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' 
TREATISE  ON  PHYSIOLOGY
APPLIED TO
                  F. J. V.  BROUSSAIS, M. D.
                          4N0* '
Knight of the Royal Order of the Legion of Honoui-, 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 Societies of Philadelphia,
                     New Orleans, and Louvain, &c. &c
TRANSLATED FROM THE FRENCH,
                      JOHN BELL, M.  D.

lecturer on the Institutes 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, Fellow of the Philadelphia
               College of Physicians, Corresponding Member of the
                   Academy of the Georgonli of Florence, &c.
                     R. LA  ROCHE, M.  D.

Member of the American Philosophical Society, and of the Academy of Natural Sciences of Philadelphja.
           if the Phils " '
            Academy (
Fellow of the Philadelphia College of Physicians, Corresponding Member of the
        [emy of Medicine of New York, one of the Editors of the North
American Medical and Surgical Journal, &c.
        SECOND AMERICAN EDITION,

             WITH NOTES A\L COBBECTIOXS.

          __________________-------------\ ■-- t v-A '



               PHILADELPHIA:

CAREY.  LEA & CAREY—CHESNUT STREET.
1838. 
£>".'

Easiebn District or 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
Cabey and 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, &c. &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.
BKEIUtETT—NINTH STREET,
     PHILADELPHIA. 
TABLE  OF  CONTENTS.
                             PART  I.
                            CHAPTER L
Preliminary Observations
Idea of Man    .....
                            CHAPTER II.
Of the Composition of the Human Body     v
        -,                    CHAPTER  HI.
Of the Vital Properties of the Tissues; Vital Power; Vital Laws
                            CHAPTER  IV.
History of the Functions of Relation.  General Observations  .
Summary View of the Functions of Relation
                            CHAPTER V.
Examination  of the  External Surfaces qf Relation, or the External
                Senses     .....
Sect. I.—Of the Skin  ....
Sect. II.—Of the Senses of Sight and Hearing
Sect, nL—Of the Sense of Sight     ....
          Of the Mechanism of Vision
          Of the Local Phenomena of Vision.   Of the Sympathies
              observable in the Ocular 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 Hearing
              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 become
              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 Dis
              eased in the exercise of its Functions .
                            CHAPTER VI.
Examination of the Encephalon, and of its Spinal Prolongation
                            CHAPTER VII.
Examination or Study of the Sensations—Instinct—the Operations of
              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           •
Pao.e
  25
  25

  29
51
59 
IV
CONTENTS,
CHAPTER VHI                        pA6J_
166
166
168
173
194
 Of Laughter, Ennui, and Sleep       .       .              «
 Sect.  I.—Of Laughter        ..'.•■•
 Sect. H.—Of Ennui   ....-••
 Sect, in.—Of Sleep   ....,■■
                             CHAPTER IX.
 Corollaries on the Intellectual Operations, and the Passions   •       •       A°^
                             CHAPTER X.                             '
 Of the manner in which the Exercise of the Intellect, and the Affec-
              tive Movements,  and the Passions, become causes of
              Disease       ....••
 Sect. I.—Of the manner in which the Exercise of the Intellectual Fa-
              culties disorders Health       ....       195*
 Sect. II.—Of the  Morbid Effects  of Lively  Emotions, and of the Pas-
              sions, united to the Exercise of the Intellectual Faculties       198
 Sect. III.—Each  Passion exercises a Morbid Influence over certain
              Organs       ......       206
riECT. IV.—Of Painful Passions without Reaction             .       .       208
Sect. V.—Of Painful Passions with Reaction  ....       212
                             CHAPTER XI.
Sect. I.—Of the Muscular Apparatus  of  Relation, and of its Depen-
              dencies       ......       219
Sect, II.—In what manner the Exercise of the Musoles may occasion,
              or become Cause of Disease   ....       233
                             CHAPTER  XH.
A Summary of the Functions of Relation      .                            240
                              PART II.
                              CHAPTER I.
Of the Organic Functions in general   .       .                           247
                             CHAPTER n.
On the Nerves destined to the Organic Functions    .      .              249
                             CHAPTER III.
Of Respiration .......
Sect. I.—A Summary Description of the Respiratory Apparatus
Sect. II.—Action of the Respiratory Apparatus in General
Sect. III.—Of the Aeration of the Blood in the Lungs
Sect. IV.—Mechanism of Respiration, or the Aeration of the Blood
Sect. V.—Modifications of the Mechanism of Respiration
Sect. VI.—Of Aeration in particular   ....
Sect. VII.—In what manner the Mechanism of Respiration may become
              the Cause of Diseases  ....
Sect. VIII.—Diseases resulting  from Derangements in the Aeration of
              the Blood in the Lungs             .      .              ngg
                             CHAPTER IV.
\ppendix—On the Functions of the  Cerebrum and  Cerebellum, as
              tending to throw light on the action of the Respiratory
270
271
274
274
275
277
280

286
Muscles
291 
CONTENTS,
V
                             CHAPTER V.                         PaoS
Function of Assimilation ,    .       .      .             •             305
Sect. I.—A Summary Description of the Digestive Apparatus       .      305
Sect. II.—Of the Functions of the Digestive  Apparatus;  Hunger-
              Thirst  ......
Sect. IH.—Action of the Digestive Apparatus—First Assimilation
Sect. FV.—Of Defecation.—Encephalic Relations of the Large Intestine
Sect. V.—In what manner the Exercise of the Organs of Digestion be-
              comes the Cause of Disease  .
                             CHAPTER VI.
Of the Absorption of the Nutritive Substances
Sect. I.—A Summary Description of the Chyliferous Apparatus
Sect. H.—Of the Functions of the Chyliferous Apparatus
Sect. in.—Of the Diseases which result from the Action of the Chyli-
              ferous Apparatus     ....
                            CHAPTER VH.
Of the  Circulation of the Blood       ...
Sect. I.—Description of the Heart    ....
Sect. H.—Of the Functions of the Heart in the Adult
Sect. IH.—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. VIH.—Of the  Capillary Circulation
Sect. TK.—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 Apparatus, 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 VIH.
Of the  Depurations     ...
Sect. I.—Of Cutaneous Depuration
Sect. n.—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
^ect. VII.—In what manner the Action of the  Depurating Organs be-
              comes the Cause of Disease   .                           43 i
                             CHAPTER IX.
Of the  Secretions                                                     44r' 
VI
CONTENTS.
Sect. I.—Of the Cutaneous Secretions
Sect. H.—Of the Mucous Glands
Sect. III.—Of the Lachrymal Gland and its Dependencies
Sect. rv.—Secretors for Digestion
          Of the Parotid Gland
          Of the Sub-maxillary Gland
          Of the Sublingual Gland  .
          Of the Liver       ....
          Of the Pancreas    ....
Sect. V.—Of the Functions of the Organs of Secretion
Sect. VI.—Of the Action and Use of the Sebaceous Follicles
Sect. VII.—Of the Action and Uses of the Mucous Glands
Sect. VIII.—Of the Secretion of Tears
Sect. IX.—Of the Physiological Action  of the Salivary Glands
Sect. X.—Of the Physiological Action of the Liver   .
Sect. XI.—In what manner the Secretions become Causes of Disease
                             CHAPTER X.
Of the Internal Exhalations    ......
Sect. I.—Of the Tissues charged with the Internal Exhalations
Sect. II.—Of the Physiological Action and Uses of the Serous, Adipose,
              and Medullary Tissues       ....
Sect. III.—In what manner the Internal Exhalations become Causes
              of Disease     ......
                             CHAPTER XI.
Of General Absorption .......
Sect. I.—Summary Description of the Lymphatic or Absorbent System
Sect. II.—Physiological Action of the Absorbent System
Sect. III.—In what manner the Absorbent System becomes disordered
                            CHAPTER XH.
Of Nutrition    ........
Sect. I.—In what manner Nutrition becomes a Cause of Disease
                            CHAPTER XIH.
Of Generation in  General      ......
Sect. I.—A Summary Description of the Genital  Organs  of Man and
              Woman       ......
Sect. n.—Physiological Action of the Genital Organs
          Of the Union of the Sexes .....
Sect. HI.—In what manner the Action of the Genital Organs becomes
              the Cause of Diseases .....
Sect. IV.—Of the Diseases of the Foetus                          .
                            CHAPTER XIV.
Of the Development, Consistence, and Decay of Man.—Of the Various
              Temperaments       ....
Sect. I.—Of the Temperaments       .      .      .      .       .
Sect. II.—Application of the Temperaments to Age and Sex—Diseases
              thence resulting      .....
Sect. III.—Of the Alterations in Temperaments by the Influence of the
              Circumfusa, Habits, and Regimen
Index  ......
Page
444
445
445
447
447
447
447
448
449
449
452
453
454
455
457
459

