfaces of relation.  This
much is certain, that we never find any in the interior of the cra-
nium, where absorption  does not convey any fluid coming from the
exterior.  It is generally believed that  the serosity of the arach-
noid membrane enters directly into the small veins of the pia mater.
  Be this as it may, we cannot confidently affirm, that the lymph,
absorbed from the tissues which have no communication with  the
exterior, never penetrates into the  lymphatic ganglions; all that we
can  say is, that it  need not of  necessity pass through  them,
and that, among the fluids taken up  on the surfaces of relation, there
are some which are not  required to take this course,  such as pure
water,  alcohol,  &c, whilst others must necessarily be submitted to
the influence of the ganglions, and  traverse the whole extent of the
lymphatic system before penetrating into the blood-vessels.
  It may still be demanded, if, among all the fluids which are ab-
sorbed directly by the surfaces, there are not some which, from the
capillary system, may reach secreting organs without going through
the heart and the lungs.  Many anatomists have asserted, that water,
absorbed in the digestive canal, penetrates directly to the kidneys;
but as  there have  never been found any particular vessels which
could convey it, it would be necessary to admit a kind of retrograde
movement, which should cause it to pass from the capillaries of the
intestines into the renal arteries; and this would be a purely hypo-
thetical assertion. 
OF GENERAL ABSORPTION.               4o^
  At any rate, the rapidity of urinary excretion following the abun-
dant ingestion of water is greatly analogous to that of perspiration,
which occurs in preference when the skin is much stimulated,  as
is observed every day during the heats of summer. In fact, scarcely
has a man, whose skin  is greatly excited by heat, swallowed the
water, when immediately the perspiration shows itself in abundance.
It will doubtless  be  alleged, that it is not the water drunk which
can make its way to the surface in so short a period; but here is
another fact well worthy the  attention of physiologists.   In for-
mer times, when the question was  put by water, the accused was
made forcibly  to swallow  a quantity of this  liquid, so that the
stomach was horribly distended.  Well,  what was done to preserve
him from the ill consequences of this excess? The abdomen was ex-
posed to the heat of an open stove;  immediately the sweat poured
outabundantly from the whole of the skin, and particularly from that
of the abdomen, and in some  minutes the bulk of this part was  re-
duced to its ordinary dimensions.  It was facts of this kind, and others
of an analogous nature, which induced Bordeu to believe that the
fluids traversed in every direction the cellular, which he called mu-
cous tissue. We confess that there still exists much obscurity on this
point of physiology, and that we do not yet know enough, to enable
us to explain in a satisfactory manner why the liquids submitted to
absorption take the course of the blood-vessels, rather than that of
the  great  lymphatic apparatus.   As respects ourselves, we will
merely say, in a general manner, that the fluids which  follow this
course appear to us to be those which,  coming from the exterior,
require a previous elaboration in the ganglions, before penetrating
 into the circulatory apparatus; but we do not flatter ourselves with
 "iving the explanation of the exceptions to which this law shall be
 liable.
   Absorption  is performed in an uninterrupted manner; but many
 circumstances  cause it to vary.   The facts just related  prove that
 whenever an excretion is increased, absorption is also in the same
 proportion; consequently it must be admitted, that when the sweat
 flows  out abundantly, contractility is singularly increased in  the
 lymphatic system, and in the veins. But are we to believe that the
 pulsations of the heart are accelerated in the same proportion? We
 do not think that this condition is indispensable. We sometimes see
 that, under the influence of diuretics,  absorptions  suddenly take
 place, which carry off the serum collected in the peritoneum: and 
470
OF GENERAL ABSORPTION
the kidneys eliminate, in a short time, all this fluid, without any
increased frequency of the pulse takpg place; yet we must concede
that the acceleration of the systole of the heart  is favourable to
absorption,  and gives rise  to  more multiplied movements in the
vascular, and consequently in the lymphatic apparatus; and thus the
state of fever always increases  absorption.   We say more multi-
plied movements, because it appears to us that the absorbent ves-
sels must, like the veins, act upon their fluid,  by alternations of
contraction  and of relaxation,  although it may be  impossible to
perceive them: perhaps at some future period that instrument will
be discovered which shall render them perceptible.
   The  mental  affections have  a  notable influence on  the pheno-
menon  of absorption; itisknownhowfartheycan increase the action
of the secretory vessels; and we have already remarked that elimina-
tion ought necessarily to augment absorption. It is the observation of
this last relation which has directed physicians to the prescription of
purgatives,  diuretics, and  sudorifics, to persons whose lymphatic
and ganglionic system is overloaded with lymph, or who labour
under what is called obstructions.  The advantages of this kind of
modification are nevertheless limited by the super-irritation  which
the stimulants  employed can produce in the mucous lining  of the
digestive  tube; for, whenever it becomes immoderate, the secreting
vessels  do not act, and the tissues loaded with  lymph attract an ad-
ditional quantity,  in place of freeing themselves  from what they
had before.
   The  absorbent apparatus  is so much  the  more active  as man is
less advanced in life.   The action of this system is truly astonish-
ing during early infancy; it preserves much of its energy in youth;
it diminishes in proportion  as the decline of  life approaches, and
becomes very feeble in old age.   In women absorption is less ra-
pid than in  men; it may be considered as existing in the highest
possible degree among persons of a rigid and robust habit,  whilst
in subjects of an opposite constitution it is always very feeble.

  Section III.—In  what  manner the Absorbent  System be-
                      comes disordered.

   In order to  comprehend correctly the etiology of the diseases of
the lymphatic system, it is  sufficient to call to mind the stimula-
tions  which it is  accustomed  to  obey, and what are the organs 
                DISEASES OF THE ABSORBENTS.              471
which sympathise the most with its ganglions.   Now, the stimula-
tions which cause the  absorbents to act are  those of the mem-
branes of relation, and the organs which sympathise the most with
these ganglions are likewise these same membranes.  In fact, when
the stimulation  caused  by foreign bodies placed in  contact with
these surfaces  determines them to the performance of absorption.
the action  of  all the lymphatic vessels thence arising, and the
ganglions in which they terminate, is necessarily increased: such is
the chief cause of glandular phlegmasia; for it is of little importance
what  may  be the object of the stimulation experienced by the
membranes of relation;  whether it be occasioned by the want  of
absorption  or by some other cause, it is sufficient that it should be
So, in order that irritation should be developed  in the lymphatic
apparatus.   We have already seen that inflammation of the internal
mucous membrane of the digestive canal  could produce that of the
ganglions of the mesentery; well, it is the same case with the phlo-
gosis of the skin:  when it exists, the ganglions to which the lym-
phatics of the part are distributed simultaneously become diseased:
hence buboes  of the groins in catarrhs of the external genital mu-
cous membrane, and even in inflammation of the toes.   All erysi-
pelatous affections cause the adjoining glands to tumefy;  inflamma-
tions of the mouth, as also those of the face and neck, produce the
same effect upon the cervical ganglions.  Let  there  arise a phleg-
masia on the  hand or the fingers, do we not immediately perceive
the glands of  the arm-pit, and  all  the lymphatics which  pass
to  it, take on  a  state  of inflammation?  Let the mucous  mem-
brane of the bronchia? be inflamed, the bronchial ganglions become
tumefied;  and,  if the  catarrh  continues, they  experience a real
phlegmasia.  It is then a fixed law, that irritation may be transmit-
ted from the surfaces of relation to the lymphatics and neighbour-
ing ganglions.
   I have endeavoured to satisfy myself whether the  inflammations
of the serous membranes produce the  same effect as those of the
mucous in the visceral  cavities, and I  have had reason  to be con-
vinced that this relation does not exist:  the peritonites, and pleu-
risies, do not induce the swelling of the glands of the  mesentery
nor those of the mediastinum; and whenever those glands are alter-
ed in the bodies of those who have died from such phlegmasias, we
 are certain to find a complication of enteritis or of bronchitis; which
confirms the conjecture hazarded above,  that the fluids absorbed by 
172
DISEASES OF  THE  ABSORBENTS
 the membranes called  serous need not necessarily traverse  the
 lymphatic ganglions.
   Although simple inflammation, absque materia, of  the skin or
 any other membrane of relation, is sufficient to cause the tumefac-
 tion of the ganglions which receive therein lymphatics from it, wc
 confess that this influence is much more marked if the phlogosis
 be caused by liquid matters, very acrid and capable of rapidly tra-
 versing the  absorbent apparatus.  It is thus that inflammations of
 the arm, after inoculation of the vaccine virus,  and those of the
 fingers caused by a very acrid matter  in dissections, act rapidly
 upon the lymphatics of the limb, which become phlogosed, forming
 a knotty cord with a reddish line, and soon become complicated
 with inflammatory swelling of the axillary glands.
   Ought not this fact to throw some light on pestilential buboes? I
 for my part believe it; for if the  plague is caused by a peculiar mi-
 asmatic poison, this might have an affinity with the lymphatic ap-
 paratus, and, whether it penetrates to it, after having been absorbed
 by the skin, or whether it reaches it by circulating with the blood,
 its presence is sufficient to excite  inflammation of the ganglions the
 most disposed  to contract it   In the histories of this disease, we
 hear of nothing but sub-cutaneous buboes; it remains now to inquire
 whether the glands of the mesentery are not in this disease more
 voluminous  and more inflamed  than we are  accustomed to find
 them in  the most common sporadic gastro-enterites.   The same
 investigation should be made with respect to the  ganglions of the
 mediastinum, for it appears to us that the mucous  membrane of the
 bronchia?  must  frequently, during the time of a plague, participate
 in the inflammation of that of the  stomach and  intestines.   I
 have distinctly  said, that in certain epidemics  of our climate the
 gastro-enterites are much more frequently accompanied by* ganglio-
 nites of the mesentery than in others;  this difference is perhaps
 owing to the presence of some miasmatic poison, the source of which
 is not well known; perhaps also it is dependent on the moisture of
 the atmosphere: what induced me to think so is, that those years
 in which  I found  the ganglions  of the  mesentery most affected,
 have been very rainy,  whilst those in which ganglionites were
 most rare, have been very remarkable for their dryness.
  This observation leads us to remark the influence of  cold, and
particularly of cold with  moisture, upon  the lymphatic ganglions;
it is clearly manifested upon subjects of a scrofulous constitution. 
DISEASES OF THE  ABSORBENTS.
473
In fact a cooling of the surface  suffices, without the co-operation
of any cutaneous  inflammation, for a painful and  truly phlogistic
tumefaction of the glands of the neck to supervene.  It is in this
way that those engorgements of the nose, lips, ears, and of the
cervical  glands observed in  spring  and autumn in young sub-
jects, whose skin  is delicate and sensible, are most frequently ex-
cited.  If the constitution be vigorous and sanguine, there results,
in the  glands  or in the sub-cutaneous tissue of the face and neck,
abscesses which often run through their period on to suppuration,
even in a  very short time; but if such diseases be more  lym-
phatic than sanguineous in their nature,  the  adenites do not
progress with so much rapidity; they  become chronic,  and it  is
then that   they take  the name  of scrofula.  In  our  opinion,
it is solely to  the predisposition of the subjects that this difference
must be attributed, and we shall now endeavour to support this
opinion by  the best authenticated and the most familiar facts.
   Man ranks  on the highest degree  in  the zoological scale as re-
gards the extent of respiration.   In his character of a warm-blooded
animal, he  is  destined  to live  in an atmosphere unconfined and
abounding in  oxygen.   If he is deprived  of this first condition,
his lungs do not attain  that degree of development of which they
are  capable,  and the other  organs are weakened in the  same
proportion; the muscular apparatus particularly can acquire neither
volume  nor strength, because its vigour is closely connected with
that of the lungs.  Under these  circumstances man sinks  below
his original type.  From this  we perceive that when  confined
from his earliest years in the enclosure of badly aired cities, and
deep and narrow  valleys, he must necessarily degenerate.
   But this is not all: when the air which surrounds him is not
sufficiently  renewed, he is necessarily deprived of light, and satu-
rated with  water.  This double cause of debility adds always  to
the first, for the want of light  is to man the privation of a stimulus
necessary to  his growth.  It  is  in  vain for him to  obtain abun-
dant nutriment;  he cannot derive  any benefit  from it, if these
organs are  not rendered  fit for a perfect assimilation by air adapted
to the wants  of his system.   He will then under such circum-
stances make  a bad use of the nutritive materials, and his develop-
ment will never be complete.    But if we add to these two causes
of weakness  the  humidity with which the air he breathes is satu-
rated,  we  shall find that the abundant evaporation,  which always
                               60 
474
OF GENERAL ABSORPTION.
takes place from his own body, will not be  dissolved; his vessels
will then remain surcharged with lymph; he will become chilled,
particularly if the air is deficient in caloric; he will no longer have
sufficient fibrine, and colouring matter; he will not regain regu-
larly his heat when it has been abstracted, and his tissue, moisten-
ed and  relaxed, will not have that readiness to free and energetic
inflammation, which is remarked in those of his species who  live
in diametrically opposite states of the atmosphere.  It is thus that
a diminution of the respiratory power will bring on a degeneration
of the temperament of man, and will render him  more predisposed
to lymphatic maladies.   Let us now proceed  to  investigate the
manner in which they are developed, and what relations connect
them with other irritative diseases.
   The  deficiency or the weakness of the power which presides
over the composition of the tissues, must, in our opinion, produce a
double  effect:  1st  to  render the solids less coherent; 2d.  to es-
tablish a plethora of the lymphatic fluids: is it not in this that con-
sists the predisposition to scrofula,  or the scrofulous, called also
strumous diathesis?   But in what part is this  disposition more
particularly manifested? Is it not in the gelatinous parts, at a dis-
tance from the centre, and where  the sanguineous system has the
least degree of predominance?  It will be then the tissues which
compose the  frame of the body, the fibrous membranes which cover
it, the tendons, the ligaments, the lymphatic vessels, and the  sub-
cutaneous ganglions, which will be the first affected.  But what will
communicate the irritation to them?
   The skin,  a membrane formed of gelatinous tissue, abounding in
white capillaries, either lymphatic or secretory, possesses in fact a
sanguineous  net-work; but during infancy it has not yet acquired
the degree of power to  which it is destined.   Nothing is easier
produced, under the influence of cold, than the diminution of the
sanguineous circulation of the skin,  and that of the cutaneous trans-
piration.  The power of reaction  is not however entirely deficient;
the skin, chilled at every moment by the subtraction of its caloric,
has still a tendency to  become heated; but these efforts, constantly
renewed,  over-irritate it.   It  takes on  an inflammation, which,
becoming predominant in the White vessels, on  account of their
softness and  extreme  irritability,  gives rise to the  first scrofu-
lous engorgements, those of the lips, cheeks, ears, nose, fingers, and
feet; hence,  among  the white tissues, those are the most active 
DISEASES OF THE ABSORBENTS.             475
and the most sanguine, which become first irritated: they possess
action sufficiently to contract irritation, but not enough to experi-
ence it to that extent which induces us to call it sanguineous.   They
claim it, therefore, in that degree which we call scrofulous.
  This first impulse being given under the influence of alternations
of heat arid cold, it is understood that it ought to be repeated in
similar  tissues,  which, although situated beneath the  former, are
still superficial, and scarcely participate in the vivifying influence
of the internal  functions.   They possess for  their preservation in
adult age, firmness of composition, and the natural cohesion of their
molecules, which render  them  but  slightly irritable; hence they
are affected with more difficulty; but, in infancy, they are  tender
and excitable, and have not yet acquired these qualities so necessary
to the preservation of the harmony of the functions.
  They must then receive the inflammatory impulse:  and so ac-
cordingly they do in a greater or less degree in all  children,  and
particularly in those subjects in  whom the force of aggregation has
little power, that is to say, in scrofulous  constitutions.  In  this
manner the  irritation, developed in the skin,  being communicated
to the sub-cutaneous ganglions, swells and hardens the  cellular tis-
sues, softens the ligaments and tendons, and the lymphatico-adipose
masses found about the articulations and called improperly synovial
glands, and penetrates to the  cartilages and even to  the  bones,
attacking first  the most spongy and those which form the articular
surfaces; in a word, the scrofulous irritation, developed in the gela-
tinous tissue of  the interior, advances from  the  more soft  to the
more hard,  unless some accident arrest its progress.
  But,  while indicating  here the action of cold as a determinate
cause of scrofulous affections, we are  far from wishing to insinuate
that it is  the only one.   Every thing which excites irritation in
the tissues that are susceptible of it, without  producing an evacua-
tion which shall  unload them, can produce  the same result.   Scro-
fulous irritation may then commence in the midst of tissues,  which
in ordinary cases it affects only secondarily: it is in this manner that
contusions are  observed to immediately develope strumous  inflam-
mations in the  cellular tissue and in the articulations; whilst simple
wounds made by cutting instruments, heal with great facility,  par-
ticularly when there has  been a copious haemorrhagy.   These are
very notorious facts, and  cannot fail to aid  in elucidating: the que^
tion which now engages us. 
17 b'
or GENERAL AnsORPTlON
   The sympathetic irritation excited by the influence of the mucous
 membranes adjoining  the skin, and even by the  influence of that
 lining the  large viscera, may  likewise, by  acting on  the surface,
 excite the  scrofulous inflammation wThen the predisposition is firmly
 established: it is in this manner that the phlegmasias of the interior
 of the mouth affect quickly  the cervical ganglions, and even the
 salivary glands; it is in virtue of this  law  that gastritis produces
 amygdalites and  strumous ophthalmias in children possessing this
 unfortunate constitution, and gives rise on the skin to scabby erup-
 tions, which evince  all the  characteristics of scrofulous inflamma-
 tion.
   There are some individuals of the human species who pass through
 all the periods of infancy,  and even of youth, without the scrofu-
 lous diathesis, under which they labour, manifesting itself by any
 appreciable sign.  The softness of their flesh,  and the  little firm-
 ness of their  ligaments and bones,  were the only evidences  of it
 even on to adult age.  But this period arriving, an accidental irri-
 tation is often sufficient to demonstrate all  the evils attending this
 kind of organization.   It is in these subjects that the confinement
 in a gloomy and damp place, such as a prison; the suppression or
 the cessation of a habitual evacuation,  such  as the  menses; an itch
 taken by means of contagion; ringworms excited by external causes,
 or  chronic gastrites;  the suppression  of mucous drains,  or  of a
 habitual suppuration,  produce suddenly  scrofulous inflammation,
 so much the more intractable  as there does  not exist a prospect for
 their healing,  derived  from the changes at  puberty.  It is also in
 virtue of this  very deplorable diathesis, that we observe so many
 persons a prey to interminable affections of the skin,  of the mucous
 membranes adjoining  the exterior,  of  the  ligaments, periosteum,
 cartilages, and even of the  bones, when they have  been  so  unfortu-
 nate as to contract a syphilitic phlegmasia.   The more they are
 stimulated  by real or imaginary specifics,  the greater is their suffer-
 ing; the point of irritation continually changes its situation; and too
 often their maladies terminate only at the moment when the stimu-
lants with  which  they are  overwhelmed, have produced,  in the
viscera, a phlegmasia that causes their death.
  In fact, although the irritation called scrofulous commences in
the organs of the surface, it can in  a very great majority of cases
reach the viscera ; and  it is unfortunately almost always  under the
influence of medicines  that are thought to  be able to arrest the dis- 
                »iSEA^Es  OF THE ABSORBENT?.             477

ease that this dreadful epigenesis is manifested.  The viscera, being
warmer, and plentifully supplied with  blood, resist it at first, and
contract only irritations purely sanguineous, susceptible of a radical
cure; but if we neglect to combat them by appropriate means, which
destroy them in other subjects, or if we obstinately persist in the
use of tonics, the internal white tissues are finally roused into ac-
tion; and as the scrofulous predisposition, though less in the interior
than externally, still persists, the viscera  are  infarcted with  lym-
phatic engorgements which no longer admit of any hopes of cure.
The same defect of nutrition which produces the scrofulous predis-
position,  can also  become predominant  in  the osseous system ;
then the bones, no longer incrusted with calcareous phosphats, re-
main flexible, and yield to the weight of the body and  the action
of  the  muscles, thereby giving rise to many deformities.   These
unconsolidated bones  are very often extremely irritable, and con-
tract slow phlegmasias, which produce engorgements of the sur-
rounding  soft  parts.   The same remark may be  made  respecting
the progress of this disease  as upon  that of  the  preceding, with
 which  it is often  complicated.
   But  there is a viscus the affection of which is still  more inti-
mately connected with osteo-malaxy; whenever the  ossification of
 the bones of the cranium is retarded,  the brain, whose  increase is
 not confined by  them,  takes on  an  extraordinary  development
 which  it retains during life; but very frequently  this hypertrophy
 becomes  morbid  in the pulp, which degenerates, and there takes
 place in the ventricles an irritative exhalation of  serosity, produc-
 ing what is  called  hydrocephalus.  It  is difficult  to  determine
 whether this abnormal growth of the encephalon be not  sometimes
 dependent upon a primitive irritation of its tissue, rather than on
 a defect of ossification; but  it is always certain that one or other
 defect  exists with regard to the  diversion  of the  nutritive  ma-
 terials, which, not receiving the  normal  direction,  on  account of
 the weakness of the assimilation,  and the languor of the eliminat-
 ing power,  establish  a lymphatic plethora very favourable  to  the
 development and irritation of the white  tissues.
    The exuberant  nutrition of the  abdomen is also  manifested  in
 Uic scrofulous disposition, *vhen there is connected with it a slight
 enteritis,  either by the enormous enlargement of the liver and the
 swelling of the ganglions of the mesentery, or in consequence ot
 the gases which  the  irritation of  the membrane unceasingly fur- 
478
01 GENERAL An>ORPTION.
nishes.   The  lungs have not been  observed to participate in  it;
but, on the contrary, the curve of the softened ribs,  and the sink-
ing in of the sternum, produce the narrowing of the thoracic cavity,
and the compression of the lungs and heart,  which retards the pas-
sage of blood through these organs,  forces it to stagnate in the head
and abdomen, and  to  favour the plethora and the exuberant  nu-
trition which renders those organs  liable to  inflammation.  But at
a later period, when puberty directs the  last effort of growth to-
wards the thoracic organs,  we then  see them contract an irritation
so much the more violent,  as the solid bony walls do not yield to
their enlargement;  and,  if the scrofulous diathesis still  exists,  the
inflammation of the glands will succeed  that of the sanguineous
vessels,  and there will be  great  danger  of  the  occurrence  of
phthisis.
   It is in this manner that the retardation of the general growth,
and the weakness of the lungs, caused by the want of air, and of
light, and by the influence of moisture, after having produced dur-
ing infancy scrofulas and ostco-malaxy, become, at a  later  period,
the cause of the most  fatal visceral inflammations.   Let us now
examine in  what light this diathesis should be regarded.
   We have seen that it is founded on an abnormal irritation of the
gelatinous tissues, in which the sanguineous circulation  is languid;
and a very  marked irritability of those  parts which, in a  normal
state,are tiie least irritable; that in virtue of this disposition,these tis-
sues contract the  irritation  during the operation of ordinary stimu-
lants  upon  the economy;  that, when  thus  irritated, they invite
the lymph, become tumefied,  and  undergo a kind  of suppura-
tion whicli  is peculiar to  them.  This progress of things is some- '
what  analogous  to  that  of sanguineous inflammation,  and yet it
should  be  distinguished from  it; the precision of medical lan-
guage demands it, and the  words in use  do  not attain this object.
Shall  we use the  word scrofula?  It  is  founded  upon  the re-
semblance  of the  lymphatic  affections   of man to  those of the
hog (scrofa),  and does not convey an  idea of the physiological
modification taking place on these occasions.  Shall  we  adopt the
expression of white engorgement?  It does  not express any better
the physiological modification, and besides recalls ideas of obstruc-
tion through weakness, or  a supposed coarseness of the molecules
which would be disproportioned to the caliber of the vessels.  The
expression infarction (empatemens) is no better. There remains that
of lymphatic inflammation; but if we wish to designate fully this 
                 DISEASES OF THE ABSORBENTS.             479
class of irritations, the above is not a suitable term; for it supposes
inflammation, with all its properties, in the white tissues, which is
by no  means the fact.   This inflammation is possible, in some of
them,  such as the ganglions, the secretory glands,  the cellular tis-
sue, and  the  serous membranes;  but  it does not always exist in
them,  and the tumours adduced  as examples  of it are  the very
ones  in  which it does not exist.   Shall  the term chronic  be
added?  This term will still demand an explanation: it will be ne-
cessary to say that this chronic inflammation of the white tissues
bears no analogy to that of the sanguineous vessels:  well, it is pre-
cisely  this peculiarity that the word sub-inflammation expresses;
and it  has also the advantage of representing at the same time to the
mind,  the chronic inflammations of all parts of the body, whenever
they invite there other  fluids than the  blood, and  produce tuber-
cles, the lardaceous state,  schirrus, encephalocele, mcelanosis, and,
in a word, all those degenerations which may serve  as a foundation
to the  disorganizing ulceration  called cancer.   When  the sangui-
neous  inflammation is  conjoined with  this,  by opposing the term
sub-inflammation to  that  of  inflammation,  we  easily convey
the idea of what takes  place in  the part irritated.   Does the irri-
tation  commence  slowly, confining  itself to the  accumulation  of
white  fluids,  it is a primitive sub-inflammation.   Does the  irri-
tation  begin by redness and heat,  it is  inflammation.  Are fluids
not sanguineous accumulated at the same time  in the part, it is a
mixt inflammation, partly inflammatory, partly sub-inflammato-
ry.  Are the heat and redness dissipated,  the  irritation becomes
purely sub-inflammatory; it is a consecutive sub inflammation; and
as such, it must, like the primitive, be very slow in its progress.  But
whenever the  sub-inflamed part suddenly reddens, becomes  in-
flamed anew, and advances rapidly  towards disorganization, it is
because the inflammation has returned to the part, and has a second
time become mixt; it is a secondary mixt phlegmasia.
  Such is the language that we  have adopted in pathology: it ap-
pears to us to express nothing more than the facts appreciable to
our senses, and does not prevent each  one  from entertaining his
own opinion  with regard to the cause  of the phenomena in ques-
tion. Of what moment to me is the true cause determining sub-in-
flammation or mixt inflammation; the partisans of viruses may at-
tribute the irritations  either to syphilis, scrofula, or herpes, &c.,
in the  same way  as sanguineous inflammation is sometimes referred 
4»0              OF  GENERAL  ABSORPTION.
to the variolous virus, sometimes to the rubeolous, and at other tunes
to miasmata; yet it will not be  less useful to possess terms which
shall portray each shade  of these irritations.  Until specifics  ait
discovered for each of them, of  which wc are allowed  to  doubt,
we shall always find in the language above proposed, the first indi-
cations, those which direct us to the modifying of the irritation by
the two classes of remedies with which we are acquainted, and  the
employment of which is familiar to us, viz. the antiphlogistics and
revulsives. For a long period of time nosologists placed the vario-
lous at the head of the inflammatory diseases: has this classification
therefore prevented the discovery of vaccination? and is it not to
the precision that physiological medicine has attained in the diag-
nosis of the seats of the irritation at the different  stages of this
disease, that is owing the great success which renders it at the pre-
sent day less fatal than formerly?  Impressed with this great truth,
that the danger of confluent small-pox is in a great degree the conse-
quence of  the violence of the  erysipelas of the face, a celebrated
practitioner of Lyons, Dr.  Janson, applied  leeches to the neck:
an abundant  haemorrhagy ensued  from the bites; all the alarming
symptoms were  dissipated; the greater part of the pustules were
discussed;  a small  number suppurated without  injury; and from
confluent, as it was, the variola became discreet, and the patient es-
caped without deformity. *  We have frequently obtained  similar
results in the hospital of Val-de-Grace,  an account  of which has
been given in the Annates de la Mtdecine Physiologique.
  *  Compte rendu de la Pratique Chirurgicale de I'Hotel-Dieu de Lyons, during six
years, read in public meeting of the administration of the hospitals of that city,
the thirtieth of December, 1823, page 45. 
4?1
                        CHAPTER  XII.

                         OF NUTRITION.

   This is pre-eminently the function of the living body; it con-
 stitutes the end and object of all the others, and the organs which
 perform them are but the more or less remote instruments for the
 accomplishment of this.  The seat of nutrition is in  every part,
 since all the tissues have need of nutriment; though still the mode is;
 different in each of them.
   Nutrition is the same from the first moment of  existence to tho
 end of life; it is purely  chemical, consisting as it does in two phe-
 nomena,  composition and decomposition,  both of which depend
 on molecular affinities.
   These affinities are different from those observed in inanimate
 bodies, hence they are called vital; and the chemistry which sets
 them in action, receives the name of vital chemistry.
   They are necessarily  pre-existent to what are called vital pro-
 perties, as these  latter  are but the effect of the  former.  What,
 in fact,  if it be not vital or organic  chemistry,  is it that  forms
 the fibre, and imparts to it both its  contractility and the power of
 elongating itself after  having been condensed? and since sensibility
 is but the perception of  contractility, as we have before shown, the
 former necessarily supposes the  prior existence of organic che*
 mistry.
   But here an important question is presented to us: is  this faculty
 of composition and decomposition distinct from matter? We  con-
 ceive of matter as obedient to  its  laws:  these  are  of three kinds,
 physical, chemical, and vital; physical in the masses, and chemical
 in the molecules of all bodies,  but vital in organized bodies  only.
 Physical and  chemical laws are modified, but in a peculiar manner,
 by vital ones in the beings of this last class.  Living bodies  coun-
 terbalance the effects of chemical  laws, but do  not  alter them;
 attraction is always the same, though acting on the living body;  its
,effects are only moderated or  suspended for a longer or shorter
 period.   It is the same  with heat, the contact of cold bodies, elec-
 tricity, and water, viewed as external agencies operating on the living
                              61 
4S2
OF NUTRITION.
body; their action is only modified to a certain extent, and when-
ever these agents have much energy, life is unable to resist  them:
organized bodies are susceptible of the same modifications as inert
ones; they are projected, attracted, burnt,  frozen, in a word dis-
organized.
  Chemical laws are modified inanother manner: they may, itis true,
when very powerful, destroy organized beings, as is seen in the ef-
fect of concentrated caustics; but they serve as a basis for the for-
mation of these same beings, which does not happen with the phy-
sical laws.   Scarcely has nutritive matter been introduced into the
stomach, when the play of molecular affinities to whicli it'had been
subjected, and which  prepared the way for its return to the inert
state, is altered, the affinities take another tendency^ and this matter
is assimilated to the body with which it was placed in contact. The
new kind of molecular affinities thus commenced will persist so long
as the above substance shall belong to a living body, and will cease
at the moment of its elimination, to be replaced by another.
  Let us  now reason  on this fact of demonstrable truth, in order
to reply to the question  which  we proposed to ourselves.   If the
same molecules can at one time be obedient to the laws of general,
and at another to those of vital chemistry,  and if these molecules
appertain to matter, it is evident that this last cannot be confounded
with the laws by which it is made to move.  Now the body of an
animal, and of every organized being, is formed entirely of  parti-
cles which  had been at a prior period obedient to other chemical
laws, and which will soon obey again different ones: therefore, the
laws of organic chemistry can be distinguished from  matter.
  What  is  true in the subject before us in reference to vital, is
equally so as regards general chemistry, and even physical laws,
since we can conceive in a living body an action of varying  power
based  on  these latter.  Wherefore  physical, chemical, and vital
laws, ought of necessity  to be distinguished from matter.
  The phenomenon of sensibility, on which are founded the exer-
cisesof the instinct and of intellect, presupposing, as we have alread)
proved, the existence of chemical and vital  laws acting on matter,
cannot, for the same reason, be confounded with them;  whence I
naturally infer that the intellect is as distinct from matter,  as  are
the laws of  natural philosophy and of chemistry.   It follows that
physical, chemical, and vital laws, instinct, and intellect are a^ ao
many phenomena, the ideas of which we derive from the modifica- 
OF  NUTRITION.                        •  483
Mons of matter,  but which it is impossible to confound with it; and
I do not see what there can be alleged against the very simple pro-
cess of reasoning by which we were led to this conclusion.*
  • In announcing this truth, we have gone, we believe, as far as it is allowed for a
physiologist.  It is indeed quite enougti for us to have distinguished matter from
that  which makes it move.  What more could we say without trenching on the
province of metaphysics ? Shall  we say, for instance, that sensation and judgment
cannot be simple movements of the organs ?  We have no assurance on this sub-
ject, either by the aid of our senses or by reasoning; it is an affair of faith which is
not susceptible of demonstration.  Shall we say that no physical or mechanical
contrivance or arrangement of tissue,  can account for the peculiar modifications
of sensation,  odour, colour, &c. ? Were we  to say this and all else in a similar
strain which we meet with in the work of M. Blrard, we should only be repeat-
ing and paraphrasing what we have written, while treating of the vital  properties,
" that sensibility and intellect are not material, but incomprehensible results of
the exercise of contractility."
   But when certain philosophers maintain that sensitive and intellectual pheno-
mena arc not the consequence of organization, I am at a loss to understand them.
It is alleged that matter does not give rise to them, but it is still the manner in
which this matter is modified by the laws of vital chemistry, that is, the organiza-
tion which renders these phenomena possible.  Because we cannot conceive how
the motion of organized matter gives rise to ideas, it does not thence  follow that
ideas are not the result of the motion of this matter.  These are two essentially dif-
ferent propositions.  Have we a better conception of how the movements of the
organs can produce the sensations and acts in animals, referred to instinct?  Do
 we  understand with greater clearness  how molecular attractions cause  the
changes in the forms of bodies ? Assuredly not: but yet we  are certain that these
changes are the consequences of the play of those affinities.
   M. Be>ard avers that the sentient power ought to be considered abstractedly
from matter, as governed by known physical and chemical laws, or as animated by
vital properties, irritability, contractility, &c, and abstractedly from  the organs
studied singly.  I agree readily to this, but I maintain that considerations of this
kind are not within the  province of the physiologist, who ought only to study the
intellectual phenomena as causes or as effects of the modifications of living mat-
ter,  under the penalties of exceeding the limits of his authority.
   To tell us that these phenomena can be studied otherwise,  is teaching us no-
 thing new ; we possess a vast collection of treatises of this kind ;  but to add that
 the  physiologist ought to do this, is equivalent to asserting that he ought not to
 be a physiologist.  Now he who studies the physical and moral relations of man is
 a physiologist, and it does not become him to study the sentient power other
 wise than in its relations with the organs.  These strike our senses; and, whatever
 effort we may make to conceal them, we can never succeed.  To  say that the
 organization of  the  brain is only a condition for the exercise of thought, is still
 saying that we do not think without  a brain; but if we can only think when we
 have a brain, it must necessarily be because we have a brain : now, if  we can only 
184
OF  NUTRlTfON.
   The laws  of which we now treat are referred to forces or pow-
ers; this manner of expressing ourselves doesnotaffect the reality of
the phenomena,—the word power being an abstract idea, by which
we mean the unknown cause of the phenomena; we may then make
think because we have a brain, it seems to me very probable, that thought takes
place by the instrumentality of the brain.  It remains to explain the wherefore;
but since it is admitted that we cannot accomplish this task, it is in my opinion
most prudent not to engage  in it.  In all these cases, I, however, am only to be
understood as speaking of the physiologist and the physician.
  I would ask those authors of treatises on physiology who desire to separate the
study of intellect from that of matter, what they propose doing with a treatise purely
on metaphysics ? Let us suppose that they have prepared it with all the perfec-
tion which they could desire; if they have left it separated, in their work, from
the physiological part, it will be of no use to this science ; if they undertake to
apply what they have said to this latter,  they cannot avoid bringing the organs
into play at each intellectual phenomenon.  In fine, all their declamations about
the moral being independent of the physical nature, all their mouthings against
physicians -who are  in the practice of only looking at the organs, all the imputa-
tions  of materialism andofgrossness of thought, are reduced to this simple pro-
position, repeated to weariness for so many ages: toe cannot conceive how the
movements of matter  can give rise to thought; a proposition which we are so far
from disputing with them, that we in our turn cannot refrain from expressing our
astonishment that the movements of matter can give rise to the construction of a
bird's nest, a spider's web, the formation of the cells of a honey-comb, &c.
  Let it be asserted that the laws of composition can be distinguished from the
organs; that is conceivable, since these latter are formed by  them; but to add that
these laws pre-exist in matter, is what we do not and never can know.  Because
the organs are formed by these laws, we cannot conclude that the latter can exist
without forming the  organs.   We have no means of conceiving of them in a state
of inaction.  If we isolate the laws of composition, it is to  aid us in the study of
their phenomena; but  if we desire to make them pre-exist or give them an after
existence, it will be by the aid of comparisons, none of which can be accurate in a
question like the present.  But this is not the place to engage in such a discus-
sion.  Let physiologists maintain  that thought may be conceived of as different
from its organs, we shall  still be able to understand them, for thought  is an ab-
straction deduced from the observation of man thinking; but if they add that the
thought of a man exists prior to and independently of his organs, they no longer
speak as physiologists, but as  complete metaphysicians, or theologians, and as
such we shall forbear  to pass judgment on them, as we are mere physiologists.
We respect the theologians who in following the revelation  treat of  religious
metaphysics, but we must tell physicians who  would speak their language, that
this kind of study adds nothing to the science  which they  cultivate,  and that it
would be misplaced in a treatise on the relations between the moral and physical
nature of man. 
OF NUTRITION.
485
use of the words, physical power and chemical power.   This lat-
ter will be  ivisible into the chemical power of  inert bodies, and
into  the chemical power of organized bodies.   For  ourselves,
we prefer employing the term laws, which does not force us
to go back to the unknown.  The vital principle of Barthez will
include vital chemistry, contractility, and sensibility, which last is
the perception of the second; but we must beware of imitating this
author in his creation of a number of secondary powers, which are
nothing else but chemical and vital laws producing  the phenome-
na of life.
  As we inquired into the vital laws at the commencement of this
work,  it would be useless to revert to them: we only recalled them
to notice in order the better to isolate the laws of vital  or  organic
chemistry; and of this therefore we now propose  treating.
  The organic  chemistry  of man constitutes  him such as we see
him.   A small mass of  fecund animal matter being given,  this has
the property of attracting the nutritive materials which it obtains in
the uterus, and of repelling those which are useless to it; and the im-
mediate phenomenon is the  composition of the organs.  The rudi-
ments of these latter existed from the moment of conception, but
they were  only developed successively, and after a certain order,
which we shall examine when treating of generation.
   Organic  chemistry persists after birth, and even acquires a new
extension.   In the embryo,  it is limited to the composition of the
organs, the materials for which were furnished by the mother. Im-
mediately after birth, the  organs  which it had prepared for acting
on external bodies  begin to go  into exercise, and new chemical
phenomena are manifested: the lungs act on the air, the digestive
canal  on the food;  and many new secretions are brought about.
Still, however, the  composition  and decomposition of the body
continue; the former is at first predominant, both are then for awhile
equipoised, and  finally the latter takes the lead, and vital chemistry
disappears, to yield up the body to general chemistry.
   Let us inquire into the most remarkable circumstances of two
phenomena so opposed  to each other, though in reality they are the
result of the one single  law.
   The composition of organs is accomplished by means of the par-
ticles of the mobile animal matter.   This cannot be employed for
the purpose so long as it circulates in vessels constituting columns
of varying size.  It must be divided to that degree as no longer to 
18b                      OK NUTRITION.

traverse the tissues, except particle by particle, which cannot take
place until it shall have completely gone out of the blood-vessels.
It is then by passing between the fibres, where the fluids are re-
strained by the laws of affinity from being diffused outwardly, that
those of their molecules, necessary to each of the fibres, are fixed in
these latter and become an integral part of them, either to serve for
their growth or to  take tb.Q place of the molecules that  have just
been detached from them, and which are carried off and conducted
back to the venous system,  to be  afterwards evacuated by the de-
purators;  as we  have explained when  speaking of the functions of
those organs.  Thus,  composition and decomposition  are accom-
plished at the same time,  and have nothing in common with con-
tractility and  sensibility;  these latter  are, then, but the means of
carrying the nutritive  matter into the interior of the tissues, and it
is the play of vital affinities which fixes it  in them by detaching the
old molecules.   Now, such  as described is the phenomenon of nu-
trition, which we have thought proper to designate by  the term
vital or organic  chemistry.
  But this is not all; there are limits to the composition and growth
of the organs.  Each of them must be developed according to fixed
directions, and after a  certain form and degree of consistence, and
a particular manner of reflecting the luminous rays, when it is ex-
posed to the light.   Well then, all these conditions are fulfilled by
the kind of vital affinities  which takes  place in the  relations of the
fluids with the solids;  all, therefore, is, on final analysis, only the
work of those laws which we  designate under the  title of organic
or vital chemistry.
  Organic chemistry composes bodies  in length and thickness, but
it never decomposes them except in thickness, a fact demonstrated
by  disease and  senile  marasmus.   It  is a circumstance worthy of
remark, that whatever be the emaciation of a phthisical  patient or
one labouring under diarrhoea, or a subject exhausted by chronic
inflammation, we never meet with a solution of continuity in a fibre,
except in the seats of inflammation; the muscles are reduced to very
minute bands, but they preserve all their fibres without any solu-
tion of continuity.   It is  the same case with the other tissues; the
shortenings which  may be observed are pure and  simple contrac-
tion of the fibres, which being no longer stretched either by the in-
terposition of calcarious phosphate, as in rickets, or by the presence
of fluids, are condensed and  present less bulk in every sense.  The 
OF NUTRITION.
'tS7
 ime observation may be made in senile marasmus; if it be solely
the effect of age, we do not meet with any solution of continuity.
  This admirable law may be considered as the safeguard of the
existence of animals.   If decomposition had gone on in every di-
rection, the slightest indisposition would have interrupted the con-
tinuity of the  organs; and the contractility of fibre, by widening
the space between the extremities,  would have necessitated cica-
trizations  that would  have prevented a complete  restoration  of
strength.   What, would it have been in the case in which  the body
is brought to the state of marasmus? Never would an animal have
recovered from a disease of even little intensity.
   Whenever organic chemistry has composed the  organs, it de-
posits the residue of nutrition in their interstices;  if a derangement
comes on in the animal economy, by which the sum of the nutri-
tive  materials is diminished,  this power begins by resuming those
which it had extravasated, and seems only to  attack the tissues in
their thickness after having exhausted this reserve.  Does not this
fact lead us to believe  that the thickness of  the tissues solely de-
pends on  an  animal matter interposed between the fibres, which
in a measure  is but attached to and does not constitute a part of
Ihese  latter?  After all,  nothing is more  difficult to solve than
this  question, because we   have no means of isolating the  fibre of a
healthy man from all the fluids surrounding it.  It may be, indeed,
that the  matters of which we speak form an  integral  part of the
fibre, and that they are detached from its circumference in the de-
composition of marasmus; but under whatever light we may view
this subject,  it must always be conceded that there is  in  each  one
a central  base, which normal decomposition can never attack.
   The decomposition which I call abnormal  is that produced  by
inflammation  and its numerous varieties;—of  these we shall speak
when  treating of the diseases of nutrition.
   The composition of the organs being the  grand phenomenon of
life, the others must be, at least in  a great measure, subordinate to
 it.  Whenever the composition is rapid in all parts of the body, as
 happens during the period of growth, and in  very rapid  convales-
 cence, the assimilating chemistry of the digestive passages, which
 is intimately  allied to that of the  composition of the organs as a
 phenomenon of the same order,is equally rapid; digestion is prompt,
 and the  desire for food is felt with more  than  usual frequency.
 Hence an association, of which the stomach  is the medium.   In 
488
OF NUTRITION.
 fact, this viscus exercises a great influence over the intellectual fa-
 culties that are to determine the movements of locomotion for the
 gratification of these wants;  there  is therefore  an uninterrupted
 chain, from the molecular movements of organic chemistry on to
 the phenomena of intellect and instinct.
   It is this union which constitutes unity in man,  and in the  ani-
 mals with an organization most nearly resembling his.   We doubt-
 less shall  never be able to  conceive what relation can subsist, be-
 tween the  internal  movement which  composes and  decomposes
 the solids, or which changes the form of the fluids, and  that which
 assimilates foreign bodies; between these movements and the stimu-
 lation of the nervoso-vascular  expansions  of the membranes of
 relation; between  this stimulation and  the  perception of a want;
 between this perception always accompanied by the exercise of the
 intellectual faculties, and the cerebral influence over the nerves for
 locomotion and the viscera; finally, between this last influence  and
 the  contraction of the  muscular fibre : yet we  distinguish very
 well all these phenomena, and are sensible that one is not the same
 as another.   We vainly refer them to what we call life,  or, if it be
 preferred, vital power; still it is not less certain that the physiolo-
 gist has need of specific terms to express them, and I think that he
 may make use of them without  subjecting himself to the charge of
 ontology:  he will recognise then, in the living body, perception,
 innervation, contraction of  fibre, and will see in these the evident
 effects of stimulation; but that will not  prevent his understanding
 that the composition of the organs and the transformation of fluids
 constitute a process which cannot be confounded with the preceding;
 to it he will attach the name of organic chemistry, and the word
 life will express the combination of these phenomena.

 Section I.—In what  manner Nutrition  becomes  a Cause of
                           Disease.