472
474

476

480

489.
490
491
498

508
517

524

525
529
529

544
556
557
568

574

584
589 
      PREFACE

BY THE  TRANSLATORS
  Physiology is indebted to Haller for  its being freed  from the
theories of the chemists and mechanical philosophers.  He was the
first to show, by his experiments on irritability, that the series of
phenomena, to which we apply the term life, in an organized body,
is the result of laws of action peculiar to it, and inimitable by  all
the conjoined efforts of art and science.   The inductions which  he
drew from this discovery, were, however, unfortunately suffered to
remain among those abstract truths, the precise purport and applica-
tion of which are often long in being detected.  A different and hap-
pier fate attended the physiological inquiries of Bordeu. The positions
which he laid down, that man is a compound of various organs, each
of which has movements and actions of a specific character, and enjoys
alternate activity and repose; that the organs possessed by  all indivi-
duals are the brain, heart, and stomach, which may be regarded as the
triune of the human frame, and the true supporters of life; and that the
body is to be considered as composed of two lateral and symmetri-
cal  parts, served as the ground-work to the magnificent creation of
Bichat.
  The labours  of  this  celebrated genius constitute a remarkable
era in medicine.  It is admitted by all, that  the laws of gravita-
tion and attraction can never,  by any subtlety of reasoning or refine-
ment of language, be lost sight of, because they are necessarily and
intimately connected with the movements  of matter, whether in
the revolution  of orb around orb, or minute molecular changes.
With  nearly equal  propriety, we may say that the laws of the vital
functions cannot now, by any metaphysical abstraction or deceptive
scientific analogies, be  misunderstood or perverted, because  they
are founded on the observed nature and properties of the organized
elements or tissues, the play of organ upon organ, the sympathy of 
Viii
PREFACE.
  membrane with membrane.   Though perhaps it argues a too san-
  guine spirit, we feel inclined to place the services which Bichat has
  rendered to medicine in his General Anatomy, on a parallel line with
  the benefits conferred on astronomy and  natural philosophy  by
  Newton in his Principia.  National prejudice and the pride of old
  opinions have retarded the diffusion of the works of both these be-
  nefactors to their species.  It was reserved for a Voltaire to eventually
  give currency to the principles of Newton in France.   Has Bichat
  yet found a worthy and impressive commentator in England? More
  than twenty years were allowed to elapse before his great work was
  translated  in that country, and then not until the task had been first
  performed by an American physician.*
   We are the more solicitous on the present occasion to direct the
  attention of our readers in an especial manner to the labours of Bi-
  chat in physiology, not merely for the purposes of a retrospective
 history of  that science, but in order that a knowledge of them may be
8duly estimated as a necessary and indispensable condition for the
 full and clear understanding  of  the  author  whose  work  we have
 translated.  It is a truth,  far from being sufficiently and diffusively
 known, that Broussais is  the practical commentator and expounder
 of the General Anatomy, to  which he has given an extension and
 diversified application, similar for the purposes of medicine, to what
 the first books of Euclid have received in surveying and navigation.
 They who have tasked their ingenuity, and wearied themselves  in
 bibliographical research, with a view to detect what they are pleased
 to call the  source of his theory, ought to be apprized of his own frank
 and manly acknowledgment, which  we have heard  him make to his
 class, viz.  that his chief merit and ambition  consisted in  carrying
 out the ideas of Bichat, and adapting them to the pathology of dis-
 ease and the practice of medicine.  Where, in fact, but in the doc-
 trine of the tissues did he imbibe his dislike to ontology, and his
  skepticism of the alleged  specific syphilitic and scrofulous viruses—
  where, but from the author of the work on the Membranes, did  he
  derive his opinions respecting the dependence of the various secret-
  ing organs on the surfaces on which they open.  No stronger proof
  of this strict relationship  can be adduced, than the work which has
 recently appeared in France under the title  of Jinatomie  Patholo-
 gique, Dernier Cours de Xavier BichatA  There  is such com-
Dr. Haywood, of Boston,     j Translated by Mr. Togno, of Philadelphia, 
PREFACE.
IX
plete identity of views in many parts of it with those held by Brous-
sais, that the reader persuades himself, according to the opinion
dominant in his mind at the time, either that the latter had  bor-
rowed from  the manuscript lectures of the Dernier Cours, or that
the work is the production of a partisan of the new school, who has
made Bichat utter what we may  suppose that celebrated teacher
would have advanced, when applying his physiological principles
to pathology.
   The cause  of medicine has suffered, as well from the neglect of
physiology, as from the defective method of teaching it. Functions
have been described too much in  the abstract, without a due at-
tention to the modifying agents  of hygeine, and  the  gradual  con-
version  of the  phenomena  of health  into the  painful  disturb-
ances of disease.   As  well  might  we  hope to become acquaint-
ed with  the  moral  nature of  man, by a knowledge of his dis-
position  in a  state of primeval innocence.  For all  useful and
practical purposes, the nearest approach  to good is made by know-
ing how  to evade and repel evil.   It is  of very little moment for
us to learn the precise quantity of  blood circulating in the arteries
and veins, the mechanism of the stomach's contraction, or the na-
ture of the fluid, aura, or vibration  of which the nerves are conduc-
tors.   What  most interests in the  functions of these parts, is to be
aware of the causes which unduly accelerate or disturb the  action
of the sanguiferous system, retard the changes of ingested substances
into chyle, and modify, alter, and pervert the ability of the nervous
system to receive impressions, experience sensations,  and  transmit
the orders  of volition.  Mechanical physiology and  the  study of
healthy function will doubtless prove interesting to the gentleman
scholar, and the person addicted to natural history,  but  they are
poorly calculated to  meet the wants and gratify the wishes of the
physician.  They are as barren of results, favourable to the healing
art, as  a system of materia medica made up of an enumeration of the
sensible  properties of medicines, and dogmatic statements of the
diseases in which they are useful, without any explanation of their
mode of  operation, or the variety of effects dependent on the parti-
cular condition  of the organs to which they are applied, and the in-
tensity and duration of the morbid symptoms, which  they are in-
tended to palliate or remove.
   Physiology, in the present work, is elevated from the station of
a low  subsidiary  to  be a  guide  to our science, by  which the 
X
*REFAC£.
 physician is led out of darkness, or the worse obscuration of the
 limbo  of  vanity.  The  resources  of experiment and observation
 are conjoined, each being made  to  correct the other's fallacies; as
 when the hasty inferences from the former are  revised and modi-
 fied in the more safe though slower inductions of the latter.  Ana-
 tomy and pathology constitute the  only sure foundation of physio-
 logy? by making us acquainted, the first with the order of prece-
 dence of structure to function, the second with the disappearance of
 function consequent on the destruction of structure.   The primary
 failure of a part to be developed, as  in an inferior class of animals or
 in monsters, shows, by the absence  of a function, the office which it
 was  destined to performs its slow removal by the disorganizing
 process of disease, being  productive of similar functional loss, leads
 us to a like conclusion as in the  former case.  Evidence of a middle
 nature is found when the energy of function  is proportioned to the
 integrity of structure, and the entire and ample development of an
 organ acted on by its appropriate stimuli.  Here begins the physiology
 of observation, in which  we add to  the data just indicated a notice
 of the effects of the particular agencies in the classes of the circum-
fusa, applicata, gesta. and percepta on the organs, the extent to
 which the relations between  these are  modified at the different
 epochs of life, and of the  seasons, and diurnal cycle.
  Let us apply these rules to the study of the nervous system, of
 the two divisions of which, the encephalo-spinal or voluntary, and
 the sympathetic or involuntary—the first presides over the functions
 of relation, the second over those of nutrition.  In  doing this  we
 hope to place before our readers some of the  leading and most im-
 portant propositions of the author of this volume. Comparative ana-
 tomy and pathology, aided by an observation of the effects of growth
 and development from infancy on to adult age, have enabled us to
 form  a pretty correct estimate of the functions of the encephalon,
 and in a more particular manner of  the cerebrum.   W'hen we  see
 that it  is  entirely wanting in  many of the  lower animals  is at
 first semi fluid, and afterwards soft and incompletely formed in  the
 foetal state of the  more perfect ones, that it does not acquire its ful-
 ness of outline, and firmness of structure until some time after birth
 and even  in  certain cases of monsters is totally absent, we become
 convinced that this part is not necessary to thegrowth and vio-ourof the
 rest of the body, nor to the  discharge of the various functions of assimi-
 lation, or limited locomotion and sensation, since these are evincedjr 
PREFACE.                         xi
 the above circumstances of anencephalous beings, either naturally or
 through malformation.  Pursuing the same path of observation, we
 soon discover that the difference  between the beings without brain,
 or in which there is little more than the rudiments of one, and those
 others higher in the scale, with this part more fully developed, con-
 sists in the latter displaying more multiplied instinctive movements
 and actions indicating thought.  We rightly infer, then, that the ence-
 phalon, connected as it is with other regions of the body by means of
 the spinal cord and nerves, is the part where the impressions on the
 sensitive surfaces are received and  combined, not, as  may happen
 in common ganglia,  to be followed by automatic movements, but to
 precede the radiation of that stimulus which gives locomotion to the
 human frame, for the carrying certain preconceived ideas into effect.
 We learn, in other words, that the encephalon is the originator and
 framer of mental acts—the operations of instinct and  intellect,
 and of moral feelings  and passions.   But as these endowments
 are not  equally  possessed by every animal,  our next  branch of
 inquiry is to  observe  under what peculiarity of encephalic con-
 formation they are  manifested,  and what  is  the  assignable pro-
 portion between particular development and special function  or fa-
 culty.  The gradual growth of the brain, attended by a proportion-
 ate evolution and increased energy of the faculties  of the mind, a
 difference in cerebral development corresponding with differences
 in mental energy, and a particular development constantly coincid-
 ing with a special function, are facts, which faithfully recorded  of
 late years, have formed the foundation of a natural and satisfactory
 system of mental philosophy, and furnished the strongest proofs  of
 the efficiency of physiological observation.
   The inferences from pathology must harmonise with the deduc-
 tions from what we see of healthy structure and coincident function,
 and be identical with the phenomena exhibited in monstrosities and
primitive deficiency  of the organ.  But here let us carefully distin-
guish  the'first  more violent and diffusive effects of disease, when all
the parts adjacent to  that first irritated, are in a state of turgescence
and disturbance,owingto contiguity and sympalhy,fromthesecondor
chi'onic, in which the vascular and nervous disorders no longerembrace
a large circumference, but are restricted to the part primarily affect-
ed. It is at this time  that the alteration of structure by induration,
softening, or ulceration, will show negatively the office performed
by the part or organ  during health, in the loss of function when  it 
xu
PREFACE.
is thus changed or obliterated by disease.  The phenomena  imme-
diately succeeding fracture of the cranium and pressure  of a piece
of bone or coagulated blood on the brain, are  not indicative  of the
disturbed  function of the particular cerebral portion thus irritated,
because the shock radiates through and  oppresses the entire mass,
which, in its turn, compresses the nerves at the base of the cranium,
and  arrests or greatly disturbs the functions of the sensitive and
motor organs.   But let the pressure of the bony fragment be with-
drawn  by suitable means, and time allowed  for  the engorgement
and turgescence of the brain to'subside,  and then the loss of mental
faculty consequent on the alteration or destruction of the part  pri-
marily wounded,  will show  us clearly its office in health.
  In addition  to the other means of investigating function, by not-
ing the effects of primitive deficiency of structure and secondary al-
terations by disease, physiologists have had recourse to vivisection
or direct and sudden  ablation of parts, either  by the knife or cau-
terization. Plausible at first view as this last method may appear, it
is liable to many fallacies, the chief of which consists in the general
sympathetic disturbance attendant on the local injury. The state of
the animal at this time too closely resembles the first or acute patho-
logical condition of the human subject, after accidental violence to a
part, or its subjection to phlegmasia, for us to  draw any  safe infer-
ences.   He who should  assert that the  kidneys aid the stomach
in its digestive function,  because this last is impeded in nephritis,
would  not risk  more of conjectural deduction  than  many have
done in the conclusions respecting the subjection of muscular move-
ments to the  cerebellum,  on account of the  irregular  locomotive
efforts  of  an   animal, after  this part of its encephalon had been
wounded by cutting away horizontal slices. That our skepticism of
the value of most of  the vivisecting experiments is justifiable  and
salutary, we have adequate proof in the discordant and contradic-
tory opinions  of those physiologists who habitually and  confidently
appeal to them as decisive authority.  Nor can we help', in  the in-
stance  of the study of the functions of  the brain, contrasting these
discrepancies with the general harmony, if not complete uniformity
of results from comparative  anatomy, foetal growth, gradual deve-
lopment with increase  of  age,  and  changes  induced  by  slow
disease.
   We must not, however, as already intimated, rest satisfied with a
bare knowledge of the functional exercises of which an or»-an is ca- 
PREFACE.
X1U
pable.  We are required to investigate the various modifications to
which it  is subjected, in virtue of impressions made on other and
remote organs. This is the most interesting department of physiology
to the physician, that by which the principles of hygeine are sagely
applied, and rendered subservient to pathology and therapeutics.  It
is one moreover, in which the author of the present work has display-
ed much  ingenuity, and patient and methodical research. Though the
text had  been given by others, for him was reserved the signal me-
rit of illustrating by copious commentaries, and making the practi-
cal application of the close union between the physical and moral
nature of  man; and  of explaining how the external world often
takes its colouring from the nature of the internal or visceral sen-
sations of the individual at the time.  He has not committed the er-
ror of Bichat in supposing the passions to have  their seat in the
nervous  system of organic life, or that prominent portion of it, the
epigastric centre.  But whilst he justly regards the brain as the seat
both of intellect and the affective movements, and the  centre of all
our relations with the objects by which we are surrounded, he traces.
in strongly marked characters,  a multiplied series  of actions com-
pounded of cerebral guidance and visceral stimulations.   In his ex-
treme desire to elucidate this part of his subject, he has perhaps ex-
posed himself to a charge of repetitions of argument and redundan-
cies of style; and  the critic might advise remodelling and curtail-
ment.  Notwithstanding these blemishes, we cannot, after all, avoid
acknowledging that our knowledge of these somewhat abstruse con-
nexions  between the functions of relation and those of nutrition, is
singularly enlarged by the manner in which the  author places be-
fore our view the  two internal mucous  membranes, pulmonary and
gastro-intestinal, as surfaces of relation, in common with the cuta-
neous  expansion  and the  senses, so  called.   To these   he has
likewise  added the  mucous  surfaces  of the bladder  and of the
organs of generation in both sexes.   The acts of  the individual are
then, setting out from these data, a result compounded of the innate
energy and activity of the cerebral functions-, the  intensity of sti-
mulation of the external senses, and the particular condition, at the
time, of the internal and sensitive mucous surfaces. In the passions
of love,  jealousy, anger, and grief, we have admirable  examples  of
these compound movements: nor are the more purely intellectual
processes exempt from similar though less energetic visceral modi-
fications.  One conclusion is irresistibly forced on us by the reason- 
XIV
PREFACE.
 ings of the author; that philosophers must always be, and ever have
 been, utterly incompetent to an analysis of the moral and intellec-
 tual faculties of man, without a previous qualification for the  task
 by a knowledge of physiology.
   The first part of this work is mainly devoted to an examination
 of the relations which the brain sustains with the senses, both exter-
 nal and internal, and the  apparatus of voluntary  movements.  In
 the second part of the volume, the author begins by  a description
 of the great sympathetic or intercostal nerve, the connecting chain
 of the viscera, which bears the same relation to nutritive or organic
 life that the brain and its dependencies  has to  animal life or the
 functions of relation. Very different from the cerebral centre, which
 is of ulterior formation in the new being, the sympathetic appears
 contemperaneously with the first rudiments of  the  viscera,  conti-
 nues to  be increased with their growth, and its  junction  with the
 spinal cord is complete only after having obtained its full develop-
 ment.   Taking this fact in embryogeny in connexion with the ar-
 rangement of the nervous system in some of the inferior classes of
 animals and in vegetables, both of which are destitute of an encephalo-
 spinal axis and  corresponding nerves, and are simply  supplied, the
 former with ganglia united by filaments, the latter  by corpuscles
 or globules in juxta-position, but not in corded form,  we  are fully
justified in the belief that the sympathetic nerve presides over, or