  It is sufficient for the solution of  this question, to call to mind
the linking together of  what  we have just  given the idea.  Nu-
trition, which consists,  as  we all know, in  the composition  and
decomposition of the organs, is uninterruptedly exerted; but it is
necessarily influenced and modified by all the stimulations imparted
to the living body.   Let us engage in the details of this important
fact, first observing what makes composition predominate, and then 
                    or abnor;\i\l  nutrition.               *-!'
 enquiring into what  agencies n-nder decomposition more potent,
 and what diseases thence result.
   The most common  cause,, of the excess of nutrition is incontesti-
 bly an excessive alimentation.  The stomach,  over-irritated  by
 nutritive materials in  too great abundance,  assimilates  beyond the
 Wants of the organs :  the  first result of this increase of action is
 polysarcia; the second is plethora; the third is hemorrhage; after
 which comes inflammation, which arises in the most irritable part.
 The stomach will, in consequence, be the most frequently attacked
 by it: but it may react upon another organ, the brain for instance;
 and the irritation having become predominant in this viscus, will
 invite blood to it, whence will arise a host of disorders.  We know
 also that the super-excitation of the stomach and duodenum brings
 with it that of the liver.   I will not dilate  on  all  the diseases that
 might proceed from excess  of assimilation, having pointed them
 out while speaking of digestion and circulation: I will only remark
 that, in early life, and in what is called  a scrofulous habit, the ple-
 thora is more lymphatic than sanguineous; which singularly favours
 the coming on of sub-inflammation, that always breaks out in the
 most irritated parts, as if to give a flat contradiction to those authors
 who can see nothing more in this than a relative predominance of
 debility.
   Muscular exercise likewise augments  nutrition, which is espe-
 cially  active in  the muscles themselves: this is not,  it is true, a
 cause of disease, but as the stomach acquires by exercise a conside-
 rable assimilating power,  and as it loses it with great difficulty,
 when  rest follows labour, nutrition operates to  the benefit of the
 adipose tissues and the blood-vessels, whence result polysarcia and
 plethora, together with all the  consequences of  these  two states.
 We constantly observe this march  of  things in men who abandon
 themselves to idleness after having been habituated for a  length of
 time to fatiguing exercise.   This is one among  those  causes that
 most effectually lay  the  foundation for inflammatory diseases at a
 more advanced age.
   Cold o-ives more energy to composition than decomposition, ei-
ther because the stomach, being less excitable, supports and assimi-
lates a greater quantity of aliments, or because cutaneous elimina-
tion is of less amount.   If muscular exercise be used in cold wea-
ther, the individual acquires the greatest volume and bodily strength
of which he is susceptible: but if he be  inactive and  exposed  to 
lite
OF NUTRITION
cold, the excess of nutrition is only evinced in the  fulness of ti>"
fat and  blood: hence plethora, polysarcia, sanguineous, lymphatic,
and mucous accumulations  in the  viscera,  are the  effects of this
over-abundant nutrition.  But we must observe, that in this state
man supports very well those stimuli that excite the  secretions.
And  hence the extravagant fashion  for purgatives  in  cold coun-
tries.
  Whenever one organ is more strongly irritated than the others, it
acquires an excess of nutrition, becomes hypertrophied, and exposed
to inflammation.  This last process is itself a powerful cause of hy-
pertrophy.   The inflammation,  in fact, always begins by increas-
ing the vitality and the volume  of the  tissues attacked  by it  I
have frequently had occasion to open the bodies of those who had
sunk under the first period of a phlegmonous phlegmasia, and I al-
ways found a considerable increase of fat in  the part affected and in
its immediate vicinity.   Itis in this way that a slightattack  of gas-
tritis gives rise to collections of fat in the omentum and mesentery,
and produces a remarkable projection of the abdomen, which, join-
ed to the freshness of complexion,  gives an idea of strength and
health,  whereas it  is  often  only the prelude to the  most dreadful
inflammatory diseases.   If the excess of nutrition be directed on
the thoracic  cavity, the lungs, overloaded with blood and  unable
to expand, become diseased; the heart is in a state of hypertrophy,
and the dyspnoea, which often assumes the name of asthma, is the
first effect of this pathological state.
  Hyper-nutrition of the brain gives rise,  in early  life, to an ex-
cessive volume of the head, a state often, as I have  already said,
converted into hydrocephalus; but in more  advanced life this ple-
thora leads to encephalites,  madness, and  apoplexy.  The mor-
bid fulness often shows  itself in the throat,  especially in youthful
age, and thereby  predisposes to,  and keeps up, very violent and
often extremely untractable anginas.
  Irritation,  when  acting more particularly  on the nerves,  produ-
ces  hypertrophy of them, either in their trunks and branches, or in
the ganglions, or, finally, their sensitive expansions.  Sensibility
and mobility are at this time excessive,  and inflammation,  at any
rate of a chronic kind, is the inevitable consequence of this state.
  If originating in  the tissues in which lymph abounds, the irrita-
tion causes in them a hypertrophy which  advances  more  slowly
than that prodttced  by sanguineous inflammation, but which  carries
m 
OF ABNORMAL NUTRITION.
491
to a much greater extent the volume and deterioration of the irri-
tated parts'.  Nutrition is depraved, and creates in them abnormal
tissues,  which finally rendet the organs hotter and more sanguine-
ous, until, sanguineous becoming joined to  sub-inflammation, the
cancerous disorganization is on the point of appearing.  There are,
however, a great many cases, in  which the abnormal  or morbid
mode of nutrition of the lymphatic tissues serves to harden  them,
and  keep away the  blood, by obliterating the vessels  by  which
they are supplied; then the part becomes fibrous, cartilaginous, or
osseous, and it  is impossible  for the cancerous alteration to take
place.
   There is another variety of abnormal hypertrophy which gene-
rates fungous growths, called likewise vegetations, and which are at
the same time of two kinds: some, hard but sanguineous, may pass
into the cancerous state; others soft, and rather serous than lympha-
tic, grow without bounds, and display  no  tendency to  be carcino-
 matous; sometimes  even they are seen to dry, wither up, and come
 away of  themselves.   The skin,  especially when  ulcerated, and
 the membranes of relation, are their most usual seat.
   Those red and fungous tissues, so rich in blood-vessels and  known
 under the names of bloody tumours, fungous ha?matodes, anomalous
 tumours, cancroides, and improperly compared to the natural erec-
 tile tissues, as of the cavernous bodies, the iris, the nipple,  &c. are
 also the effects of a pathological hypertrophy.
   Cysts or sacs, whatever be the matter  they contain, are hyper-
 trophies; the primary nucleus of which is an irritated cell or areola.
 Those that contain  blood arc  formed round a clot,  produced by an
 effusion, the  serous portion of which has been absorbed.  The cel-
 lular tissue, irritated  by the presence of foreign bodies, is the part
 which is organized  into cysts, vegetates, and is on  its inner surface
 converted into a kind of tissue analogous to that of  the serous mem-
  branes.   In  general all foreign bodies inclosed in our organs, such
  as balls, are capable of producing this effect;  it is sufficient that they
  be not too stimulating to give rise to a suppurative inflammation
  round them.
    If we cannot entirely account for all these varieties  of abnormal
  nutrition, observation leads us at least to refer them to an irritation
  which invites the fluids to the affected part, and deteriorates in vo
  rious ways the organic chemistry. 
iyd
\*V NrTRlTln*.
  The modifications by which  decomposition predominates anoV
consequenfly the nutrition of the living body diminished, are all
those which we have seen capable of augmenting it,  and others
which are entirely of an opposite nature.   The first and most pow-
erful of these last causes is the defect of  nutritive materials.  This
fact, is so evident, that it would  be idle for us to stop at it; but we
cannot forbear  speaking of the  influence that food of a bad quality
exercises on  the decomposition  of the solids and fluids.  It is al-
ready seen that we allude to scurvy.
  This affection, characterised by sanguineous extravasations, either
externally (as in the haemorrhagies), or in the interior of the tissues,
as the skin, and  cellular net-work, (asecchymoses, vibices,) presents
at the same time to the observer fragility of the muscular fibre, which
easily tears when it is forced to contract with energy, and engorge-
ments in the parenchymas eminently venous, such as the liver and
spleen.  We, moreover, meet with a languid absorption, producing
dropsy and  inflammations, which promptly go on to suppuration,
ha?morrhagies,  and gangrene.
  These phenomena have been attributed, by physicians, to the
extreme  diminution of vital  power.   There  is, without  doubt,
weakness in scurvy: but this asthenia is different from that of other
diseases, for  death will follow  exhaustion  from a host of chronic
affections, without any sign of scurvy.    I have examined these dis-
eases attentively, in order to have an opinion  based  on something
solid; and I have always remarked, that the patients who sink under
gastrites, whether acute (adynamic fevers*) or chronic, constantly
presented some traces of scorbutic decomposition.  This  observa-
tion leads me to believe, that the primary seat of scurvy is in the
mucous surface of the digestive  passages, whether the disease pro-
ceeds from substances of difficult assimilation, such as putrid meat,
stagnant water, aliments of either kingdom  altered by water and
salt, or moulded, or is the effect  of a chronic inflammation; in other
words, that this latter never occasions it without being at least com-
plicated with an inflammation of the above surface.
  There are cases  in which moisture, sadness, and  darkness are
taxed with being causes of scurvy;  but do they ever accomplish it
without having  previously interested the mucous tissue of the ab-
* Writers long ago pointed out the analogy between the putrid fever and scurvy. 
OF ABNORMAL NUTRITION-
493
doinin?  1 do not believe it; and I now think, that if wc observe
so min-h weakness and fragility in the blood-vessels, serous tissues,
and muscles, it is because previously a particular mode of irritation
had been established in the internal membrane of the digestive canal,
bv which assimilation was rendered  imperfect,  especially as regards
the formation of gelatine and  fibrine.  This  modification is  fre-
quently repeated in the membrane covering the gums, which is in-
flamed, ulcerated, and mortifies; but this inflammation may be. want-
ing, or, when present, may be the  immediate product of cold  and
saline  food, and the bad state of the membrane of the mouth then
renders its disorganization easier.
   In fine, I  am inclined to believe, that in scurvy, whatever may-
be its cause, there is  I. an  irritation of the internal membrane of
the digestive canal;  2. an  imperfect assimilation of the  elements,
especially of fibrine and gelatine, either in the tissues  formed out
of them, or in the blood which directs them to different parts of the
body.   Now this radical vice of nutrition cannot exist  without a
diminished  cohesion of the fibre, and this diminution seems to me
to  explain  why  contractility is languid;  why the vessels rupture
and allow the escape  of their fluids; why the muscular  fibre is so
fragile that it is often torn in the efforts of contraction; and,finally,
why the tissues in scorbutic persons are  so easily disorganized in
phlegmonous inflammation.
   Then come excessive evacuations, either of blood or secreted
fluids; and we know  that,  when they are not traumatic, they are
constantly dependent on irritation.
   Exercise, by favouring composition, may also, as an exciter be-
yond bounds of  the action of the  eliminating organs, especially of
the skin, become a powerful cause of decomposition and marasmus.
   The same may be said of all the agents susceptible of unduly
exciting the secretory action.   Coition in excess hastens decompo-
sition, less by the evacuation of semen, which is but trifling,  than
by the increase of nervous activity and  cutaneous exhalation.  The
effect  is remarkable.   I have  seen it in Spain in the studs, in the
case of stallions which were abused, because the number was dimi-
nished by military requisitions.  I have seen  them become in less
than a fortnight  extraordinarily thin, though they had a great ap-
petite, and care was taken to exempt them from  any other kind of
fatigue. 
-494                    OF NUTRITION.
   In attributing this emaciation to an exaltation of sensibility, I do
not give an explanation wanting the support of analogy; we know
that all  strong passions and even frequent convulsions  give a pre-
dominance to decomposition; persons who have much business and
care become  sensibly thinner under the influence of these causes.
even though  they make use of an abundant and substantial nourish-
ment, whilst those who leave off business and lead  a careless and
easy life never fail to become fat.   I have frequently observed, that
repeated convulsions induced emaciation in a very short time, and
that, when made to cease, colour and flesh were at the same time
restored to such persons.   Differences of this nature are especially
very sensible in subjects of a nervous temperament; for there are
some so insensible and cold, that nothing short of a famine or in-
flammatory disease can endanger their nutrition.   Atmospherical
heat gives dominant power to decomposition, by the double  influ-
ence of the exaltation of sensibility, and the increase of cutaneous
transpiration; but the wasting away is more  particularly remarka-
ble in  the cellular tissue;  for it is an observed fact that exercise
may support to a  very great  extent  the  nutrition of the muscles
under a burning sky, as we find in the Arabs of the  desert.
   Among the causes hastening the  decomposition of the organs,
inflammation must not be overlooked; though its  first effect is, as
we have seen, to increase the nutrition of the part which it attacks,
its secondary consequence  is, in addition,  constantly to bring on its
softening and a purulent collection either  with  or without ulcera-
tion.   This cause is even  the only one, among those of a sponta-
neous nature, that can break the continuity of the tissues: besides
this, inflammation gives rise to emaciation,  both by the obstacle
which  it sympathetically opposes to the assimilating action of the
stomach, and by the state of spasm or erethism which it keeps up,
as also by the evacuations  caused by  it when  it  is  carried to the
degree that produces fever.
   Sub-inflammation has but  little agency on general  nutrition,
unless  it  be  complicated  with inflammation and erethism, or it
interests the organs that preside over assimilation  and ha?matosis.
   Our readers doubtless cannot have forgotten, that, when classing
scrofula with irritative diseases, we assigned  to  it  as  a primary
cause, the languor of the assimilating power, or rather of the com-
position of the tissues; it would consequently be useless to recur to
this point. 
OF GENERATION IN
GENERAL.
493
     Does there exist any instance of the debility of nutrition, or the
   predominance of decomposition,  that can be regarded as foreign to
   irritation viewed either as cause or effect? My opinion on the sub-
   ject is this.
     The languor of the power of composition may depend on a defect of
   oxygen, caloric, or light, or on the effect of poisons, or of delete-
   rious gases; it is  in  these  eases  either  acute or chronic.   In the
   first it  is promptly mortal, and may take place without irritation;
   in the second it is always followed by this state, so that the  seda-
   tive indications are simultaneously presented with those of excita-
   tion: I mean to say, that if on one side  the  system  has need of a
   stimulus adapted  to nutrition, such as oxygen, caloric,  and light,
   it exacts at the same time the withholding of other agents of exci-
   tation, and even sometimes the bringing on of evacuations, either
   immediate or revulsive, of some fluids, such as blood, or the secre-
   tion of  an artificial phlegmasia.   I only know of senile marasmus
   that can neither be the cause nor the effect of irritation, and Which
   depends solely on the weakness  of vital chemistry; but it is well to
   be apprised that this marasmus must not be confounded with that
   in certain old  persons, who are far from having attained the natural
r  limits of their existence, and  who are  only thus exhausted by a
|  visceral inflammation, kept up by the improper use of stimuli.
     I have given in the Annates,  vol. v.  p. .545, the case of a caries
<t  and softening  of  the cervical vertebra?, observed in a woman at-
   tacked with cancer of the breast.   1 do not believe that  we can
   look on the decomposition of these bones  as independent  of irri-
   tation, which  in this case was present in the mammary glands, and
   might have been  repeated in other tissues.  I do not therefore deem
   it necessary to insist more on this point.
                    CHAPTER  XIII.

               OF GENERATION IN GENERAL.

Genkration, or reproduction, is performed in many ways in the
ries of living bodies.   The more complex their organization, the
are difficult  is the execution of this function.   It is known to all 
4*96              ok generation in genkrav.

that the limbs of a polypus detached  from the trunk arc converted
into polypi: and the same is the case  with a great number of plants
that  are.  reproduced  by grafting: but in  the languor of animated
creatures, reproduction is effected by means of an  organ ad hoc,
for the purpose of forming the germs.   It is not less remarkable
that these organs  are of  two kinds;  the one male and the other
female, which  constitute  the sexes.   In many species  of animals
and vegetables, the two sexes are  united in the same individual;
but soon, and in proportion as her work is perfected, nature shuns
Uiis union, and even  goes so far as to give to each  sex  a peculiar
constitution in relation  with the generating organs  allotted to it;
whence it results, that the sexual differences are so much the more
definite as animals are more elevated  in the zoological scale.
   The sexual organs of  the male give—those of the female receive.
We know that these latter retain and develope, but we are  yet far
from^Jetermining with precision what is  given by the first.   Until
the View  being  is organized, we  see nothing but free animal matter.
This is secreted,  or, more properly,  fashioned by means of vital
chemistry, in  the generating organs of the two  sexes; in whom
there is therefore respectively male animal matter, and female ani-
mal matter. But this double nature is sterile in the organs of both
sexes,  so long as they are not brought together in a certain manner.
   We  shall, therefore, have to study, in the function of generation,
1. the  sexual organs of the male and female; 2. the causes  produ-
cing and the  circumstances  attending their union, whence results
the mixture,  or being placed in  relation with  each other, of  the
reproductive animal matters; 3. the preservation and growth of the
new  being, in the sexual organs of the mother; 4.  its issue, or  the
foetal ejectment; 5. and finally, the continuation of its growth,  so
long as the mother is to furnish it with nutritive matter.  All these
points  are so  much the more important, as each of them is connect-
ed with the etiology of numerous morbid affections.

Section I.—A summary Description  of the  Genital Organs
                    of Man and Woman.

   In man we meet with the organs that  secrete  the semen; those
which  serve for its deposit; and finally those which convey it out-
wardly.
   I.  The first  are the testicles,  glandular  organs  to the number
of two,  lodged in the scrotum,  of  an  ovoid form, and reddish 
OF GENERATION IN  GENERAL.
497
appearance, soft, and as it were pulpy, a result seemingly produced
by the interlacing of numerous and in degree filamentous ramifica-
tions of the spermatic ducts or secreting vessels.  Their more imme-
diate envelope is a fibrous membrane called albuginea or peritestis,
of an opaque white, analogous  to the sclerotica, though less thick,
and  sending into the interior of the parenchyma, which it covers,
filiform or flattened prolongations  that divide the  testicle  into
several lobes, separated  by partitions.   They  are united towards
the superior part of this organ, where is found the corpus High-
morianum (sinus of  the seminal  vessels, Chaussier),  an oblong
prominence which is traversed obliquely by, or in which are dis-
charged the principal trunks of the seminal  vessels which pass to
the epididymis.
  This is a small oblong body, vermiform, swelled at its ends, and
resting on the upper border of  the  testicle, to which it is only ad-
herent by its head, or most swelled extremity, and by its tail, or
smaller end, while its body,  still smaller  than the tail, seems
free.  The epididymis is a canal formed by the  re-union of vessels
which, after having  traversed  the  corpus  Highmorianum, meet in
the head of the part above spoken of, are next continued into its
body, and terminate in its tail.
  From this last arises the vas deferens, which  leaves  the tes-
ticle and unites itself to the spermatic artery and vein, and to lym-
phatic vessels and nerves, to form  the spermatic cord.  This rises
vertically towards the  abdominal ring, in which it is engaged, and
on going out from which the blood-vessels and lymphatics, as well
as the nerves forming the cord, pass on to their respective trunks.
As to the vas deferens, after having left the cord and passed on each
side  through the abdominal passage of the small pelvis or inferior
strait,  it goes to the sides of the bladder, passes under the inferior
region of this organ, nearly meets its fellow, and finally  terminates
in the vesiculae seminales.
  The testicles and epididymis are enveloped in several membranes;
viz. from within outwardly, the tunica vaginalis, a serous mem-
brane, which is merely a portion of the peritoneum: it encloses each
Lcsticle, without  however containing  it in its cavity; the fibrous
coat, forming two small sacs,  situated externally to the preceding
one; the erythroid coat, or cremaster muscle, formed by fibres of
the   ilio-abdominal  muscle; and   the  dartos—cellulo-filamentous
membranes, which are in apposition at the internal part, and thu<=
                              63 
i'JS         *    OV GENERATION.  IN  GENERAL.
separate the two testicles from each other: finally the scrotum,  or
cutaneous envelope, which is only  a prolongation of the skin, pre-
senting on the median line a prominent  surface called raphe, and
corresponding to the apposition of  the dartos.
  The testicles receive the spermatic  arteries, and  give origin to
veins of  the same  name: we discover in them lymphatic vessels,
but as yet we have not been able to trace into their substance any
nervous filament belonging to the cerebro-spinal apparatus,—which
would restrict  their supply to the splanchnic nerves  that reach
them in company with the spermatic arteries.
  II. The organs  in which is deposited the semen are the vesiculae
scminales, membranous sacs, two in number, situated on the lower
part of the bladder, before the insertion of the ureters,—in  figure
irregularly conoid, knotted at their  external surface, and terminating
by two very short and small canals, which  open into the vasa de-
ferentia, and at the same time give origin to the ducti ejaculatores,
which open into the urethra on the lateral parts  of  the  verumon-
tanum.
  III. Finally, the excretory  organs of the semen, and their ap-
pendages, are  the  urethra, the corpora cavernosa, prostate  glands,
and  the glands of  Cowper.
  The urethra, a membranous canal in length from nine to twelve
inches, extending  from the neck of the  bladder to the end of the   \
penis, presents in the direction of its length three distinct portions,
L. the one prostatic, embraced b\ the prostate gland and  nearest
to the bladder; 2. the second membranous, from eight to ten lines
in length, placed beneath the symphisis pubis; 3. a third spongy,
and  much the longest, beginning below by an enlargement called
bulb, and terminated above by another  expansion,  which  has re-
ceived the name of glans.
  The canal of the urethra is situated in a kind of channel,  formed
below by the corpora cavernosa.  These truly  constitute but one
body, the two posterior roots of which are attached to the internal
border of the rami of the ischia and pubis, whilst the anterior ex-
tremity represents a truncated cone united at the base of the glans.
  A mucous membrane lines the interior of the urethra,  and forms,
towards the neck of the bladder, on the median line, and inferiorly,
an oblong projection, called verumontanum.  A cellular membrane
is applied to the exterior of the urethra in its two first portions,
and  the*third is formed of  a spongy tissue. 
OF GENERATION IN GENERAL
  The appendages of the excreting organ are the prostate and the
glands of Cowper.
  The first incloses the urethra at its origin; it is tolerably volumi-
nous, formed of an assemblage of mucous follicles which give  rise
to excretory ducts,  the orifices of which are at  the surface of the
verumontanum.
  The glands of Cowper are two small bodies placed beneath the
urethra, and  before the prostate; they give origin to two excretory
ducts, the orifices of which are seen before the verumontanum.
  In the female we meet  with the organs of copulation, those of
conception, and of gestation, and those for the nourishment of the
child.
   I.  The first are the vulva and its appendages.   We call vulva
the combination of the external parts of generation; it includes 1. the
mons veneris,  a fatty, rounded  eminence, covered with hair, and
placed before the pub's; 2. the labise, membranous  folds occupying
the lateral and upper parts of the vulva; 3.  the nymphae, mem-
branous  ridges situated at the internal portion.of the great labia;,
and more or  less elongated; 4. the clitoris, an erectile tubercle of
a structure analogous to that of the  penis, and  hid by the labia?;
5.  the meatus urinarius, or external orifice of the urethra, whicli
canal is much shorter and wider than that of  the male; 6.  and,
•lastly, the hymen, or the carunculae myrtiformes the remains of
this membrane, which more or less completely closed the entrance
 of the vagina before defloration.
   The vagina, or vulvo-uterine duct, is a membranous cylindroid
 canal, placed in  the  interior of the  small  pelvis or inferior strait,
 opening to the vulva on one side, and embracing the neck of the
 uterus on the other.  It is lined by a mucous membrane which is
 supported by a spongy tissue.
   II. The organs of conception and  gestation, are the ovaries and
 the uterus with  its appendages.
   The uterus or womb, a pyriform organ destined to lodge the
 foetus is situated between the vagina and the ovaries, communica-
 ting with the first by its neck,  and with the latter by two canals
 which go out  on each side from the  superior edge of its body, and
 which are called  Fallopian  tubes.  These canals, contained in
 folds of the peritoneum, called ligamenta lata, pass on each side
 to the ovaries, to  w> u-h they only adhere by one  of  the fringe*
  which terminate their external  extremity called fimbrnp. 
500
OF GENERATION (N GENERAL-
  The ovaries are two ovoid bodies less voluminous than the testi-
cles, and contained in the substance of the ligamenta lata: they
are attached on one side to the uterus  by a small ligamentous cord
called ligament of the ovary, and on the other to the Fallopian
tubes by one of the processes of the fimbriae.
  The uterus is lined by a mucous membrane; but the proper tissue
of the organ is not yet  perfectly known: comparative anatomy may
powever lead to the belief of its muscularity, since  in the large
quadrupeds muscular  fibres are very evident.   The Fallopian
tubes are likewise lined by a mucous membrane, external to which
wc sec an erectile spongy tissue  like that of the urethra.  As to
the ovaries, they are enveloped in a cellulo-filamcntous membrane
sending a  great number of prolongations into the interior  of their
tissue.  This is composed of cellular lobes, each containing a small
transparent vesicle of the size of a millet  seed.   The uterus,  the
Fallopian tubes, and ovaries,  receive nerves from the great sympa-
thetic and spinal cords; they are also supplied with arteries, vein--.
and lymphatic vessels.
  III. Finally, the organs for the alimentation of the infant are the
mammae, glandular bodies of a hemispherical form, to the number
of two, situated  on the lateral and anterior parts of the chest,  and
presenting  towards the centre a roseate or brownish, circle  called
areola, surmounted by a conoid tubercle named nipple, on the sur-
face of which open the vessels called galactophori.
  Independently of the skin which covers them, and which, agree-
ably to a remark of Bichat, on approaching the nipple, bears a resem-
blance to the mucous membrane; and besides the layer of fatty  cel-
lular tissue of varying thickness beneath the  skin, the mamma? are
essentially  composed of a voluminous gland divided  into lobes of
different sizes, these lobes into lobuli, acini, &c: the glandular acini
give rise to  ducts called galactophorous or  lactiferous, which
unite in a fasciculus terminating at the nipple.   The mamma? re-
ceive arteries, and give origin to veins and lymphatic vessels; the
nerves observed in them come from the intercostal and the brachial
plexus.

  Section  II.—Physiological Action of the Genital Organs.