 is the immediate material agent of circulation, nutrition, and secre-
 tion and the assimilating functions in general, and that it alone is
 fully competent to produce the necessary  innervation for their full
 performance.  The instances of foetuses born with all their thoracic
 and abdominal viscera entire, although both brain and spinal  mar-
 row were wanting, and of the mollusca already adverted to, which
 have no encephalo-spinal axis, are additionally corroborative proofs
 of the correctness of this position.   Consisting, as the sympathetic
 does, of numerous ganglia joined together by filaments in a longitu-
 dinal course, and of plexuses intimately interwoven with  each
 other, and from which proceed twigs to envelop, as  in a kind of
 net-work or sheath, the arterial and capillary vessels which supply
 the mucous membranes and their glands and the heart itself, we can
 readily understand how it becomes a bond of union among all the
 viscera of nutrition or of organic life, and hence, also, how irritation
 of one viscus is transmitted to, and  participated  in by  the others.
 The sensibility of this nerve being of a very low grade, the inter- 
PREFACE.
XV
 nal changes wrought by assimilation, are scarcely felt in a healthy
 state of the animal  economy; nor would  the abnormal alterations
 be made sensible but for the interweaving of the nerves of the en-
 cephalo-spinal axis with the sympathetic,  in the cardiac, pulmonic,
 solar, and hypogastric plexuses. Here we are taught a difference be-
 tween the internal and the external surfaces of relation, that is, between
 the mucous and cutaneous  membranes, in the former deriving its
 vessels from  that division of the arterial system  solely supplied by
 the sympathetic, whilst the latter receives abundant ramifications
 from the nerves of animal life or of the encephalo-spinal axis.  The
 sensibility of the mucous is, in consequence,  much less than that of
 the cutaneous tissue, and pain is not in the first,  as  we constantly
 find it in the second, a sentinel prompt to apprize us of deviations
 from the normal state,  such as irritation, congestion, and  disorgan-
 izing inflammation.   Whenever disease in the viscera is  indicated
 by pain and disturbance in the cerebral  functions  and voluntary
 muscular apparatus, the symptoms are revealed to us entirely  by
 the medium of the  pneumo-gastric and the lower spinal nerves inter-
 woven with the sympathetic.
   We now discover that the functions of the mucous membranes
 are of a two-fold nature—first, as internal senses, they are,  except
 the portion lining the jejunum and part of the ileon, in relation with
 the brain, and modify the operations of the intellect and the passions,
 as already adverted  to; next, as surfaces  on  which  are performed
 the processes of nutritive absorption and depuration, they  are in the
 domain of the sympathetic nerve, and according to the number and
 variety of the stimuli or modifying agents applied to them will be
 their influence over the series of internal movements, which consist
 in the fixation of new matters in  the  organs,  and the elimination
 from them of old.  What we see as of uniform and  general occur-
 rence in the  nervous  system of animal holds  good in that of orga-
 nic life: viz.  that the  vivacity  and extent  of impressions, and the
 readiness of their transmission are proportionate to the expansion of
 the nervous tissue; and that the peculiar properties and functions of
 a nerve are rarely if at all evinced until thus  expanded.   The mu-
-cous, especially the digestive mucous surface, presents this condi-
 tion in the greatest latitude for the sympathetic, and we may  very
 properly regard it, with the author, as the surface whence impres-
 sions are conveyed to all the plexuses by  which the assimilating or-
 gans are so liberally supplied and intimately linked together.  The 
XVI
PREFACE.
  innervation  through the nerves of the  encephalo-spinal axis is
  prompt, but  generally in a longitudinal direction and  in a limited
  track, whereas, though slower in the sympathetic, it takes place in
  all directions, owing to the numerous anastomoses between the dif-
  ferent ganglia and plexuses.
    Enlightened by these anatomical and  physiological  data, we are
  prepared to appreciate the effects of abnormal digestion, first, on the
-  brain, and through it on the  organs of motion and sensation, in the
  phenomena of mental excitement, impatience and anger, muscular
  weariness, pain and intolerance of the accustomed stimuli from the
  class of the circumfusa; secondly, on the heart and lungs, the glands
  subservient to digestion, as the parotid, the liver and the pancreas,
  and on the  mesenteric glands, the kidneys, and the organs of gene-
 ration. The first series of effects are recognizable by pain, restless-
  ness  and general uneasiness—the  latter are usually more obscure,
 and are often only indicated  by the altered nature of the secretions
 and by imperfect depurations. In derangements of the abdominal vis-
 cera, the stimulations conveyed to the brain through the filaments
 uniting the ganglia with the spinal cord, or  by the anastomosing
 branches of the pneumo-gastric, give rise to  a crowd  of confused
 sensations, constituting hysteria, hypochondriasis and  melancholy,
 or in the more acute states, muttering delirium, subsultus tendinum
 and coma.
   These distinctions, which are legitimately deduced from anatomy
 and the physiology  of observation,  are of  the highest moment
 to the pathologist and physician. They must  be constantly held in
 remembrance by the reader, if he would obtain  a clear  concep-
 tion of the author's  reasoning  in this  work, and  shall we add,
 of the nature  of disease.   Once master  of this key, he will  find
 opened to distinct view all that would otherwise  be abstruse  and
 concealed in  the Chapters on  the Sympathetic Nerve,  Abnormal
 Assimilation,  Depuration, Exhalation, and  Secretion. We can by it
 easily understand how abundant alimentation by stimulating the di-
 gestive mucous surface, that on which the sympathetic is so largely
 expanded, will be followed by rapid absorption, and consequent  ple-
 thora, and copious deposition, and nutrition, going on to polysarcia—-
 in fine, increased activity of all the nutritive viscera.  If this state be
 kept up, the secretors and depurating organs becoming overtasked by
 the mucous stimulation, will pour out an increased quantity of fluids
 from the various  emunctories, as of sweat, urine, and pulmonary ex- 
PREFACE.
XV11
halation—in other words, irritation at one side of the expansion of
the sympathetic is promptly responded to by the others.  Gastro-en-
teritic irritation, whether from the abuse of food or excess in stimu-
lating drinks, or medicinal agents, is the signal for hepatic, mesenteric,
glandular, and renal disorders, associated with derangements of the
pulmonary organs. Sensation to the extent of producing pain is not a
necessary accompaniment of these phenomena.  It may or may not
be co-existent with them,  according to the extent of the sympathies
of the functions of relation. Occasionally, indeed, when the simple
super-excitement of the digestive surface is succeeded by phlogosis
ending in disorganization, we find associated  with violent  depura-
tory and  secretory efforts of the viscera alarming pain  and disease
in the brain and senses: but at other times, although the lungs are
overtasked to the discharge of vapour and carbonic acid, and the
kidneys to that of urine, turbid, black, and even bloody, whilst the
other mucous surfaces are in a state of the most disorganizing ex-
citement, as in  cholera and yellow fever, there is often no complaint
uttered—no pain felt—no irregularity in the cerebral system, and
in cases of the last mentioned disease, even the strength of the mus-
cular apparatus is but slightly if at all diminished.   So  also in the
chronic diseases of the assimilating organs going on to marasmus,
and accompanied by a slow fever, the mind retains its wonted ener-
gies, and no complaint is made, except of occasional lassitude. These
facts duly weighed and arranged must give us an improved symp-
tomatology, and incite us to a still more thorough investigation of
the morbid changes in the internal viscera.  Are  we not in the too
habitual practice of estimating  their diseases by the sympathies of
the organs of relation, and of making the presumed condition of the
latter the measure of our treatment  of the former, as when languor
and disinclination to muscular  movements are attempted to be re-
moved by alimentary and medicinal stimuli to the digestive viscera,
already in a state of commotion and suspended function from ex-
cessive irritation.
  That we have not overrated the influence exerted by the first acts
of the digestive process over all the subsequent ones of assimilation
ending in the deposit of nutritive matter in an  organ, will  appear
still more evident from some additional arguments which we now
offer.  Repeating after Hippocrates, ventriculus sicut humus, we
may be allowed to compare the more simple yet distinctly marked
organization of vegetables with that of animals,  and regard the soil
                              3 
XVlli                      PREFACE.
 as supplying to the former what the matters in the stomach  do to
 the latter, and the bibulous and spongy radicles of the root as simi-
 lar to the absorbents of the mucous surface.   Now we know, as
 phenomena coming immediately under the cognizance of the senses,
 that the rise of the sapin a plant, its elaboration into various  new mat-
 ters, gummy and resinous, and the growth of buds, efflorescence and
 fructification are directly dependent on the preliminary process of
 absorption by the spongy terminations of the root.  Alter the re-
 gularity of this function, apply acrid fluids to the root, or  surround
 it with compost of too rich a nature,  and the plant becomes  un-
 healthy, its leaves lose their verdure, the bark  its smoothness  and
 firmness,  the secretions of gum are arrested, and fructification  de-
 stroyed, or this product is  small,  shrunk, and ill-flavoured.   The
 vegetable  physiologist may perhaps  add that the integrity  and
 healthy state of the leaves are likewise necessary to the vitality of
 the plant.  It is on the foliated structure that the stimulus of light,
 heat, and  electricity chiefly act, by keeping up  a properly balanced
 exhalation and absorption of aerial matters on its expanded surface.
 Here we find the same function performed by the leaves for  vege-
 tables, which the lungs fulfil for animals: and whilst we admit that'
 the respiratory  process is capable  of modifying the  nutritive  ab-
 sorbent apparatus in both, viz. sap-vessels and lacteals, we are still
 bound to believe in the paramount influence of the digestive spongy
 radicles and  mucous  surfaces,  respectively, over the entire cor-
 responding organized bodies of which they constitute so important
 a part.
   The pulmonary  mucous tissue performs very important offices in
 the animal economy. Through it does the oxygen of the atmosphere
 effect that change in the nature of the blood so essential to the vita-
 lity of all the organs—by it is accomplished that depurating discharge
 of carbonic acid and vapour the retention of  which would  prove so
.deleterious.   This surface, capable of being so variously impressed
 by air of different degrees of purity and temperature, and  by dele-
 terious gases and vapours, must of course have multiplied  relations
 with the other surfaces and organs of the body; and accordingly the
 heart, brain, skin,  and stomach are found to sympathize with its ir-
 ritations, as we  see in  catarrh, bronchitis, asthma, and the oppressed
 respiration in close and hot apartments.   Its relations, as in the case
 of the digestive mucous membrane, are of a double nature__first, with
 the brain, by means of the pneumo-gastric nerve—and secondly, with 
PREFACE.
XIX
 the heart and abdominal viscera, through the intervention of the
 sympathetic.
   Ought we, after this view of the structure, functions and connex-
 ions of the pulmonary and gastro-intestinal  mucous  membranes, to
 be surprised at the emphasis with which  the author of this work
 descants on their pathological bearings.   They  are, especially the
 last, the most frequently offended  of all the parts of the human
 body by various stimulation, often  as abrupt as it is  violent: and
 they propagate more diffusively and profoundly their irritations to
 other and remote organs as well of nutrition as of relation. The rea-
 der cannot desire a more felicitous application to practical medicine
 of these principles than is found in the chapter on the Depurations.
 The succession of symptoms after the introduction of a noxious sub-
 stance into the stomach is there so naturally described, and clearly ex-
 plained,  that we find it impossible not to recognize in them a picture
 of the malignant and pestilential fevers of authors, and to see in the
 hurried secretions consequent on the diffused irritation throughout
 all the assimilating viscera, a'counterpart of  our own  perturbating
 treatment  by the  use of emetics,  cathartic,  diuretic,  and  dia-
 phoretic remedies.   It  is not always required that a foreign body
 should be introduced into the digestive passages, in order  to give
 rise to the above series of eliminatory actions.   A strong stimula-
 tion of the principal organ of digestion, the centre of the chief cords
 of the great sympathetic, excites a  succession  of irritative  move-
 ments, which, if not arrested by too powerful a gastro-cerebral con-
 gestion, will finally terminate in an evacuating process of the elimi-
 nators, and frequently of the secreting organs which  perform the
 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.  Have we  not in all these circum-
 stances an  explanation of the  importance attached to Crises in
 fevers, and  of the  rigid attention with which they were observed
 by the older writers who practised in warm southern climates, in
which gastro-enteritic  constitute the larger number of diseases.
When the rules of hygeine  are  neglected, and  the  laws  of sound
physiology broken  by perpetual stimulation of the gastric surface,
 we can easily conceive how the continued eliminatory struggle of the
 skin and kidneys should so  enfeeble their functions as to give rise to
 chronic  cutaneous  and  renal  affections.   The almost  uniformly
 morbid appearance of the  tongue  in these cases  added to other 
XX
PREFACE.
symptoms of chronic gastritis would seem  at once to  indicate the
etiology of the  malady, and  the means of relief: nor have all the
experimental trials of conjectural medicine  advanced us as far as
these simple guides furnished by physiology.   By the one we have
been led to the use of irritant after irritant, with a view to obtain-
ing certain antilithic and specific effects, and after all have  settled
down into the belief of what the other would have at once pointed
out, viz.: that the alleviation and cure of the  morbid secretions is
best obtained by a removal of the primary and central gastric irri-
tation.  For this purpose the simplest demulcent drinks and a milk
diet will be found  more efficient than all the heroicals of the ma-
teria  medica.   If  we were  allowed to reason on  the  author's
views, as exhibited throughout this work, we should be tempted at
once to regard them as unquestionably correct,  because, while ap-
pealing to nature,  they yield the strongest support to sound mora-
lity.  No health for the sensualist—no permanently pleasurable
emotions for him  who  passes the bounds of moderation in the in-
dulgence of his appetites, are warning monitions of constant recur-
rence in this volume.
  Much criticism has been extended to  Broussais for his use of the
term organic chemistry.  His defence  is given  in the chapter on
the Internal Exhalations, in which he states that  he is indebted to
Fourcroy for an expression so happily indicative of the numerous
changes in the internal structure of an organ, as in secretion, exhala-
tion, and nutrition, all which, in his opinion, take place beyond the
boundaries of the circulation, and in virtue of certain affinities,
termed vital or organic, because not explicable by the laws of com-
mon chemistry.  Under the head  of the functions just indicated,
and in his section on the capillary circulation, he enters into a de-
tailed argument, strengthened by much  plausible reasoning and ap-
posite facts, illustrative of his views  on this subject.  He regards
the vessels as the conductors of nutritive materials to the tissues
into which having penetrated, they leave a portion of their contents
to be disposed of according to the  wants of the part.   The  series
of changes consequent on this extravasation or escape of some of the
principles of the blood is accomplished independently of the vessels
and by the laws of organic or vital chemistry. These are variously
modified by the condition of the organ, and notably of the nervous
tissue expanded over its  minute capillary  reticulated  structure.
Whether or  not we  receive the explanation of Dutrochet of these 
PREFACE.
XXI
phenomena being brought about by what he terms endosmosis* and
exosmosis, we are bound to admit that secretion, nutrition, and ca-
lorification ;  in  fine, the conversion of the first elaborated nutritive
fluid into peculiar products and the substance of the organs, is ac-
complished  independent of the aid of a vascular system.  In vege-
tables  there  is  no circulation,  properly so  called, of  sap, and
yet there is a rapid conversion of this juice into gum, saccharine mat-
ter, resin, and the instruments of efflorescence and fecundation; and
it is directly subservient to the growth and  mature development of
the fruit or the product of this last process.   Changes  of a  corres-
ponding character are of manifest  occurrence in the lower animals.
Which are destitute of a circulatory apparatus or well  defined vas-
cularity.
  A review of what has been said, will,  we believe, justify the fol-
lowing propositions, which are so many  applications of physiology
to pathology. «i. The principal changes in the intimate structure of
an  organ, constituting  the  secretory  and  nutritive deposits, take
place in the cells or areolae of the  tissues, and the office of the ves-
sels, both red and white, is to convey the necessary materials, and
carry back into the general circulation what is effete or useless.  2.
The modifications in the state of the functions, both of nutrition and
relation, are effected by impressions on surfaces, consisting of a cel-
lulo-nervous expansion.   3.  Most diseases are  the consequences of
irritation on one surface, transmitted to various others. 4. Neither
the activity of function, nor proneness to or intensity of disease on  a
membranous surface, can be  measured by the  size and number of
the vessels, and nerves going to it; but must be estimated by a care-
ful observation of the phenomena arising out of its relations with the
various modifiers applied to  it, or by the irritation received from
another membrane with which it  sympathizes.  5. The same laws
of transmission from surface to surface, which  govern diseases, re-
gulate the operation of our therapeutical means.  6. There is, pro-
perly speaking, no general  disease of the nerves or blood-vessels,
but the commotion experienced through the vascular  and nervous
systems is purely secondary, symptomatic, and of minor importance
—being in all  cases, except of  traumatic lesions or abscesses, the
 consequence of membranous irritation, or of a morbid condition  of
 some of the expanded ramifications of the nervous tree, and disap-