   Of the Union of the Sexes.—This union  is founded on the de-
velopment of the passion of love,  and  this latter again on thestruc 
(>V GENERATION IN
GENERAL.
501
ture of the genital organs.   Let us first  examine these desires in
man.
  The semen  is  the  principal exciter  of venereal desires; but
in general we may say that all tho stimulations of the genital orsans,
which do not pass the limits of the normal state, give rise to plea-
sure,  and may  excite desire.   Nothing  is better ascertained than
this, since children of a tender age, and eunuchs, are susceptible of
ihom.  This phenomenon is in some measure an excess of precau-
tion on  the part of nature, tending to i^ive more force to the incli-
nation which leads man to the reproduction of his species.   It is
worthy  the attention  of the physician, since it  may become  a
cause of disease.  The greater number of our wants admit, how-
ever, the like  extension, as I  have already had  occasion  to re-
mark.
   After all, real desire, that avowed by nature, is the  effect of the
presence of semen accumulated in  the  vesicula? seminales.   The
stimulation exercised  on the sensitive surface, or on the mucou>
membrane of this reservoir, is what renders the desire more  lively
and better defined, and which  excites most imperiously to copula-
tion.   It would  be, however, an error, to suppose that the semen
invites  men to coition, by the stimulation alone of  the vesicula? se-
minales; that effected in the epididymis, and even in all the semi-
nal ducts,  must be taken into the account.  There are even many
animals  which do not experience this irritation as an exciter, as they
are deprived of vesicula? seminales.   These vesicles are only evi-
dences of a more perfect organization, seldom met with but in ani-
mals  the highest in the zoological scale.   There is an evident reci-
procity  between the sensitive  surfaces,  which are  in relation with
the semen, and the brain, the organ of perception.   In the normal
series the first stimulation comes from these surfaces; the brain
takes cognizance of it  and reacts by innervation on the genital or-
gans.  It  is then that the erection is produced,  the chief seat  of
which is in the corpora cavernosa, and not in the seminal surfaces.
I say the principal seat, for the erection  is not limited to the penis;
it takes  place at the same time in the whole genital apparatus; the
testicles and epididymis are h'ardened;  and though the erection  of
the vesicles be not appreciable, we are led by induction to admit it.
The  cremaster is contracted, the scrotum and all the cellular tissue
undergo a very sensible  retraction; finally, the spongy  tissue  of
the urethra, and even  its  mucou*  membrane, participate  in the 
502
OF GENERATION  IN  GENERAL.
erection, and all these with so much the more energy, as the semen
contained in the seminal vessels is more abundant and more concen
trated.
  When the erection is accompanied with strong desires, the stimu-
lation is general throughout all the  organs liberally supplied with
nerves and vessels.  A vivid sensation  is experienced at the epi-
gastrium; the mouth is heated, the throat parched, and the secre-
tion of saliva altered;  the heart palpitates; the eyes sparkle, respi-
ration is accelerated, the vital erection of the brain is evinced in  the
exaltation of ideas,  flush of  the face, irascibility, &c.;  the skin is
corrugated, the muscles are stretched, and agreeable sensations are
experienced in all the sensitive parts of the body.
   What  is the composition of this humour which  produces such
singular phenomena?   Alas!  nothing extraordinary; albumen, a
little gelatine, some  acids and salts—articles usually found in all
the animal fluids.  The semen, it is true, is remarkable for a very
decided odour—such as we meet with in some of the grains of the
cerealia; it is the odour of the pollen of plants, and is particularly
distinct in the flower of the horse-chestnut;  one might thence be
tempted to suppose it connected with the process of reproduction;
but when we find it in the orchis root, in the mass of the brain,  and
in  recent bones, which  when sawed  exhale  it. in a very decided
manner,  we abandon  this  idea, and are compelled to grant that the
aroma in question is a principle common to various parts of organ-
ized beings; a principle, the office of which is no  more known to us
than that of the aromas of musk, or of the rose, or of castor, or urine,
and all those  peculiar to each species of animal and plant.  How-
ever this may  be, the fecundating property of the semen, and its
quantity and strength, are indicated by those of its odour.
  The  semen  is  secreted in the testicles by a mechanism which
was formerly  thought to  be well known.  The spermatic artery
brings, we were told,  the materials for this fluid.   The  secreting
vessels which are detached from small ramifications,  select these
materials, as soon as they are presented to their orifices; they then
collect and combine them, in order therefrom to form the semen;
and while this  latter goes through all their tortuous folds, it is  still
farther strained  and purified by absorption,  which takes from it
whatever foreign elements it might have had.   This elaboration is
continued in the  epididymis, the vasa defcrentia, and above all is
most marked in the vesicula? seminales. It is there that the semen. 
OF GENERATION IN  GENERAL.
503
by its detention, becomes more pure, thick, and penetrating.  It
would even acquire too high a degree of acridness, did not the ab-
sorbents, after having deprived it of all that was heterogeneous, also
carry it off: or if dreams, in defect of coition,  did not procure  its
spontaneous evacuation.
  The greater number of these assertions are, to our minds, well-
determined facts;  we would only venture  to call in doubt  the re-
ceived  mode of secretion.   The seminal ducts are perhaps  only
the excretors and  not the  true secretors of the semen, in the for-
mation  of which it seems to  us that we ought to admit something
else  besides a simple separation of nutritive materials floating in the
circulation.  But, as  I  have explained myself elsewhere on this
subject, I shall not recur to it; I would only request anatomists to
study more attentively  the structure.of  the testicular parenchyma.
  In the female, the desire depends entirely on the normal excita-
tation of the genital organs; its seat is  in the  clitoris and vagina;
but it seems that the aptitude to true pleasure depends on the in-
fluence  exercised  on these parts  by the adequate development of
the ovaries.
  We shall here give some general facts relative to  the desire, and
which we think fit to point out, as they  will  find their application
in pathology.   If the venereal appetite  is  the more decided (as
granted by every physiologist) in proportion as the semen is more
abundant and  charged with prolific principles,  it must  follow that
the desire will be  stronger in man than  in woman, who has no sti-
mulus analogous to his.   In  fact,  man  desires because he has in
himself a  material cause of  stimulation, which irritates him the
more the longer its expulsion is delayed.  Woman, deprived of this
stimulus, only desires because of an irritation much less intense in
the genital apparatus.   The source  of the pleasure is in man  him-
self, the source of the woman's enjoyment  is in man.  Hence a
prodigious difference between the two sexes; a difference affecting
all their actions, and influencing the part which each  has to play
in the social state.  Woman, wanting in the most powerful stimu-
lus, only has desire in general in proportion to the eagerness of man
to gratify it; nothing is easier  than to calm  her erotism, unless  it
has already gone beyond the normal state, or that improper stimu-
lations have raised the irritation of  her organs to that degree which
corresponds with the orgasm of female animals. It is because woman
is not the slave of the want of this enjoyment, that she can, with- 
$0.4
OF GENERATION IN  GENERAL.
 out suffering, forego it for such a length of time in order to suckle
 and direct the physical education of her children.   Hence we ne-
 ver hear, even in cases of erotomania, of her forcing man to gratify
 her desires; she is contented, as the late Buisson observed, to win
 him by gestures and  speech, but never does she undertake to sub-
 due him by force.
   It is to the want of semen, to the general constriction of the sexual
 organs, to the little blood which passes  through those destined to
 copulation (the vulva and vagina), to the feeble innervation taking
 place  in these tissues, that we must attribute the vagueness of  the
 desires of a  young and innocent virgin.   The clitoris is here  the
 only  organ that can excite the others; but at this time it is very
 slightly, developed.   In general, desire is only strongly felt by wo-
 men who have felt the stimulus of the approach of man.  We do
 not find in them that inflammatory tumefaction of the vulva and
 vagina which constitutes the orgasm in the  females among the brute
 tribe; nature has not submitted them to that humiliating state,  in
 which the female is forced to entreat, with loud  cries, the caresses
 of the male.
   We know the influence exercised by the imagination on  these
 organs in the two sexes; it is such that any idea relating to love is
 necessarily accompanied with some slight  degree of vital erection
 in the sexual organs.
   All the  signs of irritation, the picture of which we drew when
 speaking of erection, are greatly augmented during coition; and the
 emission'brought about by the friction of the genital sensitive sur-
 face during  the voluptuous junction, is  its natural termination.
 Some  reflections might well be made here  on the effects of all fric-
 tion exercised on the surfaces of relation; it will suffice for our pre-
 sent purpose, to say, that the kind of stimulation belonging to the
 sense of touch is one  of the most energetic with  which we are ac-
 quainted.
   The emission  takes place in  man from  the vesicula? seminales*,
 and, in animals deprived of these organs, from the seminal canals.
 The seminal  liquor, brought forward by the oscillatory movement
 of the vesicula? seminales and  the excretory ducts of the testicles,
 arrives in  the  urethra near  the verumontanum.   So soon as the
 mucous membrane or the internal sense of this canal  has Telt the
 stimulation resulting from the presence of  this fluid, the bulbo-ca-
 vernous muscles which on one side envelope the bulb of the urethra
at the beginning of this canal, and on the other embrace the root1- 
                 OF GENERATION IN GENERAL.             505

of the cavernous bodies, undergo convulsive contractions which are
participated in by the ischio-cavernous muscles and the sphincter
ani, and to each of which corresponds a jet of semen.  The levator
ani always partakes of this convulsive movement, in  order to fur-
nish a point of support to all the above-mentioned muscles; and these
convulsions are renewed as often as  the excretory canals continue
to furnish semen.
   We may infer from this exposition, that the genital apparatus of
man gives rise to  numerous sympathies, of which some are local
and others remote.  The local ones observed are,  1st.  of the gland
and the entire skin of  the penis,  and scrotum, with the apparatus
secreting and  holding the semen; 2d.  of the internal surfaces of
this apparatus, and of the urethra, with the  erectile tissues and eja-
culator  muscles.   The remote sympathies depend on the lively
stimulation which the brain, sensible  of the irritation of the genital
surfaces, internal as well as external, transmits to the nerves of re-
lation; hence some sympathies take place in  the senses and muscles,
and others in the viscera comprising those of  generation.
   In woman coition is attended with  very nearly analogous effects;
the local sympathies are, however, limited  to the influence of the
irritation of the vaginal mucous surface, on the musculo-erectile tis-
sue embracing the orifice of the canal, on the  Fallopian tubes, ova-
ries, and clitoris, which latter, in these cases, as well as in those in
which it is first stimulated, reacts on the  above tissues.
   Though women do  not secrete semen,  yet coition often  pro-
duces  in  them  convulsive  contractions  of the vagina, which is
thereby shortened and approximated to its axis, with the effect of
an expulsion of a mucous fluid.  This phenomenon  appears to us
merely the imitation of what takes place in man; it is not by any
means necessary to conception, and must be considered as depend-
ing on the same law under which man has  mamma?,  though he be
deprived  of mammary glands, and woman a  clitoris, though she has
no need of it for generation, and does not expel by its means either
semen or urine.  These kinds of organs and acts,  which to us
seem useless, are only in relation to the species; they are the im-
press of that grand law which presides  over the organization of all
animals of the same class, and  are attached to the extended views
of general physiology and comparative anatomy, which we find de-
veloped in the works of M. Geoffrey St Hilaire, Tiedemann, and
ethers.
                                64 
506
OF GENERATION IN GENERAL.
  The stimulation of the vagina, produced by coitus, being, as wc
have said, communicated to the whole uterine apparatus, the Fallo-
pian tubes are thrown into a state of erection, by which, of them-
selves, their fimbria? are  applied to  the  ovaries, which they em-
brace.   This is an indispensable preliminary for conception to take
place;  after which it is  necessary that the semen thrown into the
vaginal cavity, should pass the neck of the uterus, penetrate into
the Fallopian tubes, and traverse them so as to reach the ovaries.
One of the last mentioned organs is adequate to bring about concep-
tion.   Stimulated by the semen, it reddens and swells at the most
yielding point; its investing membrane is ruptured, and gives issue
to a drop of gelatino-albuminous matter, which the Fallopian tube,
the fimbria? of which are  still applied to the ovary, takes up, ab-
sorbs,  and conducts, by a kind of peristaltic movement, into  the
cavity of the uterus.  This drop is nothing less than the embryo,
or at least it is contained in it.  But what  takes place at the moment
in which the semen is in  contact  with the  surface of  the  ovary?
Here begins the obscure, the inscrutable: we are all aware of the
numerous systems proposed for explaining generation, all of which
may, however, be reduced to the three  following, now presented in
a chronological series.
   1. The mixture of the two seminal fluids, an opinion, the origin
of which goes back as far as the ancient philosophers, and the one
adopted  by Hippocrates and Galen; 2. the system of  ova, which
has the most numerous class of partizans;  3.  the system of sperma-
tic animalcula?, which only dates from the  microscopical observa-
tions of Leuwenhoeck and  Hartsoeker.
   According to this latter belief, the male alone  furnishes the em-
bryo;  his semen contains thousands of them, under the  form of
small animals, observable, we are told, by  the  aid of the micro-
scope.   The office of the female is restricted to the furnishing it
with a lodging, which it finds in the vesicles of the ovaries; one of
which is penetrated by the most  vigorous of these animals,  that af-
terwards grows  and is developed  like the larva of the fly in the
gall-nut
   The system of the ovists is the precise counterpart  of  the  one
just stated: they maintain that the embryo exists ready formed in
the ovaries; every female having a certain number of them, which
would remain in a state  of useless repose during life,  did not the
semen masculinum come to arouse them.  As to the origin both of 
                 OF GENERATION IN GENERAL.             507

 these animalcula? and the embryos of the ovaries, some believe that
 they  were formed at the creation, and included one in the other in
 the first male or in the first female; others, that they were at that
 epoch dispersed at random  through nature, and taken in together
 with  the ingesta and absorpta, by the other organs, and by them
 finally deposited in those  of generation.
   The third opinion, which was supported by Buffon with all  the
 eloquence he was  known  to possess, holds a medium between  the
 two preceding ones: it admits in the woman a semen secreted by the
 ovaries, though not  demonstrated  by anatomical researches or ex-
 periments. This liquor flows, we are told, along the Fallopian tubes
 in the moment of coition,  and is mixed with  the semen masculi-
 num.  Each of these fluids contains particles extracted from  the
 individual  who furnished  them, and their combination round a sup-
 posed mould produces an embryo, male or female, according to the
 predominance of one or other of the parents.
   I do not believe that we can  seriously  enlist  ourselves as  advo-
 cates  of any of these three systems,—hypothetical as they  all
 evidently are: even though we admit their being animals, we know
 of no demonstration of these microscopic corpuscules being truly
 men in miniature, doomed to live and die by myriads in the most
 abject degree of the zoological scale; since  similar microscopical
 animals are found in vinegar, and a great number of vegetable in-
 fusions, which are not destined for generation.   It  is no  less vi-
 sionary to admit an embryo in each ovarian vesicle; first, because it
 is impossible to demonstrate any in it, and those who assert their
 having distinguished these things in the ova1, or the unfecundated
 roe, have done nothing else but imagined a fiction, in order to give-
 support to  their opinion;  and next, because this peculiar state of
 torpid existence, unsusceptible  of any ulterior  development until
 the instant when the semen shall arrive and stimulate the ovary, is
 a gratuitous supposition,  resembling that of  the spermatic animal-
 cula?,  and a tale, the invention of which is unsupported by any fact.
 Finally,  the  mixture in the uterus of two seminal fluids, each con*
 taining molecules extracted from the bodies ef the two sexes, and
 which are to  be arranged  round a pre-existing  mould,  is  another
fiction, the more inadmissible, in as much as the female semen  has
 no existence, and as conception is not accomplished  in the uterus.
  What remains to us then as proved?   1. The existence in  the
 ovaries of the female,  of  several small deposits of  animal matter 
 '<tS             OF GENERATION  IS  GENERAL.
mtended for generation ;  2. the existence of another animal mattti
furnished  by the testicles of the male, and destined for the same
office as the former ; of such a nature, moreover, as to  exert a
lively stimulation on the internal genital mucous surfaces (internal
genital senses)  of  the two sexes ;  3. the absolute necessity of the
direct contact of this last matter with the surface of the ovary, or
with the animal matter previously excreted from it. *
  These conditions being fulfilled, fecundation takes place:  it is
in the human species, as in all other animals and in vegetables, the
wrork of organic  chemistry;  the necessary vital impulse having
been given, that is to say, all the movements  necessary to bring
together the two animal matters  having  been performed, the  play
of molecular affinities, directed by the unknown power which we
call life, or. vital power, accomplishes the rest; and to attempt to
penetrate into its mysteries is to bewilder  ourselves in  darkness.
Have we after all any clearer comprehension of the nutrition  of a
being already formed, than of the formation of a new being  ? Alas!
we  do not even know how to explain the formation of a cicatrix,
or the composition of a humour, the principles of which were not
pre-existing in the blood : still  more, all the art of our chemists
does not go so far as to imitate a single one of the animal or vegeta-
ble  fluids, even though they think they have united together all the
materials composing them.   Why  then should we find  any thing
more incomprehensible in generation than  in other vital transfor-
mations ?
  Is conception effected at the moment of coition? I do not believe
that there  can be  any doubt on this  subject.   Women endowed
with much  sensibility distinguish  very  well the moment, which
must be that in which the semen,  having traversed the Fallopian
lube, is brought  in apposition with  the  predisposed  ovary.  It
seems to us, moreover, that  the  perfect  resemblance between two
twins is a proof that they have been conceived at the same moment;
for  how believe in the possibility of two  precisely equal vital im-
pulses?  We do not know whether the formation of two twins de-
pends always on the simultaneous  fecundation of the two ovaries;
the gestation of three or even four children, shows,  at least, that a
single ovary may furnish several embryos.
  • Even though the aura seminatis fecundates, our position is not the less tenable
the emanation from the semen is still semen. 
OF GENERATION IN GENERAL.
509
  The uterine cavity presents, according to experimenters, no change
until the nineteenth day after conception.  During this interval the
principal phenomena take place, it is said, in the ovary.  The point
touched by the semen undergoes a vital erection resembling inflam-
mation; a vesicle  is formed, which breaks, and  the contained hu-
mour is absorbed  by the tube,  the fimbria? of which had remained
attached to the ovary from  the moment  of conception.   This hu-
mour is nothing else but a small ovum, in which are contained the
embryo with its  cord and  membrane; the opening of the vesicle
giving issue to the fluid, leaves a yellowish point, somewhat resist-
ing,  which gradually disappears, and is called corpus luteum.
  It is, then, towards the nineteenth day, according to  general
opinion, that in woman the ovum  arrives in the fundus of the  ute-
rine cavity.  At this epoch the embryo, which  it encloses like  a
true parasite,  has gained sufficient strength to apply its nutritive
mouths to the surface within reach.   It is now fixed in the uterine
cavity,  which combines all the conditions necessary to its develop-
ment.   First,  it determines, by the stimulation of its combined ab-
sorbing mouths (placenta),  a vital  erection, accompanied with heat,
and afflux of fluids; in a word,  a true shade of inflammation.   The
sensibility of  the uterus does not seem to be at first augmented.
but the stimulation  of  this  organ  cannot fail to be repeated in the
other.viscera.   There are numerous grades of this influence, but we
must here restrict ourselves to those which do not pass the normal
state.
   The "uterus being now subjected to a continual stimulation which
converts it into a centre of fluxion, ceases to be affected by the pe-
riodical stimulation which gave rise to the menstrual congestion and
haemorrhage.   Some  women  are, however, an  exception to this
rule, especially in warm countries; but the hemorrhagic congestion
can, we are told, only take place at  the neck of the uterus, since
the internal surface, in connexion  with the foetus and its appendages,
no longer communicates with the exterior.  This principle recog-
nized by authors must," however,  be liable to exceptions; there are
a great number of  cases in which the blood, or  else gases, escape
from the  cavity even of the uterus;  superfostations prove likewise
that the opening  of the two Fallopian tubes is not always obliterat-
ed by the membranes of the foetus.  The only point now at all in-
volved in doubt  in this question, is  that the portion of the uterine
surface, corresponding with the placenta,  can never, in a normal 
510
OF GENERATION IN  GENERAL.
state, communicate with the exterior.   As for the rest of its extent,
it is possible that the chorion does not entirely occupy it, or that it
may in part be detached from  it without injury to the growth of
the embryo.
  The retention of  the blood of the menses occasions plethora and
polysarcia; most of the internal functions are raised to the highest
degree of activity,  and the mother is in a  condition to furnish an
abundance of nutritive materials to her uterine burthen.
  This latter, endowed with a peculiar modification of life, attracts
the more free animal matter to it, in proportion as its own consump-
tion is considerable.   Hence arises augmented volume  of the ves-
sels of the womb, thickening of its sides, development of its mus-
cular fibres, and without doubt also corresponding  increase in the
nervous matter entering into  its composition; for the further preg-
nancy is advanced, the more influential does this organ become;  and
when the  epoch for the evacuation of its contents has arrived, it ex-
ercises a despotic sway over the two nervous systems of the animal
economy.
  If we follow the foetus  in its development,  we shall find that,
towards the expiration of the first lunar month, all  is blended to-
gether in  the form of a small mass,  gelatinous, albuminous, oblong,
and swelled out towards its middle, having nearly the  shape of a
short worm, or rather of a vermiform  larva ; the cord comes  out
from the protuberant portion, and is thick, short, and funnel-shaped.
At  this epoch,  no organ is  distinguishable even by the aid of the
microscope ;  all is white, transparent, and readily dissolved in
water.
  By continuing to observe this gelatinous mass, we see  it deve-
loped in the^oJlowing order.  The head begins to be recognizable
at first, on account of its being  larger than the other extremity,
and afterwards  because we distinguish in  it small  spots, which
mark out  the future seat of the nose, mouth, and ears; the heart is
seen to beat; small spots announce the future position of the genital
organs; the head, at first apparently blended with that of the chest,
becomes more and more removed from it in proportion as the neck
is defined. At a later term, the tubercles which sprout  from the
trunk are  the first sketch of the limbs ; these begin with  the hand
and foot, which have at first a membranous appearance, and which
recede from the trunk by the successive formation  and growth of
the  fore arms and legs, and of the arms and thighs.   This march 
OF GENERATION IN GENERAL.
511
already followed in the development of the head, is then common
to all  the extremities;  let us say more, it is that of the growth of
the  bod)  generally; the most important parts, the principal centres
of action, are the first formed; they then  recede from each other,
in order to give place to the intermediate  organs, which,  as yet,
had been only formed in faint outline.
  An important remark is to be here made; it is, that the placenta
takes a growth much more rapid than the foetus in the beginning of
gestation.  The bibulous vessels composing it set out at first from
the  umbilicus,  from which they  diverge ;  they  are  afterwards
united, and constitute a mass of a funnel shape ;  but in proportion
as pregnancy advances, this mass is removed from the body, and
the  cord joining them acquires length : there is here then the same
kind of development as of the  head and  limbs.   As the placenta
is the preparatory organ of the nutritive juices of the foetus, it at-
tains its  growth before the latter, and is  only exceeded  by it in
volume at a tolerably advanced period of pregnancy.
  We  shall not stop  to repeat after authors,  the  account of the
growth of  the foetus corresponding to the different epochs of gesta-
tion, because our  knowledge is not sufficiently advanced to enable
us to deduce therefrom any conclusions applicable to pathology.   It
is sufficient for us to have directed attention to the general mode of
evolution of the new being; it consists, as  we have  said, in the vis-
ceral masses being the first formed; in their being very close to each
other,  and  as it were blended together; in their then separating in
proportion as the intermediate organs are developed;  in the extre-
mities  of the limbs appearing likewise before the  other  portions;
and finally in the placenta offering the same peculiarity in relation
to the umbilical cord.
  It is very desirable that we should possess details of the growth
of each of  the organs which form the masses of  the  viscera; such
observations  have been  made as regards the brain.   Tiedemann,
setting out from the  data furnished by Gall,  has remarked that  the
superior  portion of the medulla oblongata is  the first seen, and the
cerebellum and the hemispheres of the cerebrum appear like small
prominences, which gradually enlarge while receding from the pri-
mitive tubercle, and finally exceed it in volume.   We always find
then that the most important organs are the first formed, and that
the others are detached from and grouped around them.  This does
not imply the assertion that they are produced from them, but only 
31J
OF GE.NKKATION IN GENERAL.
 that they are at first in close  approximation, and then  separate
 while acquiring size, and allowing of the growth of the interme-
 diate tissues.
   We are of opinion, that the shock of vital electricity, if we may
 be allowed  the expression,  which  constitutes conception, must
 mark out, in the small  gelatinous mass, the route which is to be
 traversed by the nutritive juices, in order to  the formation  of all
 the organs: or,  if other phraseology be preferred, that this commo-
 tion  impresses on the  molecules an intestinal movement,  whose
 continuation must produce the arrangement  under which all the
 organs will be formed.   We believe that the  female  furnishes, at
 least in major part, the matter of the embryo,* but that the arrange-
 ment which disposes this matter in the form of an  embryo, only
 takes place at the moment in which the two matters are brought in
 contact.  We do not mean to affirm that the impetus belongs ex-
 clusively to the male; were it thus, the child would constantly re-
 semble its father, whereas it presents at one time the perfect image
 of its mother, and at another that of the father,  and more frequently
 the combined features of both parents.  I  have likewise very fre-
 quently observed, that the child, while it exhibited the most charac-
 teristic features of the father, had the constitution and temperament
 of the mother, and vice versa.   Now these united facts do not allow
 us to believe either that the foetus is secreted and formed complete by
 the mother, and only receiving from the father the impulse determin-
 ing its growth; nor that the father has the exclusive privilege of giving
 to the prolific matter secreted by the mother, the motion by which
 its organs are to be arranged.   We are then of  necessity compelled
 to admit that the vital impulse, or the movements of affinity of vital
 chemistry, which mark out the first lineaments of the foetus, pro-
 ceed from both parents.   The animal substances prepared in each
 of them for generation, are inert until the moment in whieh they
 are united; but so soon as that of the male has  simply touched the
 surface of the ovary, it penetrates it in spite of the thin serous lamina
 enveloping it.   Then begin the intestinal movements; the  mole-
 cular vital  attractions  which are  to  make up the foetus.   They
doubtless  do not thus  produce  it at  the first moment,  but by
their continuation they finally form it.
  • The facts proving this are most numerous.  The egg of the bird, the roe of
fishes, are only provisions of nutritive matter destined to supply the embryo until
the time in which it can provide for itself by articles from abroad. 
OF GENERATION IN GENERAL.
513
  The embryo derives its first nourishment from the small mass of
fecundated gelatine enclosed in the cell on which the semen of the
male has operated.   It is at this epoch free, and is even so during
all the period in which it traverses the Fallopian tube; but when it
has reached the fundus of the uterus, this small mass, though en-
larged by the imbibition or attraction which it made of the adjoining
juices, is incompetent to- its nourishment   It has been consumed,
and the embryo is already furnished with bibulous vessels to form
its placenta: so soon as these vessels have vegetated on its surface,
they are implanted on the part to which they correspond.  Hence,
if the descent into the uterus has been retarded by any accident,
and if the Fallopian tube,  losing its vital erection, abandon the sur-
face of the ovary before having absorbed  the small ovum, the em-
bryo which it contains, still continuing to grow, will apply its pla-
centa either to the  tube, or to the ovary, or to the peritoneum, and,
by means of the irritation  to which  it will  give rise, will extract
from this spot the juices of which it has need  for its growth.  This
is what constitutes extra-uterine pregnancies, of which  we shall
seek the causes in the pathological section of this chapter.
   When the child  contained in the uterus has completed the period
 of its growth,  the womb has likewise arrived  at the degree of irri-
 tability which no  longer  allows it to remain in  its  cavity.  We
 say  to the degree of irritability, and not to the degree of distention,
 because,  in fact,  experience  shows, that a  uterus holding two
 children, and  consequently much dilated, is not sooner relieved of
 its burden than  that  containing but one.  It is then rather the
 duration and increase of  the irritation of the uterus, than the vo-
 lume of  irritating  foreign bodies,  which determines the effects of
 ejectment.   As to the first cause of  the impatience of  the uterus,
 it is as useless to seek for it as to pursue  that of  all the other peri-
 odical phenomena observed in the exercise of the functions.
   The efforts at expulsion seldom begin in a  sudden manner. The
 uterus at first slowly  contracts from its fundus to its neck; the fe-
 male perceives that her abdomen is constricted, and that her burden
 is directed downwards, and the head of the child strongly engaged
 in the cavity  of the  pelvis.   The labour is  at its commencement
 announced by pains sympathetically referred to the loins.   These
 pains soon become more  defined;  women compare them to  colics,
 and they who are inexperienced even go to the water-closet; but,
 at last  the true character of the pains is exhibited, women declare
                               65 
514
OF  GENERATION IN GENEKAL
 that they are of a peculiar kind, and, if the physician observes
 them, he makes the following remarks.
   So soon as the  uterus begins to contract, the abdominal muscles
 become  harder and participate in its efforts, the diaphragm taking
 part at first involuntarily, and afterwards by the influence of the
 will, which is solicited and forced by the nature of the pain.   The
 woman is  then compelled to  act, involuntarily, not only on these
 muscles, but also on all those which concur to the performance of
 respiration, and to interrupt this function, in order to aid the efforts
 of the uterus.  Nor is this all;  she is also obliged, in order to furnish
 a point of support to all these muscles, to employ those which serve
 for  locomotion, by  choosing the posture most favourable, and
 grasping with  her hands the bodies around her, and pressing, half
 bent, with her feet against whatever is  near her.
   It is by  means of these combined and repeated efforts continued
 for some hours, that the neck of the uterus is dilated, the sac con-
 taining the waters is protruded and ruptured, and that the head of
 the child traverses the straits of the pelvis, dilates the opening at
 the vulva, and is finally expelled.  The uterus, continuing to con-
 tract on itself,  next expels the  after-birth, which  is composed of
 the placenta  and of the  membranes  in  which the child  had been
 inclosed.
  After the delivery is over,  there are  great changes in the order
 of vital functions.   The uterus begins to disgorge itself in  propor-
 tion as it contracts: at first it expels pure  blood, soon after sangui-
 nolent lymph, and finally nothing more passes but puriform mucus,
 the consequence of  inflammation which  remains  in its internal
 membrane  subsequent to the detachment of the after-birth.  It is
 about the third day from  the  delivery,  and when  the uterus has
 ceased to discharge pure blood, that  the secretion of  milk, for
 which the  mamma? had been  prepared  during pregnancy, begins
 to take place in great abundance.  As it is impossible, consistently
with sound physiology, to say that the blood is directed towards the
 mammary  glands, we are compelled  to admit that the vital action,
which was spent in the uterus for the nutrition of the child, is re-
 placed by  that which presides over  the secretion of milk.  The
 change of  place in the theatre of the irritation, supposes that the
uterus is connected with the mamma? by a peculiar sympathy.
This is manifested in all the menstrual epochs by an increase of tu-
mefaction and sensibility in these organs, and seems  to be more evi- 
OF GENERATION IN  GENERAL.
515
dent during pregnancy, since, in proportion as the uterus acquires
size, the mamma? are enlarged and even sometimes secrete  milk.
But it  is when the uterus  is entirely freed from the stimulation
which had been irritating it for nine months, that the above sympa-
thy is evidenced in its highest degree of energy; the mamma? are
swelled and heated; they send to the heart, and over the entire ap-
paratus  of the great sympathetic,  irradiations which give rise to a
febrile movement;  but so soon as the mammary glands have taken
on  secretion, this exacerbation is  diminished and dissipated in a
true crisis, by an abundant excretion of milk, always accompanied
by a more or less copious sweat.
  This first effort being over, the milk and sweat flow during some
days, without any fever; and, if the sucking of the child does not
keep up the secretion from the mamma?, they  dry  up, the sweat
ceases, and the uterus regains its habit of periodical congestion and
hemorrhage.   But if the mother become  nurse, the  uterus con-
tinues ina state of inaction, until, the mamma? ceasing to be irritated,
it may once more return to the kind of normal action which it must
preserve during the entire period of fecundity.
  If next we examine the female  just brought to bed, under the
heads of instinct and the intellectual  faculties, we find maternal
love  developed, immediately on  the child which she bore  seeing
the light.  This love,  partly physical and partly moral, is prolong-
ed during the entire period of sucking, were it only by the power
of instinct, which sways the intellectual faculties, when these latter
are not diverted  from it by a series of ideas derived from another
source,  a  case very happily of  most  rare occurrence.   As  an
instinctive impulse, it is weaker  as the child grows  larger; but
it preserves afterwards all  its intellectual   character, and extends
through a period longer than that in which  it is operative with the
females of other animals.   We will not now stop at considerations
of this nature, which we have treated of in the chapter on instinct
and on the intellectual faculties; but we must here call to mind, that
the state in which the visceral nervous system is found after child-
birth, is in harmony with the moral condition  of the woman; for
this fact is susceptible of some applications to pathology. 
516
OF GENERATION IN  GENERAL.
 Section III.—In tohat manner the Action of the Genital Or-
              gans becomes the Cause of Diseases.