        * «<fsi', within—vr/jt.Q;, impulsion—«£, without—aia-pof, impulsion, 
xxu
PREFACE.
 pearing when these latter are removed.  7. The muscles are merely
 instruments for  facilitating assimilation in organic, and gratifying
 the brain and sensitive surfaces  in  animal life.   They are, except
 in as far as their lining membranes  and investing aponeuroses are
 concerned, strangers to the characteristic and decisive results of dis-
 ease, which runs its course without materially influencing or being in-
 fluenced by them. S. The masses forming the brain and spinal marrow
 are, in like manner, alien to most of the important phenomena of func-
 tion, performed  by their  expanded surfaces: they  serve as nutritive
 supports, and commissures of union for these latter, on which pri-
 marily, or through the intervention of their investing membranes,
 are displayed the principal actions in  health  and changes in dis-
 ease.  9. The functions of the vascular, nervous, and muscular systems,
 though instrumental to the series of actions constituting life, and espe-
 cially of those important ones taking place on the membranes, are not
 identical with them, nor can the laws of thecirculation^r of contractili-
 ty, or of sensibility be brought to explain the properties of these mem-
 branes, or of the part which they perform in either health or disease.—
 They are a compound structure invested with new properties, the na-
 ture of which cannot be predicated of that of any or all of its elemen-
 tary tissues: they must be studied in themselves, and with an atten-
 tion to their own peculiar laws and  sympathies.
  A glance at the number of diseases in which the  cutaneous and
 mucous surfaces  are primarily and chiefly affected, and on the sus-
 tained irritation  of which depends a crowd of alarming symptoms,
 will suffice to show that these propositions are  not laid down with-
 out due advisement.   On the  pulmonary mucous  membrane  we
 have catarrh,  bronchitis, laryngitis, trachitis, coryza, and the haemor-
rhages designated by the  terms epistaxis and haemoptysis:  on that
 of the digestive passages we meet with a great variety of inflamma-
tory affections and haemorrhages; whilst the most  numerous and
troublesome disorders of  the genital and urinary organs,  in  both
sexes, have their seat in the lining mucous membrane.  The  cuta-
 neo-mucous diseases give us all the  devastating exanthematous af-
fections, such as measles, scarlet fever, and small pox. Fevers exhaust
their malignant power on the membranes lining and investing the
 viscera.  Pleurisy, peritonitis,  and arachnitis, among the most for-
midable maladies of the three cavities, are serous  investing mem-
branes.  Rheumatism and gout chiefly  interest the digestive  mu-
 cous tissue and the aponeurotic expansion of the fibrous.  Again it 
PREFACE.
XX111
may be averred, that in all these, and many other membranous dis-
eases, there is, for the  most part, immunity of the muscular and
nervous masses and the parenchyma of the viscera from any notable
change, and that there is no uniformity in the measure of the dis-
turbance of the vascular and nervous systems, nor safe inference to
be drawn of the extent and violence  of the membranous alterations
and march of the disease from such disturbance.
  It is by pursuing this course of faithful observation,  that we may
hope to acquire a knowledge of the true principles  of physiological
pathology,  which, originating  with  Bichat,  in  his work on the
Membranes, have been so fully extended and happily diversified by
the author of the Phlegmasies Chroniques, and Examen des Doc-
trines Medicates, in the present treatise,
  Justice to him, rather than any wish on my part to claim merit for being the super -
intendent of a second edition of this work, requires me to state that the absence of Dr.
La Roche, in Europe, has deprived me of his valuable assistance on the occasion.
I have, however, preserved the plural in designating the additions made in the
form of a preface and numerous notes, because the facts and opinions advanced
in them are, I believe, common to us both,  with, perhaps, the exception of the
concluding propositions.  The public are, therefore, entitled to  the additional
weight which the name of my former associate cannot fail to carry with it in all
questions of physiology and philosophical medicine.—Johk Bell. 
 