   The mere preliminary of the generative acts, desire,  may he-
 come a cause of disease.   As a mental emotion, when it undergoes
 opposition, it causes disease in the encephalon and visceral appara-
 tuses:  hence acute and chronic insanity, partial deliriums,  palpita-
 tions,  convulsions, suffocations, attacks of asthma, constriction, and
 heat in the stomach, which may lead to latent and even acute gas-
 tritis.   In a word, there is none of the diseases which we have
 referred to the depressing emotions, to those which are founded on
 the alternations of pain, anger, and pleasure, that may not recognize
 as a cause the mental excitation resulting from the obstacles encoun-
 tered by a man, to the gratification  of his venereal desires.
   We have said that there were examples of spontaneous rabies
 produced by this  cause: they must  be considered as the effects of
 nervous irritation, which becomes excessive in the fauces, encepha-
 lon, and salivary organs,  and in the entire apparatus of the great
 sympathetic.
   The desire ungratified sometimes produces priapism or satyriasis
 in man ; and in woman it may give  rise to nymphomania ; but as
 the female sex is  destitute of the stimulus of the semen, it is less
 exposed than the  other to  the excess of genital  irritation, unless
 certain depraved habits should produce in a direct manner this irri-
 tation  on the parts submitted to  their influences.   But  in  return,
 reason is  in greater danger in  woman than in man.   We  must
 not overlook the involuntary  pollutions, especially the nocturnal
 ones, which  forced continence occasions in certain men in whom
 the secretion of semen is very abundant,  and which are often very
 difficult of cure.
   Coition may be  the source of a great  number of accidents more
 or less serious.  In the first place the extraordinary afflux of blood
 to the  cerebral substance may give  rise  in it to an effusion, which
 occasions  sudden attacks of palsy and apoplexy.  The excess of
 enjoyment may even be suddenly fatal without the effusion of any
 appreciable quantity of blood, and by the simple effect of the accu-
 mulation of this fluid in the cerebral substance.   It seems to us
 probable that the blood has  then passed  the limits of the normal
state, and  that there exists a more than  ordinary extravasation in
the encephalic parenchyma. 
            DISEASES FROM THE GENERATIVE ACTS.        517

  The violence of the palpitations  which always  accompany the
generative act, shows how much the heart must suffer in those who
indulge in it to excess.  This cause is even adequate to the produc-
tion of aneurisms: but they who are already affected with them are
much more exposed:  hence we often see such persons suffer from
violent  attacks of orthopncea, after coition, because the  heart too
distended refuses to receive blood from the lungs; or else we hear
of their perishing  in the act itself; and autopsia  has sometimes
exhibited a rupture of an  auricle or even  of a ventricle,  with a
sanguineous flooding in the pericardium.   Coition, too frequentlv
repeated, debilitates the heart, and the circulation languishes.
  The fits of asthmaf following the efforts of coition, may likewise
depend on a certain degree  of hypertrophy of the heart,jjlethora,
and a convulsive disposition of the bronchial tree.  It is nearly the
same with ha?moptysis; for the  suspension of respiration concurs
with the augmented  violence of the pulsations of the heart,  to ac-
cumulate  blood in the lungs, and to bring about the  extravasation
and discharge of this fluid.
  When indulged in immediately after a meal, coition cannot fail
to  disorder the digestion in delicate persons:  the excess of sensi-
bility developed by this act in the epigastric region, is participated
in by the sensitive surface of the stomach; there results an afflux of
blood in the vessels of  this viscus, violent pulsations, an increase
of heat, and even pains  sufficiently intense to produce a fear  of
sexual enjoyment in persons who are afflicted  with chronic gastri-
tis; and we know how great is the number of the unfortunate
thus afflicted, thanks to the prodigious vogue of the emetico-cathar-
tic, deobstruent, and  tonic method!  In general, venereal excesses
debilitate the stomach, and after an agreeable  warmth give rise  in
it to a sensation of coldness and languor, which seems to invite a
man to  have recourse to stimuli; but this  uneasiness is also indica-
tive of  over-irritation, and, if we give into  the practice of  curing
it by stimuli of too energetic a  nature, we  necessarily bring on  a
morbid  state.
  The effect of coition is also strongly felt in the urinary apparatus.
The urethra is at first irritated,  then the  neck of the bladder and
the  prostate gland are similarly affected,  with often  an  extension
of the irritation to the bladder and the kidneys; these parts become
verv excitable, and disposed to  contract  inflammation under the
influence of cold, or of stimulating drinks,  or even by the mere 
518
(IF GENERATION IN  GENERAL.
effect of the act itself; the urine imperfectly combined in the kid-
neys is decomposed in their pelves, or in the bladder, and calculous
diseases are the consequence.
  The simultaneous  excesses in the use of wine,  high-seasoned
food, and the pleasures of Venus, rarely fail to bring on nephritis,
cystitis, and gravel.
  The eyes always participate in the  irritation of the  genital  act:
they become sparkling and injected, and finally acquire an excess
of sensibility,  ana! a disposition to take on  engorgement by the
slightest irritation. This is one of those causes which most power-
fully tend to produce chronic ophthalmias and loss of sight.
  Coition is never performed without a considerable excitement of
the muscular system, which will even go so far as to produce con-
vulsions.  It is not then astonishing  that debility should be the im-
mediate effect; and, if the indulgence be too frequently repeated,
it becomes the cause of permanent  asthenia: hence men, who ha-
bitually abandon  themselves to this kind of excess,  are ill able to
bear painful and continued exercises. It is  known with what care
the athleta? of ancient Greece abstained  from venereal enjoyment
To  the same  influence must we  attribute the  diminished  strength
of voice after such excesses.   In order to preserve that  of their
singers, the Romans had  recourse to the infibulation of the prepuce;
but the  lubricity of some rich matrons soon  contrived,  if we are to
credit Juvenal, to  overcome this feeble obstacle:  Gaudenti cantu
nullius fibula durat.
  There is an important tissue, the functions of which are power-
fully deteriorated  by  venereal  excesses;  I now speak of the skin.
  The excitation of the heart, and the muscular movements, cause
much blood to arrive  at it; the skin  is heated  and reddened,  and
perspires freely; but a calm having succeeded the excitement the
perspiratory process and the impelling power of the heart are di-
minished; the skin is pale, and remains more susceptible.  If cold
impress it, there is a deficiency of reaction, and rheumatic and gouty
phlegmasia?,  and engorgements of the large viscera,  are the usual
results.
  It is therefore, on one side, by giving rise directly to visceral en-
gorgements, and on the other, by raising the excitability to  such a
degree as to exhaust and favour  the action of other causes capable
of deranging the equilibrium,  that the abuse of venereal pleasures
becomes so potent a cause of infirmities:  it is also from not having 
            DISEASES FROM THE GENERATIVE ACT».         519
well understood this kind of action, that physicians have so often
aggravated the diseases  of persons, who have committed excesses
of the above nature, in neglecting to attack  the visceral congestions
by suitable means.  In the old practice, it was sufficient that a man
was suspected  of having  yielded  with little reserve to  the plea-
sures of love,  for the medical adviser to reject, with  a  degree of
horror, the emission of  blood, and to have  immediate recourse to
the employment of the most active stimuli.
   Venereal excesses are not alike hurtful to all persons.  The abuse
is much more easy in  man, because he loses more than woman, and
undergoes more debilitating efforts; but if the latter carry the repe-
tition to such a degree as  to be an excess for her sex, she will un-
questionably have to dread more disorders, as her nerves, being more
feeble, will  more readily contract a convulsive habit, and the visce-
ral congestions, always renewed by the menstrual returns, will pre-
sent greater obstacles to the cure. It is erroneously that certain persons
repeat, by a kind of echo, that women brave with impunity exces-
ses of this nature;  experience too surely proves, that  they of the
female sex, who abandon themselves in this way, soon  lose all their
freshness  of complexion,  become  dyspeptic, contract pectoral dis-
eases,  inflammation of  the vagina, with flux and eating chancres,
have menorrhagia, occasioned by irritation  of the  neck of the ute-
rus, and often perish  the  victims of the ulceration of this part, and
of the disorganization of other viscera.
   Among men, those who are the greatest sufferers are the most
nervous, because they are susceptible of excesses to which stronger
but less irritable subjects  could never give into, and because these
excesses never fail to produce congestions in the brain, heart,  and
lungs.   We learn from this, how reserved, on the  score of venereal
enjoyments, ought to be  those young persons  of ^n  irritable and
sanguine temperament,  whose chest is narrow, and heart very ac-
tive, or even  hypertrophied: such a constitution almost always
gives them a propensity  for sexual enjoyments, and their facility
furnishes  a triumph which seduces them; for a man considers him-
self to have so much the more prowess and  vivacity as he is strong
in  coition,  an  illusion which is  the cause of his destruction.   I
have known many, whom the fear of losing their advantages in this
latter respect  kept obstinately away from bleedings, low diet, and
other debilitating means, the only ones which remained to them,
in order to escape the phthisis with which they were threatened. 
520
OF GENERATION  IN  GENERAL.
  For the appreciation of the effects of coition on the health, the
physiological physician must hold in mind the  facility or  difficul-
ty of the seminal  ejaculation in man, and of the act whicli corres-
ponds to it in the other sex; for the more difficulty there is in ob-
taining this result, the more the  excitation which is there  yielded
to for its  accomplishment is  violent  and  perturbating.   This
is what we always  observe in  those  who, from ill-timed self-
love, or vicious habits, are hurried away into enjoyments which
greatly exceed the  wants of their constitution.  In this way ori-
ginate the ha?moptyses, aneurisms of the heart, convulsions, para-
lyses, distortions of the spinal column, and many other diseases,
the obstinately untractable march of which we are often witnesses
to, without being able to find a satisfactory reason for them.
  Of all the ages,  childhood and adolescence have most to suffer
from venereal  excesses, on account of their liability to hemorrha-
ges,  visceral congestions, and convulsions.  These latter frequently
come on during the act itself, and readily become habitual  in such
subjects.  How many epilepsies are there not dependent on the
same cause?  The unmeasured repetition of these kinds of exces-
ses rarely fails, at those epochs of life, to bring on stupidity and de-
mentia.
  The adult age is that which incurs least danger from venereal
enjoyments; but they are frequently fatal to old men, less by bring-
ing on premature decrepitude, than by giving rise to apoplexy  in
those who are threatened with  it, or in causing relapses in  those
who  have already suffered from  its attacks.  One of our  medical
friends, who has  for a long time superintended many  mineral
springs in Spain, has observed that the paralytic who visited them
to obtain relief from their maladies, almost always traced their
first  attacks to the effects of a venereal congress.  It is unnecessary
to add, that aged people affected with  hypertrophy of the heart,
and we know they are in great numbers, run the triple risk of the
rupture of that organ, of suffocation, and of fatal apoplexy, if they
do not succeed in conquering this imperious habit, which tends to
bring them back to the pleasures  of another age.
  It is a well established fact, that the  same men may repeat  the
act of coition with  less fatigue in  warm than in cold climates.   We
cannot explain  this difference otherwise than by that of the secre-
tion of the semen:  this fluid being more abundant in high tempe-
ratures, its excretion requires little efforts; but if it be wished  to
repeat the act as often in cold and cloudy climates, the difficulties 
          OF  DISEASES FROM THE GENERATIVE ACTs.      521

that are encountered lead to a super-excitement, of which we have
sufficiently appreciated  the  dangers.  At any rate, we must like-
wise confess, that venereal  excesses have also inconveniences  in
southern, which they do not present in northern latitudes,—of pro-
voking excessive perspirations,—exciting thirst,  and predisposing
to gastro-enteritis,  by inducing man to make an abuse of stimuli and
tonics, with  a view of renovating his  prostrated powers.  This
same  prostration renders  him  also more susceptible of being  af-
ted by the  humid  cold of night; and also by marshy exhalations,
the influence of which is so dangerous in those climates. It results,
finally, that these sorts of abuses are attended with still  more  in-
conveniences in southern than in northern regions.
   Conception may become  to women a fruitful source of disease.
In  order to  form an idea of this, it is  sufficient  to recollect, that
the absorption of the ovum requires a certain time,  during which
the fimbriated extremity of the  Fallopian tube must remain  in
apposition with the ovary.  This permanence depends upon that of
the erection of the tube,  which latter in its turn can only be kept
up by the vital erection or organic irritation, which has been esta-
blished in the ovary since the ejaculation of the semen, and  which
will only cease when  the  prolific drop shall have been detached
from  it.   But where is  the organic irritation, however deep-seated
and slow  it  may be, that cannot be affected  by a powerful  moral
emotion?   Is there a  part  irritable and supplied with nerves, to
which the brain may not transmit the commotions it receives dur-
ing surprise, anger, fear,  &c?   It  would,  therefore, be possible,
that a lively emotion of the soul could  cause the detachment from
the ovary of the  extremity of  the tube by which it is embraced,
before it has effected the absorption of the fecundated ovum.  But
as the embryo by which it  is filled is a true parasite, to which all
parts of  the body are indifferent, so soon as the moment shall have
arrived, when the gelatinous mass  which contains it will no  longer
suffice for its  nourishment—so soon as it shall project from itself
the imbibing vessels of its  placenta, it  will implant them on  the
portion of fixed animal  matter within its reach,  and will there  de-
finitively fix itself.  If, then,  the separation of the tube from  the
ovary takes place before the ovum has reached the uterine  cavity,
the embryo, having attained that degree of development we indi-
cated  but of which it is impossible to fix the period, will attach it-
self either to the ovary, or  to a  point of the tube, or else in the  pe-
                               66 
52Z
OF GENERATION IN
GENERAL.
ritoneal cavity, and  extra-uterine  pregnancy will  be the  conse-
quence.
   A case  related in his thesis, by Professor Lallemand, furnishes
an example of this kind.   A  very impassioned woman had com-
pelled her husband to gratify her desires in the day time, without
even taking the precaution of locking the door.  At the moment
of the  ejaculation a door opens with violence;—this woman feels
an extraordinary commotion  in  her abdomen;—her pregnancy is
irregular, attended with many accidents; and  death, of which it is
not my business to describe the precursory circumstances,  affords
an opportunity of discovering that the  child had been formed  in
the cavity of the pelvis. Its placenta was adherent thereto; an inflam-
matory exsudation, which the author  compares to the membrana
decidua,* lined the whole of this cavity,  and  blood-vessels had be-
come developed in the  part  corresponding  with the placenta,  at
least as much  as the texture of the peritoneum had allowed.
   There are cases in  which the  placenta has been found attached to
the external surface of the uterus,—in others it has been discovered
on the intestines,—in others in the Fallopian tube,—in the fimbria-
ted extremity of this  latter,  or on the  ovaria, &c.   It is easy  to
conceive what accidents must result  from such attachments, and
particularly those  that would  take place on   the  intestines, or on
the stomach if it descended sufficiently low down.
   The  fact related by M. Lallemand is of a nature calculated to
elicit reflections.  The moment of surprise and terror, which this
woman experienced, destroyed suddenly the erection of the tube,
and detached the fimbriated extremity from the ovary; this appears
to me beyond doubt;  but  did the ovum fall at the instant  in the
cavity of  the  pelvis,  or only a few days  later?   The first case
would suppose that the prolific drop is absorbed by the tube,  and
carried to the uterus at the very instant of  conception.  The se-
cond  would be explained by saying  that the fecundated  ovary
produced  and  expelled slowly its little ovum, and that not finding,
at the instant this  latter was detached  from the ovary, the tube  at
the proper place for  receiving it, it has  necessarily fallen into the
  * The cavity of the uterus was lined by a similar production, from which M.
Lallemand concludes, that the uterus was  sympathetically irritated by the influ-
ence of the fecundated ovary. 
          OF DISEASES FROM THE GENERATIVE ACTS.       523
abdomen, and fixed its placenta to the nearest part*   Other facts
will doubtless  serve  to elucidate the present  one.    We know,
that observers admit that the ovary fecundated by the spermatic
fluid, requires a certain number of days to project  its ovum;  and
that it is in order to wait  for it, that the fimbriated extremity of
the tube, kept in a state of erection by the irritated ovary, remains
in apposition  with it  But were  this really the case, I am surprised
that extra-uterine  pregnancies should so rarely occur; for during
the number of days supposed requisite for the  detachment of the
ovum, women  are often exposed to moral emotions as vivid as that
of which I have just spoken, and not less capable of  destroying the
vital erection of the tube, which  maintains its fimbriated extremity
in apposition with  the ovary.   At any rate, the present reflections
are only offered in  order to elicit new researches on these import-
ant subjects.   I say important, for if the detachment of the ovum
requires so long a period, women can hardly be taken too much
care of during the days immediately succeeding  conception;  but,
how can we judge of this latter, when the woman herself is not
conscious of it?
  The obliteration of the cylindrical canal of the tubes, is, without.
doubt, the most frequent cause of sterility in women, by preventing
the spermatic fluid from reaching the ovaries. This  reflection must
make us sensible of the great importance of curing uterine inflam-
mations that might occasion the obliteration of the mouths of these
canals.
  The  emission of semen is rarely for man a source of disease:
yet it may happen that the sudden  suppression of the spermatic
excretion by  a powerful moral sensation, will  develope an inflam-
tory movement in the epididymis, or in the body of the testicle.
Examples of the sort are on record; but it must  not  be supposed
that there can result from this the imperfect procreation of an em-
bryo, as some authors have believed; inflammations, more or less
intense and painful, and,  as a consequence of these, sub-inflamma-
lions, are the only effects of these accidents.
   When the embryo, having arrived in the uterus, begins to ac-
quire a little strength, it excites strongly this organ, already irrita-
ted by the stimulating action of the semen, and the  influence of
  *  The first abdominal pain was felt on the night succeeding the accident: it
persisted during the whole course of pregiwncv, and was situated at the place
of insertion of the placenta in the pelvis. 
524
OF GENERATION IN GENERAL.
the fecundated ovary, and produces a true inflammatory fluxion on
the internal surface of the uterus.  It is then that the sympathies of
this organ may be observed and pointed out in the most satisfactory
manner: and this is surely equivalent to what some affect exclusive-
ly to call direct experiments.   The first relation noticed in nervous
or  delicate women takes  place with the stomach, for the appe-
tite becomes altered and depraved, or vomitings supervene. These
phenomena, which are generally regarded as nervous, and which
inspire no fear,  may also be the prelude of very intense acute or
chronic  gastritis, or gastro-enteritis.  We cannot too often repeat
to those  physicians who are always ready to prescribe large doses
of ether and other antispasmodics to every person who vomits, that
the above-mentioned conversion is so much the more  to be dread-
ed, as the predisposition to gastritis or gastro-enteritis  existed in a
higher degree before pregnancy.
   These gastrites are further an object worthy the utmost attention
of physicians, in as much as it often happens, that young girls are
only deprived of their menses in consequence of a chronic gastri-
tis; they become pale, are pronounced to be chlorotic, and physi-
cians  recommend  matrimony.   This latter is consummated, and
soon pregnancy, adding to the irritation of the stomach, developes
an inflammation, the progress of which it is very difficult to arrest.
We even have examples  of vomitings provoked by pregnancy,
which have  obstinately continued,  in  despite of all  the efforts of
the art, and have proved fatal,  although the  inflammation of the
stomach  was very trifling.   In such cases the modification of the
stomach was more nervous than sanguineous, but of such a nature
as to resist antiphlogistics as well as stimuli.  It is never prudent,
therefore, to advise matrimony to persons whose stomach is mor-
bidly irritable.  The exceptions that might be adduced to this rule,
are not sufficiently numerous to destroy it
   In its progress,  pregnancy gives  rise to polysarcia, and to san-
guineous plethora.   Under these  circumstances, women become
subject  to pulmonary  oppression,  to  vertigo, and  palpitations.
Their flesh is of a firm consistence;  their colour high; they walk
with difficulty; they are exposed to spitting of blood, and to inflam-
mation of the large viscera,  more  particularly of the lungs;  and
threatened with convulsions, uterine ha?morrhages, and abortions,
if care has not been taken to prevent these accidents by bleeding.
  The weight of the uterus  drags  down  continually  the  abdomi-
nal muscles, and its volume and elevation are opposed to the lower- 
OF DISEASES FROM THE  GENERATIVE  ACTS.       525
ing of the diaphragm, especially in women of small stature: the
bladder being compressed, is emptied with  difficulty, and some-
times too easily; constipation is continual.  The compression made
upon  the iliac vessels,  acting more upon the veins than the arteries,
retains the blood in the inferior extremities, and produces, in indi-
viduals of a soft and lymphatic constitution, varices and oedema.
   In  those who have borne many children, the abdominal parietes
yield, and the belly falls upon the thighs, from which results a very
unpleasant  dragging sensation; and the linea alba  being greatly
dilated, gives rise to ventral, umbilical, and other kinds of hernia.
   Such are the principal derangements to which pregnancy usually
gives origin in women of  a delicate constitution,  who  have been
brought up in  idleness, or who are too nervous; but in compensa-
tion, we occasionally notice advantageous modifications in the func-
tions: the irritation of the uterus sometimes  serves  as the remedy
of habitual inflammations.   We see the symptoms of gastro-hepa-
titis, when this inflammation is not very intense, dissipated in some
 women.   In others, chronic pneumonia  is suspended in its destruc-
 tive  progress, and health seems to be re-established.  But this ame-
 lioration is not always  of long duration, and seldom continues longer
 than the period of utero-gestation, which, for the above purpose, is
 always too short.
    As soon  as  the epoch for the expulsion of the fcetus  has ar-
 rived, the efforts  which  this function  necessitates, produce, by
 interrupting the circulation,  a stagnation of blood in the principal
 viscera.   From this may result, in women whose plethora has not
 been diminished by  sufficient bleedings, irritations of the  heart,
 which may be changed into organic diseases; congestionsof.thelungs,
 which predispose this organ to become, sooner or later, the seat of
 a fatal inflammatory  fluxion; accumulations of blood in the  brain,
 which produce convulsions; draggings of the  peritoneum and its
 subjacent cellular  tissue,  which  predisposes  to peritonites; and
 finally, a rupture  of the diaphragm, cervix uteri, or perineum, and,
 in cases  in  which the pains are strong and frequently repeated,
 the  cervix  resisting, a rupture  of the  uterus itself.   In  some
 instances, and in consequence of some peculiar disposition of the wo-
 man accidents of a totally different  nature  supervene; I allude to
 the  slowness of the labour, from the weakness of the uterine con-
 tractions,  the detachment of the placenta, and  the haemorrhages
  which are the consequence of this  latter accident  But nil these 
526
OF GENERATION IN GENERAL.
circumstances are too well known to accoucheurs, to require to be
enlarged upon here.  1 consequently pass on to the diseases that arc
the consequence of parturition.
  These result from  the laceration of the  neck of the uterus and
perineum, as well as from the loss of blood; either in consequence
of the too great violence of the congestions which take place in the
uterus at the moment of labour, or from  the slowness of the inflam-
mation which necessarily exists in the internal surface of this viscus,
particularly in that part of it to which the placenta adhered, and
from the  inflammation of its appendages, the unfortunate  effect
of an incomplete disgorgement. These irritations of the uterus give
rise to a number of secondary affections both acute and chronic.  It is
thus that the inflammation of the  cervix and fundus is converted into
phlegmon, or traverses this organ and produces peritonitis; or else
remains chronic, particularly that of the cervix and ovaries, and
occasions  organic  alterations  which sooner or later  prove  fatal,
when the  females have been so unfortunate  as  to be subjected to
the influence of stimuli before these centres of inflammation had be-
come extinct.
  If we extend our researches to the organs that sympathise with the
uterus, we shall  see its influence, or else  the premature cessation of
its irritation, develope in them a variety of inflammations.  In this
series the most conspicuous are the inflammation of the mamma?,
and the slow glandular engorgements, which at a later period pro-
duce a carcinomatous degeneration; the consecutive development
of gastrites and pneumonias, some of which have  only  been sus-
pended by pregnancy,  become once more  acute after parturition;
the cerebral  irritations which  give rise  to insanity, unfortunately
the too frequent result of child-bearing, in those cases in which an
excessive  use of stimuli  has been made,  particularly in women
whose  minds had been tormented by grief.
  We  have  seen that the skin constantly served as an emunctory
for  the serous and lymphatic fluids, which are always too abundant
in females who have lately borne children,  but wrho do not suckle
them:  well, in some cases, and  commonly in those in which  the
woman has  been  too greatly excited, and  in  which the  impres-
sion of cold has  deranged the  course  of the depuratory excre-
tions, the skin contracts acute inflammations of the erysipelatous
kind, or else participates in the  inflammation of the cellular tissue,
from which  result large oedematous phlegmons, particularly  in the 
          OF DISEASES  FROM  THE  GENERATIVR ACTS.       327