A  TREATISE
                      ON




APPLIED  TO  PATHOLOGY.
                        CHAPTER I.

                 PRELIMINARY OBSERVATIONS.

  Physiology is the science of life: it is the study of vegetables
and animals either in a state of health or disease. Our intention, in
the present work, is to apply it to man, considered in both these
states, as well on account of the functions in the former being often
elucidated by those  observed in the  latter, as because the lesions of
the functions during 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, but the former will
not be overlooked, whenever they appear to contribute to the same
end.

                        Idea qf Man.

  Man is an organized being, enjoying, in common with all that
lives, the faculty of developing and preserving himself  during a
certain space of time: this  he performs,  first, by appropriating to
himself, and subjecting to the laws by which he is governed, a cer-
tain proportion of materials which he derives from the other bodies
in nature; secondly, by rejecting all that he  has taken beyond his
natural wants, and which, after having served his purposes, has lost
the property of being any longer serviceable.
                             4 
 ~6                      IDEA OF MAN.

   In common with all perfect animals, man enjoys the faculty of
 recognising  at a certain distance  those things  necessary for  the
 maintenance of his functions,  of searching for nutritive materials,
 and depositing them in a central cavity, where they receive a pre-
 liminary assimilation,  and whence  a portion penetrates into the in-
 terior of his  tissues, whilst, the remainder is rejected as superfluous.
 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, nor deposit them in a central cavity.
   Man, also, in common with  other animals, is constituted  of a
 matter  which we shall  denominate  animal, and which presents
 itself under a certain number of forms convertible into each other:
 these are gelatin,  albumen, and fibrin; which possess the  pro-
 perty, during their spontaneous decomposition, of affecting  the
 olfactory sense in a peculiar manner.  Animals, moreover, present
 other forms  in their  immediate composition; 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 tis-
 sues.   The derangements of the assimilative faculty cause many
 others to appear;  but these do not necessarily constitute part of the
 texture of the animal.  Finally, with the three essential forms,  (ge-
 latin, albumen, and fibrin,) are found associated alkalies, acids, and
 certain salts,  as the phosphate of lime, &c, most  of which are dis-
 covered  in a  great number of unorganized 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,  and  more particularly, by the
power of reflection, or the faculty of  perceiving his  own relations,
of observing  himself whilst he observes every  thing else, and of
being impelled to this by a pleasure which  appears to be indepen-
dent of the gratification, at least immediate, of his physical wants:
hence arise in him desires of a purely intellectual nature.  Thus in
the brute, telations 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  contrary,
man,  after  having provided for his physical wants, still remains
 awake,  and is called to action by an  irresistible  desire of con- 
IDEA OF  MAN.                      27
templating 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 specially directed towards
the accomplishment of this double end.  It was formerly  the custom
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 be-
came diseased, and maintained himself alive notwithstanding the
morbid condition of his system.  When  they attempted to discover
causes of disease in the study of  physical man,  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 derange-
ments.  In this sense alone, the application of physiology to medi-
cine 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 circumstance, that physiology,
which at first was too  mechanical, subsequently became too meta-
physical; and that pathology was still too superficial and abstruse.
It was acknowledged that physiology 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 con-
nect it completely with medicine.   He  has pointed out the means
of accomplishing this task;  and,  if he has not succeeded in it him-
self, it is because the phenomena  of  disease  were presented, in
authors, under an aspect totally dissimilar from the phenomena of 
28                      IDEA OF  MAN.