lower extremities.  Others may, if they please, explain  these dis-
eases, by means of the spontaneous metastasis of the milk; but as
regards myself, I cannot see any thing more in them than an ab-
normal direction of the irritation which is so evident after parturi-
tion,—an irritation which should be limited to the secretion of the
mucosity of the uterus,  and to  that of the skin, and of  milk; but
which is called towards other parts through the influence of a  large
number of perturbating causes, such as cold, affections of the mind,
immoderate and  premature  stimulations of the digestive organs,
which nurses and some imprudent physicians imagine necessary to
produce, in order to repair the loss of blood and strength.  We
cannot too much insist upon the necessity of abstinence,  and of the
antiphlogistic treatment after  parturition, because the inflammatory
diathesis is obstinate and reappears with facility when it was thought
to have been removed.  This occurs even when women have begun to
suckle: with so much the more reason, then, must we fear it, when
owing to some circumstances  they are deprived of this precious
advantage.  Causes  occur, however, in which parturient women
incur the danger of dying, from debility and inanition.  These ac-
cidents generally take place after difficult labours, in consequence
of a profuse flooding;  and nothing is more easy than  to recognize
them by the sensation of debility, by  the  smallness of  the pulse,
paleness, coldness of  the  extremities, depression of the abdomen,
and presentiment of death.
   As the skin may contract acute inflammations, so it is not protect-
ed from those of a chronic kind; thus we see herpetic affections,  scab-
by pustules, with swelling of the sub-cutaneous ganglions, succeed
derangements  in  the excretion of the mammae.  By the vulgar,
these affections are regarded as occasioned by the milk, and they thus
designate them, a long time after the cessation of the secretion of that
fluid; but the physiological physician cannot discover anything
more in them, than an irritation of the skin which has succeeded that
of the breast, and which, in consequence of not having been destroy-
ed at its onset, has become a vicious organic habit,—a chronic sub-
inflammation.   From these considerations he will be careful not to
expose the digestive organs  to perpetual super-excitements, with
 the view of evacuating a pretended milky humour. 
52S         OK  THE' DEVELOPMENT,  CONSISTENCE,

        Section IV.—Of the Diseases of the Foetus.

  The foetus may be attacked with the inflammations by which its
mother is affected,  and with others that are peculiar to it;  hence
we  see some  come into the world with  gastrites and ententes,
accompanied with  enlargements  of the mesenteric glands.   The
child  may carry with  it pulmonary  inflammations,  and tuber-
cles which are  a  consequence  of  them.   A  commotion, or a
sharp  contraction  of the  uterus, may cause the rupture of the
membranes, which as yet are soft, and under these circumstances the
head  contracts adhesions to them.   According to  M.  Geoffrey
Saint Hilaire, such is the cause of anencephalus,  and he explains it
in a manner, the details of which must be read in his works.  Two
embryos placed in  contact with each other, whilst they are as yet
gelatinous, may unite,—which constitutes  another kind of mon-
strosity: one may  grow whilst inclosing the other in some part of
its body,—which,  at a  later period, occasions abscesses, in which
are  found  the rudiments of a foetus.
  The child may also be born with imperfectly formed organs,—with
imperforations,—vicious directions in  some of its viscera; impor-
tant organs may be  wanting,—others may be too voluminous;
there may exist supernumerary ones, &c.
                      CHAPTER  XIV.

OF THE DEVELOPMENT, CONSISTENCE,  AND DECAY OF  MAN.—OF
                THE VARIOUS TEMPERAMENTS.
         I
  When the child comes into the world, the only organs that are
fully developed in it, are such as are fundamental and the most ne-
cessary to life; that  is to say, the brain,  heart, lungs,  digestive
viscera, and  the  passages for the expulsion  of  the superfluous
portion of the mobile animal matter.  If  we examine  it  at this
epoch, we remark that the circulation is  very rapid,  but that
the serum and lymph are in excess in the vessels, whilst the
fibrine is in  a small  proportion; and gelatine predominates in 
                       \ND  DECAY  OF MAN-                  529

 me solids and fluids.   At this time absorption is very rapid; there
 is yet but a small portion of cellular tissue, which is filled with gela-
 tine.  The bones and  muscles are incomplete; sensibility is only
 aroused  for the first wants,  and sleep returns as soon as they are
 gratified.   \ et all  the organic sympathies take place with the great-
 est activity.   The head and abdomen are very voluminous in pro-
 portion to the rest  of the body; the  lungs, although large, are far
 Irom having the degree of predominance they will one day acquire,
 and the thymus gland still occupies a part of the space destined for
 them.   Of all the  parts of the body the head is much the largest,
 relatively to the others.
   At this epoch the only wants which appear at all well marked,
 are those of respiration, of nutrition, of the discharges of superflu-
 ous matters, of rest, of sleep, and external caloric; all the others are
 almost null.   That of self-preservation is only aroused  by pain, and
 not being kept up through the influence of the  mind, is  no  longer
 manifest so soon as the  child  has ceased suffering.   The little being
 is purely instinctive, and a stranger to intellect and the passions.
   In proportion as the  child advances in  age, we may  notice the
 development, at first, of the  external  parts, the growth of which
 is very rapid; the head  preserves a long time its predominance of
 volume;   but soon  the bones of the face, and the jaws,  in which
 the teeth will  show themselves, enlarge, and  cease to be dispro-
 portioned to the volume of the cranium.  The arms grow, though
 much less than the lower extremities; for nature prepares the child
 for sustentetion and walking.   The  pelvis enlarges, and,  from
 oblique that it was, tends to become horizontal: the child tries its
 strength, supports itself, walks,  and  gradually the pelvis  being  en-
 larged and straightened, a part of  the intestines is lodged therein,
 and the volume of the abdomen appears to be diminished.  Whilst
 this occurs,  we remark other changes—the external senses are  de-
 veloped, with the exception,  however, of that of smell,  which, until
 the period of puberty, is not as keen as the others.  The intellect
 is enlarged  from day to day,  and begins  to  modify the instinctive
 inspirations.   The  circulation, though not quite as active  as before,
 is still very  much so.   During lactation the child becomes very fat;
 but afterwards grows thin, in proportion  as the locomotive appara-
 tus acquires development, and  the period of puberty  approaches.
 During this  interval, absorption continues to take place with great
encrev the bones become encrusted with a calcareous phosphate, the
                               H7 
 530         OF  THE  DEVELOPMENT, CONSISTENCE,
 muscles are developed, and fibrine begins to exist in larger proportion
 in the blood-vessels, whilst the serum and lymph continually dimi-
 nish in the same  proportion.   Sensibility is extreme, the nervous
 system acquires a great degree of mobility, transmitting with rapidity
 the vital erections, which are also very numerous, and re-establishing
 the equilibrium writh  an  astonishing promptitude.   The intellect
 acquires a very great extension.   The attention  is with difficulty
 fixed upon abstract ideas; but memory, being  singularly predomi-
 nant, retraces with great facility words and the other signs of our
 ideas, although judgment has  yet acquired but little strength.
   The wants that predominate from the first periods  of infancy  to
 the age of puberty are, nutrition, which may be gratified with the
 utmost facility; that of the  discharge of superfluous matter, which
 is always urgent,  but gradually becomes less so; that of muscular
 exercise,  which is not less imperious than the want,  of nutrition;
 those of repose and sleep; that of self-preservation, which is tolera-
 bly powerful;  but, having  but a faint consciousness of danger,  or
 relying on its agility  in avoiding  it,  the child appears to  be less
 timid than the adult; he is simply less prudent.  The want of obser-
 vation is also very well marked;  for the curiosity of children is ex-
 cessive, and it  is in consequence of this that they acquire all their
 information; it is from the power of example  and  their extreme
 facility for imitation,  that they  contract habits  which will one
 day lay the foundation of their conduct in society.  The passions
 are less numerous and durable in children  than  in  adults,  owing
 to the  imperfection of their  intellect; but anger is,  in them,  so
 frequent  and  intense, as  to compensate sufficiently  for its short
 duration.
   Puberty,  prepared by the general growth of the body,  and by
 that of the pelvis and of the extremities that are attached to it, gives
 rise to a change in the physical and moral nature of the individual.
 So soon  as the sexual organs begin to acquire volume,  they be-
 come covered, in both sexes, with hair.   The semen secreted  by
 the testicles, in the male,  fills  up the vesicula? seminales,  and pro-
 duces the  erection and growth  of the penis. Stimulated by the vitil
 erection of the ovaries, the uterus is developed  and converted into
 a centre of sanguineous fluxion, which being exalted every month,
furnishes  the  menstrual hemorrhage.   The vagina  becomes en-
 larged,  the orifice of the vulva is  tumefied, contracted,  and sur-
rounded with fat,  and the mamma? are developed.   The change^ 
                      AND DECAY OF  MAN                  531

m the other organs are not less remarkable, for the voice, which
previously was always acute, becomes grave, particularly in man; this
change  depends on  the  prodigious  growth which the pulmonary-
apparatus, the most sanguineous and arterial of all the viscera, un-
dergoes, together with the heart and large vessels.  The chest soon
obtains  in  the male  sex a degree  of predominance over the  abdo-
men, although this  latter does not lose any portion of its vigour;
but as it is less arterial and at a greater distance from  the heart it
cannot equal the thorax in point of development, when the youth
enjoys the plenitude  of strength common to his species.  In wo-
man, the pelvis frequently exceeds the chest in breadth.
   The limbs enlarge, lengthen rapidly in the youth of both sexes,
whilst,  at the same time,  the  vascular sanguineous apparatus be-
comes developed:—it is not difficult to conceive the  connexion of
these two orders of phenomena.  The  bones, which as yet are in-
completely hardened, allow for some time growth in length, which
even sometimes becomes more rapid than before puberty: the ra-
pidity of growth is in  direct ratio to the degree of irritation in the
circulatory apparatus, and to the softness of the bones.  We shall
point out the consequences of this when on the subject of the pa-
thological changes it occasions.
   So soon as the bones are definitively consolidated, the growth
is limited to a thickening of the tissues.   In subjects of a  good
constitution, we only notice the enlargement of the fleshy portion
of the muscles, which become more or less well defined under the
skin.  Weak subjects present  a  growth of the bones, tendinous
parts, and cellular substance, by  which they are deformed.  But
here we observe a well marked difference between the two sexes:
in vigorous males the fat appears to be dissipated at puberty; whilst
in females  the  cellular  tissue  is developed and accumulated, as
Roussel has remarked, around the two  sympathizing centres—
the sexual organs and  the mamma?,—whence  it appears to spread
in the neighbourhood  of the pelvis, on the thighs, legs, shoulders,
and  arms, in order to  bestow on  those parts that agreeable round-
ness to  which we attach the idea of beauty.  Vet we  must remark,
that if the muscular  prominence does not set off  the form of these
various parts, there  is  no  longer either grace or beauty.
   All the functions acquire, at the period of puberty,  an  increase
of activity, which they are long to preserve.  Circulation is active,
calorification  rapid,  nutrition  energetic, absorption  very  conside- 
5.3*           OF HIE DEVELOPMENT, CUNxIVIEMEj
rable, vital  erection very  easily  excited, and very  strong, and
the nervous activity,  being always  very great,  transmits  them
from one part to another with nearly as great a rapidity as in chil
dren.   Contractility, which is generally very considerable, is par
ticularly so  in the muscular apparatus, either locomotive or visceral.
Reaction is  very powerful; and the secretory organs, and those ol
the periphery, receive and  dissipate  with great facility the super-
excitements of the principal viscera.
  The wants that predominate  at puberty are manifestly those of
nutrition,  of muscular movement, of generation, and  particularly
of observation;  for  reason, which has  just suddenly manifested
itself,  causes every object  to be viewed in a  different li^ht, and
curiosity,  having now a different direction, cannot fail to become morfe
active  and  general.   Perception  is  then very easy, the power of
attention  much  stronger  than  in children, memory has not dimi-
nished, and'judgment, which is nothing else than reason, can  draw
very advantageously from  all the  intellectual materials.    Still,
however,  this last faculty is yet very far from attaining the  point
which  it will one day reach: the vivacity of the sensations, and the
too powerful  agitations  they  give rise  to in the viscera, will  yet
prevent, for a long time, the intellect from operating with perfect
independence.   The age of puberty is that of the passions, and as
soon as one of these becomes predominant, judgment  ceases  to be
free, and reason appears as if suspended.  The want of self-preserva-
tion is so much the more urgent,  as man feels now that he enjoys
a greater degree of  physical and  moral  power to resist the causes
of destruction.  It  is the period  of  courage, of temerity, and of
every kind  of heroism.
   In the period of life denominated that of consistence, which suc-
ceeds the  entire  development of our organs,  and extends, in man,
from the thirty-fifth to the fiftieth year, but often terminates a little
sooner in  the other sex, man does not remain-stationary: for though
he loses insensibly the prerogatives of youth, he yet retains them
a long  time, and finds in what he acquires an ample  compensation
for the daily losses he constantly meets with.   The circulation  be-
comes a little slower, but in exchange it is more equal and regular;
calorification does not diminish  in a very sensible manner;  the
plumpness which man acquires, by preserving his heat,  compen-
sates him  for a minor evolution of caloric, which,  however, now
becomes appreciable.  The muscles still continue for a length of 
AND DECAY OF M\N.
535
ume to increase in size, and  if they lose on the score of rapidi-
ty of movement,  they on the  other hand retain  a  considerable
contractile power.  Fibrine continues to predominate; the serum
and lymph are in  less quantity; and absorption, though still easily
effected, diminishes pretty sensibly.  The secretions are also dimi-
nished, but the adipose  exhalation becomes more considerable.
 The vital erections, though still intense, are not so easily transmit-
ted, by which the activity of the sympathies is very considerably
diminished, particularly in the organic  functions; a kind of change
this,  which  favours  the  maintenance of the equilibrium and  of
health.  The nerves of relation have as yet lost no part of their
activity;  and in many instances sensibility even  becomes  more
considerable.    The  intellectual operations are very prompt, but
 memory  begins to fail in those  in whom it was not naturally very
 powerful.  The visceral sensations, though still very strong, de-
 range with much less facility the equilibrium of the functions.
   The wants are greatly modified during the course of  the period
 which occupies us. That of nutrition is diminished, but the stomach
 may receive  from stimuli a  degree of energy,  by which this dimi-
 nution is concealed.   As the waste is less considerable, because the
 want of  muscular exercise has  become less urgent, this  increase of
 assimilation turns to the profit  of the sanguineous  plethora, and of
 the adipose  cellular tissue.  The want of external caloric is felt
 towards the end of  the period we are  examining.   The discharge
 of excrementitial matters becomes more difficult, and this is one of
 those wants which begins to be fatiguing.  The want of repose and
 of sleep, increase at the same time in which that of exercise dimi-
 nishes  The want of self-preservation gradually increases in pro-
 portion  to the diminution  of  the strength, combined with the m-
   reased  knowledge  of "danger; yet it  is still powerfully repressed
  hy the exercise of thought.  The want of generation is preserved,
  but grows less urgent in the male sex; in the female, on the  con-
  tnrv  it disappears  as she approaches  the term of the present peri-
  od   The 3 of observation is still very great; intellect acts very
  powerfully, and daily  overcomes, more and  more, the passions,
  Z   h  minish with the activity of the circulation, and the facility
  If the Z mission  of vital erections.   This diminution, however
    only  verv evident, in reference to  the passions that originate in
   he PM sical  wants; for those of a moral nature continue to enjoy.
   veltmarked predominance, and .1 ways in ratio to the previous ex- 
-534
OF THE DEVELOPMENT,  CONSISTENCE,
ercise of thought.  Yet  it must be confessed, that the predomi
nance of the intellect,  and the continued  exercise of judgment.
which  may become, at this  period,  the  regulator of actions, are
powerful moderators, from which man derives considerable assist-
ance.   It is towards the termination of this period, that the female
loses her menses, in consequence of the diminished activity of the
uterus; and she ceases to be prolific.
  When he has attained the  fiftieth year of his age, man declines
with greater rapidity than during the preceding period; but we no-
tice  here very considerable differences,  which are subordinate to
the strength of each individual.  Some are deteriorated  in an al-
most insensible manner, and assume, with difficulty, the appearance
of old age;  whilst others, on the contrary, seem  to decay visibly.
However this may be,  the following are the changes that occur
with the progress of time.  Muscular contractility becomes slower;
man is now heavy, and supports with difficulty the efforts  of an ac-
celerated progression, though  he  may still enjoy great strength.
The lower  extremities, which are developed last, suffer first from
debility. The pulsations of the heart decrease in frequency; fibrine
begins to be diminished  in the capillaries, and is concentrated in
the large vessels, whence results the fulness of the principal visce-
ra; the adipose tissue increases in quantity, in individuals  of a san-
guineous and those of a lymphatic constitution,  and  renders the
movements more difficult   Sweat is more easily excited; the mu-
cous secretions more and more abundant;  but that of the semen di-
minishes, and, together with it, the energy of the genital erections:
assimilation becomes daily less rapid; but,  in the normal state, it
never ceases to be  proportioned to the want of nutrition; it is the
most tenacious function of the economy. Sensibility becomes blunt-
ed in the external senses, though more particularly in those of sight
and hearing; it is still very keen in the other  parts of the nervous
apparatus of relation, and the mind operates with the greatest pre-
cision.
  Whilst man goesthrough this longer or shorter period of decline,his
wants aremodified in a very remarkable manner; the want of nutrition
diminishes; that  of respiration becomes more urgent in old people
who have  acquired flesh; those of  the discharge  of excrementitial
matters are keenly felt and with difficulty gratified.   The want of
external heat increases; that of self-preservation is very greatly de-
veloped; whilst that of muscular movement  diminishing from da} 
AND DECAY OF MAN.
535
to day, the want of repose finally becomes predominant, although
sleep be  more  difficult  and of shorter duration.  The  want of
generation persists in man until old age;  but loses  insensibly its
energy.   It has been noticed, that men who have lived very long
have preserved the generating power to extreme  old age.   Hence
it would  follow, that the disappearance of this admirable  faculty
is a foreboding  sign of approaching decrepitude.  The same re-
mark is not applicable to  woman; for the cessation of this want
announces always in her the commencement of the decline; the con-
trary is only noticed  in  certain  pathological  states.  The want of
observation is one of  those that experience the most sensible dimi-
nution towards  the end  of the period  we are now examining; but
judgment does not cease to be improved until caducity.
   It is during this period that the primitive  shades of the hair are
lost, and  that these  latter  become white; but this change presents
 great  varieties.  There are individuals, particularly among men,
 who begin to be gray-headed  before the twenty-fifth year, and
 whose hair is all white before they have reached the fiftieth year of
 their age.   The same does not occur,  however, in respect to the
 beard> for it rarely changes before the twenty-fifth year, which is
 truly  the period at which the first white hairs are noticed,  in  most
 individuals, either on the head or  on the  face.   Some  persons
 attain to  the age of forty-five or even fifty years, before becoming
 gray; but at sixty years,  we hardly find one in  several hundreds
 whose pilous system does  not contain numerous  white hairs.
    The withering of the flesh, the wrinkles  and  folds  of the skin,
 and the general weakness  of contractility, do not follow the same
 course as the discoloration of the hair.  A number of individuals
 are yet fresh and vigorous,  although  their hair is entirely white;
 whilst others appear faded and  worn away, but preserve the primi-
 tive  colour of their hair  and  beard.   A circumstance accompa-
 nying constantly the whiteness of the hair, is a certain and peculiar
 yellow colour,  which, however, harmonizes  well in  some  subjects
 with  the redness and fulness of their flesh. We have not as yet been
 able to discover if those families whose hair whitens prematurely,
 offer  many examples of great longevity; but we have noticed seve-
 ral premature decays among individuals whose  hair acquires that
 colour with difficulty.    We  often  see very robust  individuals,
 whose hair becomes gray or even white, a long time before  their
 strength begins to fail; whilst, on the contrary,  we often notice an 
536
OF THE DEVELOPMENT,  CONSISTENCE,
   obstinate persistence in the primitive colour of their hair, in indi-
   viduals of a delicate  constitution.   Men,  though stronger than
   women, become gray-headed much sooner.  The hair whitens of-
   ten before the beard and the eyebrows, and  the beard, in some, in
   already quite gray, before the hair is changed.   The hair of  the
   surface of the body almost always whitens after  that on the head,
   but we often find the contrary to be the case; I have seen  the hair
   of the genital organs almost entirely white in a  young man  eigh-
   teen years of age, whose hair was black, and  whose  beard was
   hardly visible.   In a word, there is nothing more irregular than
   the discoloration of the hair.   Hence, it would  be  in vain to  en-
   deavour to deduce from it the progress of decay; fear, and uneasi-
   ness of mind, may render the hair quite white without a proportion-
   ate  diminution in the vigour of the body.  The same  obscurity
   attends the falling  off of the hair.  We  are  not sufficiently  ac-
   quainted  with the physiology of the pilous capsules, to be able to
   draw satisfactory inductions from the change of colour, and from the
   loss of the beard.
     The duration of old  age is exceedingly variable,  and cannot be
   deduced with certainty from the degree  of vigour manifested  by
   each individual in the prime of life.  We see in very many cases
   athletic men arrive prematurely at decay, and appear as if curved
   under the weight of their own body; whilst thin and small sub-
   jects are exempted from the infirmities of old age, and die before
   they have arrived at the period of  decrepitude.  Hippocrates had
   already made this observation.  The period of decrepitude is  by
   no means fixed; it is more frequently manifested about the eightieth
   year, but there are some privileged individuals who only show evi-
   dences of it at a much later period, and who are yet vigorous after
   having completed their century.   As long  as the  aged  man is not
   decrepid, it is impossible to fix the period of his  death; so soon as
   he becomes so. we can easily foresee that he  has but a  few years
   to live.   As a general rule, men of robust constitutions, who are
   neither too sanguine nor too fat, but whose  muscles are vigorous,
   are those who attain the greatest age.  Persons of  a lax habit, whose
   muscles possess little power, speedily reach the period of decrepi-
   tude; which is recognised by some unequivocal signs.
     All  the voluntary movements are slow and painful;  the embon-
.   point disappears and gives place to marasmus; the  skin  becomes 
AND DECAY  OF MAN.
537
discoloured, flabby, and wrinkled; the voice seems cracked, tremu-
lous,  and feeble; the  utterance is indistinct; the eyes  are  dim,
sunken, and with difficulty distinguish objects; the hearing is de-
praved or entirely lost: taste and smell still remain;  the  knees are
half bent and the limbs incapable of  complete extension; the ver-
tebral column yields to the weight of the viscer;\ and is bent for-
wards, which compels the old man to seek for support in  the use of
a staff, in order to preserve himself from the falling with which he
is constantly threatened; the laws of gravitation have overcome the
resistance of contractility,  and  the  physical henceforth  prevail
over  the vital  ones;  the triumph of general over  organic che-
mistry is equally progressive, and evidenced by the imperfect assi-
milation of  the fluids;  scarcely have the excretions been  evacuated
from the organs, than  they begin to be decomposed, and a univer-
sal  foetor, exhaling from all the surfaces of the body,  evidences the
slight coherence of the elements that enter into their formation.
The blood is poor, as it is commonly expressed; by which is meant
that it contains but  little fibrine, or crassamentum, that  the serum
is considerable, and that the gelatine, as also the albumen, possess
little consistence, and are  easily  decomposed.   The number  of
capillary vessels  are very much diminished, as injections demon-
strate; and.a great number of the gelatinous tissues having ceased to
be  penetrated by this vivifying fluid, become cold, obstructed with
lymph, and sometimes ossified; as is also seen in the tendons, the
envelopes,  and the arteries.  All the apophyses of  the bones be-
come more  projecting, although the  size and  weight of the latter
themselves  may be diminished; for the bones of aged persons have
less  bulk and  are  lighter than those of adults.   The teeth do not
exist; the alveolar processes,  by sinking, have protruded them out,
and the obliteration of their nutritious vessels has hastened their
decay and  fall.   The heart contracts slowly  and irregularly,  and
its  want of  impulsion  is one of the causes which have produced the
disappearance  of  the  small vessels.  Absorption is feeble, for the
contractility being weakened cannot overcome the physical laws in
the interior of the vessels, as it does in muscular masses; the fluids
are as obedient to gravitation as to the vital powers: hence those
oedematous swellings  which are seen about the ancles,  and  which
frequently deform  the legs of old  decrepid persons.   Digestion is
nevertheless still performed, and is even capable of acquiring,  by
means  of stimulants,  a power which carries nutrition beyond  the 
538        OF  THE  DEVELOPMENT, tONSIMEME, &C
wants of the individual; sensibility is wonderfully diminished, and
the transmission of weak vital erections which may still take place
is so difficult,  that the majority of the sympathies have disappear-
ed, and the reaction of the  interior towards  the exterior is fee-
ble, and in dangerous diseases absolutely impossible.
  The wants  vf the decrepid old man are very much diminished;
but those which he still has are very urgent.   If the aged person
who is still vigorous, can endure abstinence,  the one who is de-
crepid on the contrary cannot bear it.  He demands, it is true, but
little  food, but  it  is all-important for  his preservation  that he
should always obtain  it, and that it be of  a good quality: the
wants of excrementitial discharge, very difficult to satisfy, become
an inexhaustible source of evils to the aged; the want of exercise
has almost entirely disappeared,  and that of repose has  become
permanent;  but sleep, although very necessary, is at this  age ex-
tremely difficult.   The want  of generation no longer exists; that
of observation is very much diminished:  the sensitive impressions
are so obscure and feeble, that the aged individual neglects them,
in order to seek in his own memory for ideas better traced  out and
more capable of satisfying the want of thought.  The reason of this
phenomenon is very plain: it is because the organs of the senses are
much more enfeebled than the centre of perception, which, located
in a viscus of the first order,  must persist with it until the last mo-
ment.   We are not, however, to believe that the memory  may be
renewed after  it has grown old with the  rest,  since it is no longer
exercised  but  in an imperfect manner upon the actual impressions,
and we know  that too often it perverts the remembrances of things.
The subjects of  whom we are now speaking, approach the infantile
state  in this particular, that they become almost entirely the crea-
tures of instinct:  in fact, attentive  only to the wants relating to
their preservation, they are regardless of all impressions which have
not a bearing upon this subject.   We observe  them listless and in-
attentive in the midst of a numerous circle, or at least allowing to
pass by unheeded  the greater  part of the ideas which have not a
direct relation to the only want with which they perceive them-
selves harassed,  that of retaining the life which appears almost to
escape them; so true  it is, that  nature only concedes  to intellect
the portion of action of which instinct has no need.   The decrepid
old man also resembles the infant in the readiness with which he
becomes irritated at all the obstacles that  are opposed to the gratifi- 
OF THE TE.MPERa.MENVS.
339
 ation of his wants.   Finally,  the  nervous power and the muscu-
lar contractility  having been exhausted, the heart ceases  its ac-
tion,  and life terminates with the circulation,  before the  capillary
tissues of the mucous lining of the  digestive and respiratory appa-
ratuses have lost the power of assimilating and absorbing the mate-
rials necessary to the prolongation of existence.
   Such is natural death, called  the death of old age; but there are
so many causes capable of destroying  the equilibrium before this
fatal period, that this kind of death is of extremely rare occurrence.
We  shall wait for the data which will be furnished us by the dif-
ferent temperaments, before we indulge in an inquiry into these
causes.

             Section  I.—Of the Temperaments.

   By the word temperament, we mean the differences that are ob-
served between men, and which are dependent upon the relative
predominance of  each of their organic systems.  Galen,  who first
directed attention to  these differences, established them upon heat,
and cold, dryness, and moisture, and associated these four qualities
with  the predominance of  four humours, which he considered as
playing the principal parts in the human  body; viz. the blood, the
bile,  the phlegm, and the atrabilarious or black bile, a kind of hu-
mour the source of which he located in the capsulae renales, which on
this account bore the  name of atrabiliary capsules.   He accordingly
recognized,  1.  a  warm and moist temperament, which he attribu-
ted to the blood, and which he called sanguineous; 2. a warm and
dry temperament, which  he named bilious;  3. a cold and moist
temperament, which bore the title of pituitous; 4. a cold and dry
temperament, which  received that of melancholic.   But as the tem-
perament may be at  the same time sanguineous and bilious, sangui-
neous and phlegmatic, bilious and  melancholic, &c. we  perceive
that it would be absurd to admit that a man could be at the same
time,  moist and dry, hot and cold, fat and  lean: we also discover,
by the progress of vitalism, that  the  humours are  not  the causes,
but rather the effects of the modus operandi of the solids; that the
black bile is not produced by the capsulae renales, since it is nothing
else but altered  bile or blood; and we  seek  for a better foundation
for the difference between the temperaments 
510
Or the  i'Empera.ments.
    The celebrated Professor Halle referred them to the relative pre-
 dominance of the different organic systems of Bichat; he distinguishes
 them into general temperaments, which are associated with the de-
 velopment of the general organic systems; and into partial tempe-
 raments, which are dependent on the development of certain appa
 ratuses.  He bases the  sanguine temperament upon  the predomi-
 nance of the vascular, arterial, and nervous systems, he lays  down
 an athletic temperament which  arises1 from the predominance of
 the muscular system, and refers the lymphatic temperament to  the
 development of the system of that name, and to that of the adipose
 tissue; finally, he  proposes  to give the name of nervous to those
 temperaments characterised by remarkable activity of the sensitive
 system, and points oiit,  as examples,  not only the melancholic of
 the ancients, which has become synonymous with-a moody, thought-
 ful character, but also all the fat or lean constitutions, whether de-
 licate or robust, which are endowed with a lively sensibility, what-
 ever may be the moral character of the individuals.
    It is the opinion  of the professor, that the bilious  temperament
 depends on the extraordinary activity of the digestive apparatus,
 and he thinks that we may discover others of a similar kind: thus
 the relative predominance of the encephalon, of the  lungs, of the
 heart, of the sexual organs, particularly in the  female, constitute,
 according to him, so many partial temperaments, which, however,
 can be  associated with the general temperaments, just as these are
 combined with each other in different proportions.       '
   M. Begin, in his Treatise on Pathological Physiology, has de-
 signated these partial predominances by the term idiosyncrasies;
 but this expression does not  appear to us  at all suitable, because
 common use has for a long period appropriated to  it a meaning
 totally  different.   In fact, the term idiosyncrasy has  always  been
 employed to convey an idea of certain remarkable phenomena that
 we observe in our relations with  external agents, and  which are
 far from corresponding with the predominant development of any
 particular organ.    The  idiosyncrasies depend constantly on the
 manner altogether inexplicable in which  our organs of relation are
affected by their modifiers: for example, certain objects which affect
some persons in an agreeable  manner, produce disgust  and aversion
in others; certain articles of food are rejected by the stomach; others
cause an extraordinary irritation, producing convulsions, eruptions,
or irritations, in  the bladder and in the genital organs, of which 
                   OF THE TEMPERAMENT?.                341

cither individuals afford no example; there are  some persons who
cannot digest certain aliments, unless they are taken at fixed hours,
or prepared in a peculiar manner; we see  some' who never drink
when they are in health; and others are met with who can digest
only in a  certain posture.  I am acquainted with a lady in whom
the odour of a linseed poultice produces a violent suffocation, and,
if she cannot escape from it, she is attacked with a stinging erysi-
pelas of the face.   A  Prussian  captain, whom I saw  at  Paris, in
lb 15, could not bear the sight of a cat, a thimble, or an old woman,
without  becoming  convulsed and making shocking  grimaces;  a
great number of persons have a dread of a particular animal, as of
a mouse, a spider,  or a toad; some females faint at the sight, or from
the perfume of a rose, whilst this  beautiful flower forms the delight
of the generality of persons, &c.   Such are the phenomena that
are designated by the term idiosyncrasy,  and we cannot associate
them with the predominant development of any certain organic ap-
paratus.   Now, as  it is necessary that these words should possess
a meaning  generally adopted, and as  it is  not possible  either to
prevent the term idiosyncrasy from recalling to  our minds these
phenomena, or to replace it by any other which shall convey the
same idea, I do not think that we can employ it to express the
predominant development of the  visceral apparatuses.
   The varieties of  temperament should, in our opinion, be asso-
ciated with those of functions.  We proceed therefore to attempt
the classification of them on  this foundation, in availing  ourselves
of  the profound views which the illustrious professor Halle  was
in the practice of developing in his lectures upon hygeine.
   Predominance of the first assimilation, owing to  the extreme de-
velopment and energy of the digestive apparatus, makes the gas-
tric temperament.   It is often combined with hypertrophy of the
liver, the secretion of which is in excess :  this constitutes the bil-
ious temperament.  Persons of this temperament are described
as with black hair, a thin  and muscular body,  much  strength and
vigour, and lively passions.  But nothing is less  fixed than these
pretended characteristics.  We can only say that this great power
of assimilation supposes always a high degree of vigour.
   Predominance of haematosis is the sanguine temperament.  It
is often associated with the preceding, but not necessarily so; for
we  often  meet with great eaters who bear badly and repair with
difficulty losses of  blood,  whilst a number of persons remarkable 
512
Ul THE TEMPERAMENTS.
  for their sobriety, always have the vessels filled, and repair the loss
  of blood with aliments ever so little substantial.   The smguineous
  have not  always the highly coloured complexion, a circumstance
  which depends on the organization of the teguments of the face,
  and which is common to other temperaments.  They are also far
  from having always the chest full, the heart large, the pulse much
  developed, and the veins dilated.  We meet with  very  many who
  have a small heart, a pulse of moderate force, and veins  of inconsi-
  derable volume.   We must, however, still concede that hypertro-
  phy of the lungs, heart, and vascular sanguineous  system,  is very
  often associated with this temperament.  It is the same case with
  the muscles, which are usually very large in sanguineous  persons,
  in whom the fibrine is usually very abundant.   The athletic form
  is commonly combined with the simultaneous predominance of the
  first assimilation and of ha?matosis; that is to say, with hypertrophy
  of the digestive apparatus, lungs, and sanguineous vascular system.
  This coincidence establishes, when not excessive,  the highest de-
  gree of vital energy  of which man is susceptible; these  kinds of
  temperaments never fail to lead to  obesity, so  soon as they have
  attained the limits of growth in thickness.   We must take special
  care not to confound them at this time  with lymphatic subjects.  It
  would be erroneous,  in imitation of most authors, to attribute to
  the sanguine temperament, gaiety, levity, inconstancy, vivacity of
  mind, and  fondness for the kind of life called  epicurean.   Such
  dispositions are the effect of an organization of the sensitive system,
  modified by the social state,  and may be conjoined with  any other
  temperament; we may,*.however, affirm, that the facility of assi-
  milation and ha?matosis, gives activity to the brain  and food to the
  passions, advantages which man too frequently abuses.
   The sanguineous predominance may very well be combined with
 that of the lymphatic juices, forming the lymphatico-sanguineo-us
 temperament.   Persons of this constitution  have a  fulness of habit
 from their very youth, and  are throughout their life loaded with
 blood and  lymph; their  body is soft,  and  awkward in  its move-
 ments, though possessing strength and heat.  Their viscera arc
 always engorged,  their mucous membranes secrete freely, and their
 lymphatic  ganglions are more defined than  in the temperaments
 alreaey  described.    This constitution  may, like  he  preceding
 ones,  present  all  the shades of colour of the skin  and  hair,
4som the white to the deep red, from the fair to  the  black.  The 
OP THE TEMPERAMENTS.
54 •
mental qualities are subordinate to the development of the brain.
This is the most usual temperament of children, and, among adults,
of women, who recede less than men from the physical and moral
characters of early life.
   Feebleness of assimilation and of ha?matosis, gives us the anemic
temperament.  This may be found in  a thin and  haggard body,
and, if at the same time the sensibility be not exalted, this tempera-
ment will not be found to correspond with any of those mentioned
by writers.   It is the feeblest constitution of all, and  prevails to a
great extent in large  cities, where our  species degenerates.   The
flesh is soft, the muscles thin and  without strength, the skin is pale
and ash coloured; all prolonged exertions, whether of body or mind,
are insupportable: these kind of persons are only possessed of some
energy during their youth; they do  not bear evacuations of blood;
they wither prematurely, and their children cannot be raised  with-
out  extreme  difficulty.   Whenever the anemic  temperament is
accompanied by a certain fulness of habit, it corresponds to the sim-
ple lymphatic of authors: but  in  its greatest degree of emaciation
it does  not merit this term, for the lymphatic  apparatus is in fact
very irritable among subjects of this description,  as we shall find
when treating of their pathology.  This temperament is compatible
with every kind of colour: to the  lymphatic are usually assigned as
characteristics flaxen  or  chestnut coloured hair, and blue eyes; but
we find  weakness and anemia  in  their  highest  degree, among the
idle,  and the inhabitants  of large cities of warm countries, though
they have black hair and dark skin.  It  would be incorrect  to at-
tribute intellectual weakness, stupidity,  and apathy, to the lympha-
tic temperaments.  If their sensitive apparatuses be well developed,
they  possess as great energy of the intellectual faculties as the most
robust constitutions, and may be endowed with very strong passions
But strength is wanting to enable them to turn these precious fa-
culties to a useful  account; intellectual labour wearies them, and
the  passions destroy the equilibrium of their functions to such a
degree,  that the anemic are afraid of, and dare not  yield to them.
   Predominance of sensibility, the excess of which easily gives rise
 10 convulsions in the muscles of every description, constitutes the
 nervous temperament.   It is either innate or acquired; a distinc-
 tion this to be well attended to.   It is innate in very thin persons,
 and may then  be associated with  the predominance of assimilation
 ;nd hsematosis,— forming the bilioso or nervoso-sanguine tempe- 
511
OF THE TEMPERAMENTS.
ramcnt; but it is more usually allied with the anemic tempernmont,
for the greater number of thin anemic persons are nervous.   It is
almost always developed  in the course of life, by prolonged irrita-
tions of the  internal senses and encephalon, even in the athletic
and the fat and lymphatic.  This is a point of which it becomes us
to-be apprized.  The passions are not necessarily exalted, as has
been pretended, in nervous persons.  We only find them to be so
with a certain  encephalic development.   It  is  equally false that
their imagination is always lively; we meet with many in whom
this faculty is at its minimum; but what essentially characterizes
them,  is their exaggeration both of pleasures and pains,  and their
proneness to convulsions and visceral spasms.
   The predominance of the nervous system does not impress a pe-
culiar character On the animal economy, since it is combined with
every grade  of assimilation and ha?matosis: we can then neither
assign  to it peculiar forms nor colour.  If the  encephalon be very
large, the nervous phenomena are more multifarious, and neurodosia
becomes predominant in the mental faculties.  If the heart be volu-
minous, or the lungs small, the nervous phenomena will  predomi-
nate in the chest   It will be the  same case with the gastric pas-
sages,  the  kidneys, and the uterus: but it is not the nervous state
that gives rise to these partial predominances; they are innate or
acquired, and may  be met with in all constitutions.
   It seems to us desirable to give an idea of that state of the econo-
my, to which the ancient authors affixed the title of melancholic
temperament.   It  is, say they, characterised by a thin yet robust
body,  large veins, a face pale and elongated,  flesh firm,  deep and
enduring sensibility, black and smooth hair, slow and difficult di-
gestion, with frequent eructations, acid and bilious flatus, a yellow-
ish tint of the skin, and  a decided propensity to sadness, with pe-
culiarities in the character, which make such subjects be looked
upon as eccentric, or a kind of crazy persons.  To them, however,
is conceded much imagination, and even genius.  This assemblage
of traits is not necessarily met with in  the  same person.  We find
in them  the  physical peculiarities  of persons  with a gastric pre-
dominance and a nervous state, which may depend on many causes;
sadness is the effect of the sufferings of the viscera, or else it de-
pends,  together with the exaltation of ideas, on the peculiar organi-
zation of the brain, and  in such  cases it  may be coincident with
fatness as well as leanness.  It is now a  long time  since the melan- 
                    OF THE TEMPERAMENTS.                545

 i.holic temperament of the ancients has been considered as a patho-
 logical state.  We have only recurred to this question in order the
 better to analyze the  different elements of which it is composed,
 and to trace the mental part of this  pretended temperament to its
 true source, the organization of the brain.   As regards the picture
 of  the melancholic, what we can advance  with  some  confidence
 is,  that it represents in general a person with a gastric predomi-
 nance attacked with a chronic inflammation of the digestive organs:
 and as this is often met with in men of  studious  habits, it was
 thought necessary to rank the melancholic among persons of talent.
 It was doubtless they themselves who drew  their own portrait.

 Section II.—Application of the  Temperaments  to Age and Sex
                  —Diseases thence resulting.

   In early life,  the lymphatic temperament predominates: but it
 is stimulated by a slight degree of the sanguineous  in  vigorous sub-
jects; nervous irritability is  always extreme, and the digestive ap-
 paratus is very active.   The  diseases  resulting from this  state of
 things, are inflammations of the digestive canal:  they are always
 accompanied by cerebral engorgement and convulsions; and often
 depend on dentition; for the irritation thence resulting reacts on the
 head  and abdomen: cutaneous and erysipelatous phlegmasia?, and
 hardening of  the cellular  tissue, are common disorders at this pe-
 riod of life.
  The second infantile period, which begins after the eruption of
the first twenty teeth,  and extends to  puberty, presents a tempera-
ment less lymphatic, somewhat more sanguine, but still very ner-
 vous, and always accompanied with  great gastric  irritability;  the
 irritations of  the encephalon are very frequent but less violent in
them; ententes are especially predominant, and assume the name
of atrophy in  the first half of this  period on to second  dentition.
Worms are often connected with these complaints at this time.
Eruptive  cutaneous  phlegmasia? bear in them paramount sway.
Finally, hypertrophies of  the head, leading to hydrocephalus, gan-
glionic sub-inflammations, and  softening of the  bones, are  the
attributes of this age, and  are especially observable in those whose
temperament is more lymphatic than sanguine; nor shall we be sur-
prised at this,  when we reflect that this period is that  in which the
, tl'orts of growth  are especially directed towards the osseou" svs-
                              60 
516
THE  TEMPERAMENT-
 (em, and in which there is the greatest formation of gelatine and al-
 bumen.  We discover how little physiological it would be to regard
 as ab-irritative modifications, chronic ophthalmias,  and other slow
 inflammations of the openings of the  mucous  membranes, as well
 as the ganglionites in their  vicinity; no doubt but general debility
 predisposes to these maladies, but  they are not the less truly in-
 flammatory in their nature, since they exhibit all the  characteris-
 tics of this condition, and are always made manifest under the ope-
 ration of stimulants.   It is on account  of this irritability of the
 tissues surcharged  with lymph,  that  we find contusions give rise
 to scrofulous sub-inflammations in the different regions of the body;
 but as we  have explained ourselves elsewhere on the true charac-
 ter of these diseases, it is useless to insist further on the subject
   Puberty is the epoch in which the sanguineous system predomi-
 nates over all others; it is also that  of the most acute inflammatory
 disorders:  these more especially prevail in  the cavity of the chest,
 to which a decided effort  of growth is directed, and in the digestive
 apparatus, which takes on excess of action, in order to furnish the
 materials necessary for the rapidity of development.   It is at this
 age, that the essential (idiopathic) fevers of authors are of most fre-
 quent occurrence; they are nothing more than acute gastro-enter-
 ites,  with  more or less inflammatory irritation of the  encephalon;
 and if not  completely dissipated, the natural predisposition of such
 subjects, to inflammation, keeps them in  a  chronic  state; it is,  in
 fact,  during the period of youth, that the greater number of men
 contract habits  of inflammation, which makes their whole life  a
 tissue of disorders.   It is to  be  remarked, as we have elsewhere
 done, that  whenever the growth is  very rapid, the visceral appara-
 tus is in a  state  of continual irritation; the stomach is hot and has
 great sensibility, though it  digests very readily, constituting a kind
 of bulimia, which may be converted into an obstinate inflamma-
 tion ; the pulsations of the heart are vigorous and frequent, and we
 often meet with a hypertrophy of this viscus; there is also heat of
 the lungs,  and irritability of the bronchial mucous membrane.   If
 the nutritive juices be strongly invited towards the locomotive ap-
 paratus, the  pectoral cavity is  not sufficiently developed for the
 free play 6f the lungs;  they remain then too narrow relatively to
 the volume  and force  of the heart, and  the excessive impetus o.j.
 blood gives'rise  in them to  ha?morrhagies and inflammations: thi
is, perhaps, the most frequent preparatory cause of pulmonary con- 
MODIFYING DISEASES.
547
sumptions.   The efforts of growth are likewise converted  into in-
flammatory movements in the head,  articulations, and muscles.
The sanguine lymphatic temperaments are those which  present
the most frequent examples of this kind of epigeneses; on this ac-
count the  absorbent ganglions readily contract irritation of  the
phlogosed  tissues, and, if they escape this  affection, the  other
white tissues are attacked  and readily disorganized.
  The sudden evolution of the sexual organs is attended by super-
irritations, manifested in them by continual erections and involun-
tary pollutions; a kind of morbid state which  is extremely rebel-
lious, very fatiguing, and which is often  complicated  with hyper-
trophy of the heart and pulmonic irritations.
  A slow and uniform growth protects adolescents from all these
infirmities, and this kind of development is usually that of robust
constitutions, in whom the chest is usually broad and deep.  Hence,
individuals of this formation present the  most regular forms: we,
however, meet with  some among whom the limbs are not propor-
tioned to the volume of the trunk; but this kind of make does not
expose them to any  danger,  whereas the excessive length of the
extremities, even with very well defined muscles,  is commonly as-
sociated  with a narrow  chest, which becomes an inexhaustible
source of disorders.
  The coming on of the menstrual flux is for young women of this
conformation an epoch of almost inevitable disease.   In fact,  the
visceral super-irritation, above spoken of, retains the blood and pre-
vents it from being directed towards the uterus; hence, the languor
which assumes the name of chlorosis; but the  discoloration is only
the effect of phlegmasia? of the chest or  abdomen, and wo to  the
physician who shall  be so little of  a physiologist as  to be  igno-
rant of it.  The proneness of the uterus to hemorrhagic  conges-
tions, may protect the viscera from the bad effects of emmena-
gogues; but if this crisis fail, the visceral stimulation makes  pro-
gress, and draws after it the most fatal consequences.
  Man having attained the age of consistence,  enjoys the constitu-
tion which is peculiar to him.  Women frequently retain the cha-
racters of the lymphatic temperament, but it is very often modi-
fied by the  sanguineous;  they  are  more nervous than men, al-
ways less athletic, and rarely enjoy so decided a  gastric predomi-
nance.   This is the place  to point out the diseases peculiar to each
ei the temperaments which we have admitted.  This task  will be 
546
THE TEMPERAMENTS
facilitated by the considerations into  which  we  have alrcadycu-
tered.
  The predominance of the first assimilation exposes man to the
hyper-irritations and phlegmasia?  of the digestive apparatus; but
it is solely because he carries stimuli to excess; for, without this con-
dition, he would discover  in  this happy temperament a powerful
resource against the physical and moral causes of  infirmities.   But
the facility with which subjects of this kind  perform digestion, in-
sensibly leads them to excesses, of which they finally acquire the
habit.   All are  not, however, equally culpable:  the greater num-
ber commit these faults  without being  aware of their  tendency,
because  they only give the name of excesses to that  quantity of
aliment which fatigues their stomach, and to the portion of fer-
mented drink which affects their reason.   They  do not know that
very substantial food, and  high-seasoned meals, which they digest
without inconvenience, and even with a feeling of comfort, must,
necessarily, in  the  end, over-irritate their stomach: they do not.
know  that a certain measure of wine, which will only cause in them
a slight feeling of gaiety, must destroy at  last their digestive pow-
ers, without its  having deranged their intellectual faculties.   They
only  think of strengthening  themselves,  and conceive they are
threatened with a dangerous debility if they neglect to carry their
meals to the most complete satiety.   If  they experience any slight
inconvenience, they merely refer it to the excess of blood or bile,
and imagine that a  bleeding  or a purge will suffice to restore the
balance of their  powers, and enable them to resume their accustomed
kind  of life:  such  practices  may not  be attended with inconve-
nience in persons who take exercise in the Open air, but those of
sedentary habits must sooner or later sink under them when they
reach  the decline of  life.   Their error is still  excusable, for  in
spite  of the eulogiums which, since the time of  Pythagoras, have
been lavished on sobriety, we are still in need of a treatise on phy-
siological hygeine;  for it  is not sufficient to  say in a general way,
that sobriety is  the foundation of health,  nor even to prove it by
numerous examples;  we  must show it from a physiological view
of the functions of the stomach, and by a faithful exposition of  all
the shades of gastric irritation, which is  developed under the influ-
 ence of the various ingesta, and followed by the  complete deterio-
 ration of the health.    Such  a work  ought to  become a classi- 
MODIFYING DISEASES.
54«
fcal one, and be placed in the hands of all  young people.   As wc
exhibited,  when treating of the diseases of the stomach, the pro-
gress of irritations of this viscus, we need but refer the reader to
the pathogeny of the digestive function.
  The temperament distinguished  by the predominance of hema-
tosis, exposes those who  are endowed with it to every kind of
phlegmasia and haemorrhage, which is not long in  being converted
into a habit.  In fact, the sanguineous have not only to dread the
gastro-intestinal irritations to which  they are so  much the  more
subject as they partake more of the gastric temperament, but like-
wise to apprehend anginas, congestions in  the lungs and head, es-
pecially if they have large lungs and a voluminous and very active
heart,  which forces the blood with impetuosity into important vis-
cera,—a kind of conformation this very common with such sub-
jects: whenever the sanguineous  are exposed to any physical or
moral commotions, and that  their customary evacuations of  blood
are suppressed, they must beware of these formidable affections.
   Violent exercise, and unusual and  long continued  efforts, are
hurtful to persons in whom the sanguine temperament is decidcdh
defined; good-living throws them into obesity, and disposes them
to all kinds of congestions; their passions are not less dangerous to
them; in  a word, it is never but with  extreme caution, that such
subjects succeed  in  preserving their health, and  prolonging theii
career to  extreme old  age.
   The lymphatico-sanguineous temperament is subject to inflam
mations of the absorbent ganglions, especially during the period of
infancy, and  it is always  with great difficulty  freed from  them.
Herpes are  likewise  very common in this state,  and are readily
produced  by acute  inflammations of the skin becoming  chronic.
It is in women of this temperament that we find  the most nume-
rous examples of schirrus and cancer of the mamma?, and in whom
metritis of the neck of the uterus most frequently degenerates into
ulcerations.   In general, all inflammations have a tendency to be-
come  complicated with  tuberculous productions in such  persons:
hence are they very liable to phthisis pulmonalis and schirri of the
digestive canal.   Temperaments  purely lymphatic partake of this
predisposition; being less irritable, they  sometimes tolerate  for  a
long period, the action of stimuli, without seeming to suffer  much
therefrom; but if the abuse of these agents be carried too far, latent 
550
THE TEMPERAMENTS
disorganizations are  brought about in this  description of  subject*,
the certainty of which is always acquired too late.   It happens not
unfrequently, that the impression of cold determines in them glan-
dular swellings of external parts, which may last for a length  of
time, without the viscera being thereby affected, and which even
seem to protect them from any attack.  But if these irritations,  as
well as the herpetic and scaly affections of the skin, happen to be
repelled, the viscera contract inflammations which speedily run into
disorganization, on account of the extreme facility with which the
internal  lymphatic system participates in the disease.   The same
remark is applicable to the suppurations, and all humoral depura-
tions of the skin: lymphatic temperaments having once contracted
the habit, of these evacuations, cannot afterwards dispense with
them without their health being endangered.  We explain this pe-
culiarity by the general weakness of reaction which characterises
this temperament; the normal  emunctories with difficulty  suffice
for supporting the balance in their functions,  and  they readily
become tributaries to the unusual evacuations accidentally excited.
A moderate but regular corporeal exercise, woollen clothing, and
atmospherical heat,  are the most efficacious preventives against
these evils;  but too frequently, the indolence so common in this tem-
perament, leads to aTieglect of exercise, and inspires with a fond-
ness for an idle life, the sinister effect of which  is attempted to be
neutralized by the internal use of stimuli, such as tea, coffee, spiritu-
ous liquors, strong wines,  and high-seasoned food.   Such  is, in
fact, the kind of life led by the inhabitants of  cities  in cold  and
moist climates, where  this temperament predominates: they are
so much the more inclined to  it,  as they  experience  comfortable ,
feelings, and derive a factitious strength, which makes them for a lit-
tle while forget their natural weakness; but with such practices they
rarely fail to destroy  their health, and  shorten  their  days.   The
diseases  to  which the lymphatics are liable, are then developed,
and rendered inveterate, under the influence of the above regimen,
and, whenever art is brought "in to afford them some relief,  disor-
ganization is already too far advanced to take a retrograde  course.
  Anemic  temperaments,  though of  a dry habit, are not less ex-
posed than the lymphatic ones.   Though their glands  may not be
at first affected by the impression of stimuli, the other white tissues
are not the  less promptly disorganized; for, though not so  much
charged with lymph, they are always very feeble, and the weakness 
MODIFYING DISEASE*
551
t.i reaction causes a retention in the viscera of the irritations which
had not been destroyed at the period of invasion.
  We teach in our course of pathology, that all the phlegmasia? of
the exterior of the body tend to advance more and more towards
the viscera, either whenever they are renewed or simply prolonged.
This axiom, of which old persons continually furnish the proof, is
equally applicable to anemic  constitutions; they always become
the premature victims to herpes, rheumatisms, or gout, whenever
they have had the misfortune to allow these diseases to become
inveterate.   One of the principal obstacles which  we meet with
in the treatment  of irritative congestions in the anemic, is that
these temperaments do not bear sanguineous evacuations.   Revul-
sion is, then, their principal remedy;  but, if we delay its use, it
often becomes of no avail.   As  lymphatic subjects are slow in as-
similating, we cannot too strongly recommend sobriety to them;
if they deviate from it, lymphatic plethora is inevitable; hence it
is only by dint of exercise that they can be on a par, under an ex-
citing regimen.
   The nervous temperament is  much  less unfavourable than the
anemic, unless it be  complicated with this latter, a result some-
times produced by the prolonged use of stimuli.   Such a combi-
nation is always  most sinister, and forever excludes the hope of
perfect health.  The purely lymphatic temperament never attains
that degree of excitability characteristic of the nervous.  A very
energetic hematosis is not, however,  incompatible with ncurodo-
sia;  but  the force  of reaction  sometimes neutralizes  its effects
What wc often meet with is  the nervous temperament associated
with a great activity of the digestive  apparatus in very thin per-
sons.   This constitution  is exposed to  a number of disorders; we
can readily  appreciate the reason of this,  by reflecting a little on
the manner  in  which stimulations of  every kind affect those
persons in  whom  neurodosia predominates.  They live much
more than others;  they are restless, agitated, tormented by the
necessity of  feeling; their sensations, always exaggerated,  give
rise to violent commotions in their viscera, which are repeated
in the locomotive apparatus.   If we follow their effects in the dif-
ferent  organs, we shall find all the disorders to which these tem-
peraments are liable; for the brain, moral affections by which they
are tormented, cephalalgias, migrims,  vertigoes; for the heart and 
552
THE
TEMPERAMENTS
 lungs, palpitations,  suffocations,  dry coughs, called nervous; for
 the digestive apparatus, a great number of painful sensations, con-
 tractions, cramps, gastralgias, pyroses, vomitings readily becoming
 habitual; for the  intestines, colics which are not always dangerous
 in proportion to their intensity, and extraordinary movements;
 hence they are very liable to  hypochondriasis; and we may even
 assert, that they rarely escape that wearisome disease, if the great-
 est care be not taken to preserve their stomachs, for the slightest
 gastritis  provokes their general irritability, and carries it to a de-
 gree of which persons of another temperament can  have  no idea.
 Women of this constitution often  become hysterical by the habit
 of simultaneous irritation established between the uterus and gas-
 tric passages.   Is it  possible for the brain  to resist the united in-
 fluences of these  important viscera?   We see it, in fact, under the
 effect of the stimulations which they transmit, give rise to a host
 of convulsive phenomena in the  muscles  of  relation,  which  are
 placed in  unison  with the visceral apparatus of the abdomen.   In
 our opinion, hypochondriasis differs from hysteria only in the vis-
 cera whence emanate the sympathetic  influences exercised upon
 the encephalon;  and very often both forms of disease are united
 in woman.  But, independent of the symptoms called  hysterical,
 we find in the female sex, after suppression of the menses, a series
 of the most astonishing phenomena, consisting in the aberration of
 the sensitive and  motific powers,—phenomena, the appearance of
 which always announces a temperament eminently nervous. Shall
 I speak of the surprising derangements of  the senses so often ob-
 served in  nervous  persons of both sexes—aberrations of sight,
 hearing, touch, taste, and smell, which would lead us to infer the
 existence  of very profound disorganizations of the encephalon and
 other viscera, had we no regard to the concomitant signs which
 evidence the integrity of these parts?
  Acute phlegmasie in nervous persons often present a peculiar
 physiognomy, which tends to make them misunderstood, and in-
 creases greatly their  danger; they are always more or less ataxic,
 and require in their treatment a particular management, which ex-
 perience alone can teach us.  In general, nervous persons are ap«
 prehensive of all  powerful stimuli, and are never debilitated with
 impunity by excessive sanguineous depletion and severe abstinence.
This is a temperament that requires to be closely examined. 
                     .vIODIFVINC. DISEASES.                 6',".

which can only be done in populous cities and among the most
cultivated classes of society.
  We may readily see, from all that has been said above on gene-
ral temperaments, that the diseases to which they are predisposed
break out in  preference on the systems and apparatuses in which
vital action predominates, and that it is important to attend  to the
particular idiosyncrasies in each person.
  Middle age, even when bordering on old age, has not yet de-
stroyed the temperament peculiar to each individual, but it is  at-
tended by certain local  determinations, which  it is important to
bear in mind.
  The action of the surface is diminished, the exercise is no longer
as great, and yet assimilation still continues very active;  it becomes
more so by the high living, which to the rich  is often, indeed, a
factitious, but nevertheless an  imperious want.  The  formation
of blood exceeds, then, the wants of the economy, and  plethora is
constantly kept  up in the  principal viscera: from this arises the
numerous evils  which  commonly  afflict idle  persons  who have
reached the age  of fifty.  The inflammations taking place  in the
external organs  henceforth tend to a chronic character; hence in-
veterate herpes, the cure of  which is  not without danger;  hence
continual rheumatisms and  gouts,  which only momentarily assume
the acute form, and which  always threaten to seize on  the princi-
pal  viscera.   It  is at this same epoch that in  men chronic irri-
tations  of the genito-urinary organs become very frequent, and
that the vaginites and metrites with which  women are affected as-
sume a disorganizing character.  The  cessation of the menstrual
flux is not limited to giving rise  to epigeneses; it is a fruitful source
of very fatal congestions and degenerations of the viscera.  It is at
this  time that the heart, so long irritated, becomes in some persons
dilated  and aneurismatic, a kind of disorder this which  singularly
aids in bringing about a cessation of chronic articular  phlegmasie.
The hemorrhoidal flux is  liable  to be suppressed; the cause of
which is not in debility, for the persons affected may be full of
vigour, but in the irritations of the  viscera,  which have been pre-
pared and fomented by errors in regimen, compression,  and atmos-
pherical influences.  Few persons  in the well-informed classes, and
among the intemperate and idle, arrive at the above mentioned age
without being affected by a gastritis or chronic enteritis, especially
                              70 
554
l HE TEMPERAMENTS
predominant in the duodenal region, and producing sanguineous
congestions in  the substance of the liver.  Now these irritations
never fail to increase at the expense of the external ones, which
abandon their first seat.   We find asthma appearing not only in
persons whose heart is affected, but also in those who have suffered
for a length of time under bronchial irritations, or sympathetically
from the influence of an irritated stomach.  The encephalon is not
less in danger than the other viscera, especially in persons of a san-
guine temperament, who have recently  been freed from habitual
hemorrhages, and in  those who have for a series of years kept up
gastrites.  Mental  emotions, excesses at table, coition, the  im-
pressions from cold, falls, violent efforts, are commonly the exist-
ing causes of apoplexy; but the predisposition had existed.   The
excessive fulness of the body acquired at this time by certain san-
guine habits,  cannot fail to hasten the explosion of  this  fatal
malady, which often  strikes a man in the midst of apparently the
fullest health.  I say in appearance, for fulness of body and fresh-
ness of complexion are often compatible with chronic irritations of
the viscera, over which such persons think they have triumphed,
when they have merely acquired  the habit of supporting them.
This is explained by  the diminution of the activity of the sympa-
thies, which are blunted insensibly with the advance of years,  long
before the epoch of senile exhaustion has arrived. Hence we rarely
meet with very acute phlegmasie in persons approaching to ad-
vanced life; they only suffer under such  from some extraordinary
stimulations; but on these occasions they have to dread a fatal ter-
mination, whenever the acute state has been preceded by  a very
chronic irritation.
   Old age, though more feeble than that period which borders on
and immediately precedes it, is subject to fewer ills: first, because
the sympathies have become still less active; then because there is
an abandonment of the greater number of habits, the danger of
which has been  recognised; finally,  for the very simple reason,
that persons who attain  this age are rarely they who had disorgan-
izing inflammations of the viscera.  This latter description of sub-
jects usually sink under such diseases between fifty and sixty-five
years of age.   Very  old men are always found among those who,
with some exceptions,  (for there are some who attain old  age
under great disorders,) have known how to husband their powers. 
                     MODIFYING DISEASES.                 n55
 or whom an extraordinary vigour of body has protected from dis-
 ease.   If such subjects learn how to make use of their life, if they
 have contracted salutary habits, they may prolong their career to
 the epoch of its normal extinction;  but if they commit excesses,
 they sink in the same manner as those of the age immediately be-
 hind  them,  and with so much the more facility, as the reaction is
 no longer sufficiently energetic to resolve visceral congestions, and
 as the  force of assimilation  is too much  exhausted to repair the
 losses always brought on by  long suffering.
   In fact, apoplexies, palsies, aneurisms,  pneumonias, and gastri-
 tes,  often terminate  the existence of old persons in  a few days,
 even when their freshness of complexion and their fulness of habit
 and  gaiety seemed still to promise them a  certain number of years.
   The  state of caducity does not belong to health; we meet with
 few  examples of it in persons who have  attained an extreme old
 age.   They  generally become defunct in a sudden manner, or by
 a disorder of a few days  duration.   Caducity is most frequently
 observable in old men attacked with disorganizations by which
 nutrition is rendered  imperfect, and it is only by dint of great care
 that art succeeds in prolonging their frail  existence.  An error of
 apparently the slightest kind is irreparable:  but  to undertake to
 enumerate all the infirmities of this age, would be in anticipation
 of pathology.  What we most  frequently observe is,  that the se-
 nile  marasmus, which comes on in spite of the best directed atten-
 tions, is an infallible presage of approaching death; but we are in-
 clined to regard it  as more frequently the primary or secondary-
 deterioration  of the digestive organs, than that of an exhaustion
 produced by age; for, in the order of nature, the digestive func-
 tion ought to persist to the last moment; and death, in our opinion,
 must happen from the exhaustion of the contractility of the heart
 which ceases to beat.

 Section III.—Of the Alterations in  Temperaments by  the
     Influence of the Circumfusa,  Habits, and Regimen.

  Man  at birth  brings  with him  the  temperament  of his  pa-
 rents; but it may be altered by the influence of the circumfusa or
 states of the atmosphere in which he is obliged to live.  We now
propose examining in succession into the effects of heat and cold, 
55U
THE TEMPERAMENT.-. MODIFIED
 of dryness and humidity, of light and darkness, of regimen and
 habits, on the constitution of our fellow men.
   Atmospherical  heat is  a  stimulant;  it tends to  exalt the phe-
 nomena  of life; hence man in general takes a more rapid growth
 in southern than in northern climates: but we must estimate the de-
 gree of the heat, its  continuation and intermission.   If it be
 great in summer only, while the spring and autumn are of a me-
 dium temperature, and the winter short, man grows freely in all
 the external parts of his body; he is muscular and robust; the san-
 guine temperament is most  common, and the complexion is dark.
 If the heat be continual, as  in the countries situated between the
 tropics,  man is still more rapidly developed, his skin is of a  deeper
 tint, and complexion bronze or copper-coloured, but his limbs are
 less muscular and  robust.  The  cellular tissue is extremely con-
 densed,  the muscles are less prominent, the temperament slightly
 sanguine, the digestive apparatus very irritable, and the nervous
 activity considerable; the genital organs are prematurely deve-
 loped, and exert great influence over the rest of the animal econo-
 my, particularly among women.  In cold, but still fertile latitudes,
 in which the winters are long and very rigorous, whilst the sum-
 mers are very short, the height is great, the  cellular tissue expand-
 ed, the  sanguineous apparatus  developed.   Man,  more excited
 through the gastric surfaces than from the exterior, has more blood
 and fat,  but not always muscles  as strong as in warm countries;
 hence his external  forms are less regular.  The hair is chestnut or
 fair, and the skin  very  white.   In temperate climates, in which
 the winters  are short and in duration nearly equal to the  warm
 season, and in which the atmospherical vicissitudes are frequent,
 the temperaments are various.  We find here united the charac-
 teristics  of the South with those of the North; the vital energy is,
 in such  cases, considerable, as in  France and a part of Germany.
 In the regions entirely northern, near the poles, in  which the soil
 is sterile, excessive cold is opposed to the growth of the extremi-
ties, which are thin and short, but the trunk is tolerably full,  the
 head voluminous,  and the hair brown or red.
   Such are the peculiarities which the different degrees of tempe-
 rature tend to impress on the temperaments; but they are  modi-
 fied by the nature of the soil, by exposure to certain winds, by
 heihliiigs.  by the emanations  with which the atmosphere isloaded, 
BY THE CIRCT'MFTTsA, HABITS, &C.
557
and by the kind of nourishment.   Thus on the sides of mountains
exposed to the south and east, and well ventilated, man is always
of a dry habit of body, very muscular, perfectly well grown, and
extremely robust; whereas in northern exposures not well open
to the sky, and  in cloudy and humid valleys, we find him weak,
rickety,   scrofulous,  and goitrous;  here the  lymphatic tem-
perament  is  predominant   Dry,  stony, elevated,  and  sterile
situations, exhibit the  inhabitants less robust than those of the
mountains, but they are thin, agile, and tolerably healthy.  In low,
fertile, and shaded plains, on the borders of  the great rivers, the
temperaments are, on the contrary, lymphatic and fat; the men
have their muscular apparatus but little developed, are weak, often
sick, and  rarely attain  old age.  It is not, therefore, abundant
nourishment which gives to man his vigour.   In fact, the moun-
taineer,  who lives, as it were, only on milk  and cheese, enjoys a
robust constitution, whilst the inhabitant of the most fertile marshes
is languishing and  etiolated.
   Large cities furnish us likewise with the  confirmation of this
truth.  The nourishment is there abundant and succulent; but the
 want of light and the effect of humidity render the inhabitants pale,
 lymphatic, etiolated, and often  anemic.
   The kind of  life led,  concurs with the  causes which have been
 enumerated above, to modify the temperaments; its influence i>
 balanced by the latter, which in their turn again are  modified by
 it.   In mountainous countries,  man is subjected, by the nature of
 the soil,  to continual efforts, which,  conjoined with the purity ot
 the air,  must tend to the development of the locomotive apparatus'.
 whilst the strongly solvent  property of the atmosphere tends to
 dry the body and prevent lymphatic plethora.  The same agencies
 operate on him, though in a less degree,  in arid and stony  plains.
 and are productive of nearly the same result.  These modifications,
 when  combined  advantageously, compensate  for the weakne>>
 of his nourishment, and man  becomes very fibrinous and endowed
 with an expanded chest, though he eat very little meat; even were
 the heat itself extreme and continued, it would not debilitate him;
 witness the Arabs of the desert, and the pastoral and hunting tribes,
 who exhibit the temperament of the  mountaineers.
   In moist plains and deep vallies, exercise, even to some extent,
 and  the most abundant nourishment, cannot  neutralise the debih- 
558
THE TEMPER VMENTs MODIFIED
  tating influence of a clouded sky and marshy effluvia; man there
  falls into an enfeebled  state:  while again, the air saturated with
  water cannot be the bearer of the emanations from the body; whence
  it follows, that  the  cellular  tissue is  charged with fat, and the
  viscera filled with blood and lymph.  Add to these agencies  fre-
  quent morbid visceral congestions, either of the continued or in-
  termittent type, and we shall find sufficient cause for the lymphatic
  or  lymphatico-sanguine temperament,  which prevails in  the
  countries above described.
   If we inquire into the influence of exercise in  the large cities,
  we do not find it productive of more advantageous results.   The
  most  fatiguing labour, and  the  most  substantial  nourishment,
  cannot prevent the inhabitants from becoming blanched,lymphatic,
 thin, and even anemic.  This is  the appearance presented by a
 crowd of artisans and labourers of every kind, who are not deprived
 of good food, but work in  manufactories, and shops situated  on
 the ground floor, or in cellars, and even subterraneous places. As to
 those  who to labours of this nature add the sufferings from want,
 it is evident that their constitutions will be deteriorated much more,
 and that not many generations will be required before they arrive
 at the lowest degree of weakness and anemia. But if to these causes
 we add the  effects of the passions, which are here much more
 exalted than in the country; and certain excesses in eating and
 drinking, which occur from time to time, (at least once a week,)
 contrasting with the usual sobriety; finally, the sedentary life and
 the trades which force so many persons to maintain a painful atti-
 tude, exercising only  their arms or their legs, and sometimes even
 having the chest or the abdomen exposed to a  continual pressure:
 if, I say, we hold in mind all these noxious agencies, we shall con-
 ceive how the nervous temperament will be associated with  the
 two preceding ones, and how the  local phenomena are produced
 which tend to organic  alterations.   Such are, in  fact, all weak
 persons with  thin limbs, soft  flesh, and narrow chest, who daily
 sink in the flower  of their age, either under chronic pneumonias
or gastro-enterites.  These phlegmasie, on the point of yielding,
are renewed by the slightest imprudence, by the least cooling of the
atmosphere; they become habitual; tuberculous productions, lym-
phatic degenerations of every kind, are not long in forming; death
strikes the younger subjects before they are married:  if they have 
HY THE CIRCUMFUSA, HABIT.-.,  &.C           559
entered into that state, Iheir children cannot be raised; they do not
pass the epoch of dentition, or else they are carried off by scrofu
las  and the eruptive phlegmasie; and families thus  become ex-
tinct after a few generations.
  But if, in return, you transport to the country, and to a favourable
situation,  shattered constitutions, they may acquire strength, and
have healthy children, who will become parents of others still bet-
ter constituted; hence we can conceive of restoration to a vigour of
temperament, as well as the  degradation of the most robust.   But
man experiences as great a repugnance to leave the city, and become
an  inhabitant of the country, as he finds temptations in sacrificing
the country life to the pleasures of a large city.   Whence it comes
to  pass, that if these latter were not incessantly supplied by robust
families,  furnished from the  country, their population would very
 perceptibly diminish,  and  would,  by time,  be converted into
 gloomy deserts.   It is true, that, in this case, the inconveniences
 attached  to a crowded population, would, by its disappearance,
 terminate; the cities having  lost their distinctive characters, to re-
 sume that of the country and of hamlets.  Such, in conjunction
 with the crossing of temperaments from marriage, are the modifi
 cations under the influence of which man passes successively from
 strength  to weakness, and from weakness to strength; so that, after-
 all, the fundamental type of our species can  never be-destroyed.
FINIP. 
ERRATA.
Page 20	ine 1 from bottom	for friction	ead	gliding.
35	,, 7 from top	„ contribute	II	contribute*
87	„ 7 from bottom	„ mollusqux	n	mollusca.
88	„ 3 from top	„ mollusqux	>J	mollusca.
94	„ 12 from bottom	„ desire of food	II	desire for food.
138	„ 22 from top	„ relations	II	relation.
153	„ 15	„ regions	II	region.
159	„ w	„ kind	1)	kinds.
165	„ 15 from bottom	„ relative	II	relatively.
173	„ 4 from top	„ wants	II	use.
174	„ 9	„ are connected	II	are not connectec
203	„ 9	„ corvical	II	cervical.
204	,, H	„ exclusively	II	peculiarly.
311	„ last	„ applicable	>l	appreciable.
333	„ 5 from top	„ sisterna	II	cisterna.
339	„ 18	„ foramen	II	preceding.
341	„ last	„ at	II	until.
342	,, 27 from top	„ variation	II	deviation.
458	» *	after ' cold,' for a comma	II	a semicolon
	„ 3 from bottom, after * prevented'		II	motion.
496	„ 3 from top	for languor	II	larger portion.
527	„ 18	„ causes	»	cases.
529	„ last	„ encrusted	n	in crusted.
 
 
£
'<c
^ 
l'K
A
A 
'-'.mi/'^-:^
,  ■ ,  - t
^f-u-I^'v
;"  V"'^
£»
■ ■■ ■ .,7 *. t '-i ..
•**•


ft»-
-*£
'V- '-*
-.* <"< ri- ' .J~,l

'**

~W£,


#?<•«
B#k -,>:'

^OJBCHjr «■ Vi
^1?