health.  This proposition, which I have already demonstrated i«
the Examen des Doctrines, will appear more evident from  the
approximations we shall have occasion to point out in the subse-
quent parts of this treatise.                             .
  I have read with extreme pleasure the article on the Trisplanch-
nic nerve, written by professor  Lobstein in the Dictionnaire des
Sciences Midicales.  The author  there  considers the ganglionic
nerves under a point of view which appears to me highly interest-
ing, and which approaches nearly to the idea I had already formed
of them, (See Journal Universel des Sciences Midicales, t. XII.
1818, and the  Examen des Doctrines.)   Such  essays abound in
useful application to practical medicine, and are worth many long
treatises.
  The simple study of the organs  in relation with their modifiers,
will always constitute, for physiologists, a fruitful and inexhaustible
source of new  truths; one from which we intend to draw.  It is for
having isolated symptoms,  not  merely 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 en-
tities, which, as we have already proved in the Examen des Doc-
trines, disfigure the science of medicine.  The same error has been
committed in physiology. Functions have been made too indepen-
dent of those modifying agents by  which they are maintained; and
hence the change from the  physiological to the pathological state,
has not been hitherto completely discovered; or, in other words,
it is owing to  this cause, 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  so soon as the one has as-
sumed the right path, the other should naturally follow.
  It is not my intention, then, to present here a history of the func-
tions, viewed  abstractedly; but rather to  give a history of the phy-
sical 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 internal changes
that are brought about, when those bodies we denominate modi-
fiers, are placed in connexion with the organs—the manner in which
organs primarily modified, modify others;  and, if these latter  ope- 
COMPOSITION OF THE HUMAN  BODY.
29
rate on a third series, to ascertain the nature of this action and when
it will cease.
  It is impossible for  us not to comprise in this study that of the
functions; indeed, it appears evident to  me  that  their history
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 func-
tions 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.

          OF THE COMPOSITION OF THE HUMAN  BODY.

  The animal matter which enters into the composition of the hu-
man body is distinguishable into 1, fixed animal matter constituting
the texture of the organs; 2, moveable animal matter, or the fluids.
The former is arranged in such a way as to leave in its interior, in-
tervals or cavities of greater or less dimensions, in which the latter
is kept in a state of perpetual motion.  Independently of these ca-
vities, the fixed animal matter is perforated on its external surfaces,
and on such of its internal ones as are in relation  with external bo-
dies, by innumerable openings through which these bodies penetrate,
or through which molecules escape that had before constituted either
a part of the fixed or the moveable animal matter.
  Gelatin, albumen, and fibrin, are the principal forms of fixed ani-
mal matter.  They exist in various proportions in the different or-
gans or apparatus, and assume in most parts of the body the  form
of lines or filaments more or less distinct from each other, 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-
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, 
 30             COMPOSITION OF THE HUMAN BODY.

 they constitute an apparatus. The common aim of this association
 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  func-
 tions is the maintenance of life.
   The principal functions are confided  to internal  apparatus, 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 lat-
 ter extend to various regions of the body.  They are denominated
 indiscriminately organic systems  or apparatus; 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 communication, resemble each other both in their struc-
 ture and vital actions: thus the diaphanous membranes, or  sacs with-
 out openings, which cover the external surface of the  viscera con-
 tained in the three cavities and facilitate their movements, are desig-
 nated collectively by the term serous system. It is in this sense like-
 wise, that we apply the word synovial system, when we wish tore-
 present the assemblage of those little sacs without openings, which fa-
 cilitate the gliding of the moving surfaces of the  joints, and of the
 sheaths of the tendons.  Bichat, 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 or-
 gans of considerable weight—the periosteum, a kind of membrane
 which is spread upon the bones, and which when there is no insertion
 of tendons or ligaments, separates them from the other tissues—the
 more or less solid envelope of certain viscera, as the proper tissue of
 the spleen and kidneys, that which  contains the apparatus of the eye
 and gives it a spherical shape, (the sclerotica,) and the external enve-
 lope of the cavernous bodies, to all which 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
 apparatus; but  the  cartilages and fibro-cartilages are merely the
 appendages of this organic system.  Finally, the muscles or locomo*
 tive powers have received the name of muscular system or appa-
 ratus.  It would appear, however, that the assemblage of these
 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, constituting together the locomotive ap-
paratus. 
COMPOSITION  OF THE  HUMAN BODY.
31
  In the early periods of life, all these organs, as regards the ap-
pearance of the substances of which they are composed, are homoge-
neous—there being nothing 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 particu
lar organs.   The bones which constitute the  basis  of the edifice,
present nothing but a  mass  of gelatin combined  with a saline sub-
stance, (phosphate of lime.)   The cartilages, ligaments, and articu-
lar capsules, organs partaking of the  osseus parenchyma,  and con-
stituting  the appendages, complements, and means of union of the
various pieces which  compose the skeleton, are  formed of gelatin
combined with a smaller proportion  of saline  matter than that of
the bones.  The tendons, a kind of appendages by which the muscles
terminate, and which  afford them a means of union with the bones,
are also composed of  gelatin  alone.  The same may be said of the
aponeuroses which assume the form of membranes, destined either
to contain the muscles submitted to the power  of volition, or to af-
ford them points of insertion;  but the  muscles, properly so called,
are presented to us as bundles, of greater or less dimensions, of red
fibres; and  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 fibrin. This matter  is found in the mus-
cular tissues, whether they  obey the  power of the will, or are inde-
pendent  of it and  belong only to the  viscera. The hollow cylinders
acting as conductors of the blood in its passage from the heart to the
different organs,  and  designated by  the  name of arteries, consist
partly of gelatin and partly of fibrin assuming a peculiar aspect; but
those which carry the blood  and lymph to the heart, present little
else than gelatin,  except perhaps in that part of their course where
they are more voluminous, and nearest the heart; for here, in some
animals,  fibrin is discovered.
   Albumen, which derives its name from its resemblance to the white
of an egg, enters mainly into the composition of the brain and spinal
marrow. The whole massof these organs, however, does not consist
of it;  since  in them, as in other parts  of the body, the small vessels,
arterial or venous, are merely cylinders of gelatin: this matter con-
stitutes 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 
 32            COMPOSITION OF THE HUMAN BODY.

 principal convolutions.  Gelatin is likewise 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 albumen exist in them, it
 can only be in small proportion.  Fibrin 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 in their pro-
 per tissue, and  the vessels and nervous extremities with which
 they so  plentifully  abound,  are  gelatinous; nevertheless, as these
 nervous extremities appear to be in a  pulpy state, we are led to
 infer that they contain also some  albumen, since it is found in  the
 cerebral pulp.  To  the chemists, therefore, we are to look for cer-
 tainty on  this subject,  by their separating these tissues  from all
 foreign  matter, before  submitting them to analysis.   The cellu-
 lar tissue, 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, and isolates them,
facilitates  their movements, and appears in all  their  interstices.
 This tissue, which  is so universally spread,  and so important, is
 composed of gelatin in nearly  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, excretory ducts,
nerves, and cellular tissue, and many of  them, possessing, besides
these  tissues, a  serous, muscular,  and  mucous  membrane, it is
evident  that the three principal forms of this matter must necessarily
be found in them.
  These three  forms predominate likewise  in  the fluids, or, in
other  words, in the  free and circulating animal  matter,  known
commonly under the name of blood.   There exists, besides, a  red
colouring matter, which, in the greater number of animals, appears
to be associated with fibrin.   We likewise find in the blood those
saline substances,  or at  least  their elements, with which certain
 gelatinous tissues become encrusted:  but what in the history of the
 animal fluids seems  most worthy of the attention of philosophers,
is, that with gelatin, albumen,  and the  fibrin  of  the blood, certain
 organs have the power of engendering new forms of animal mat-
 ter.  Thus the follicles  of the skin  produce a sort of fat or wax 
               VITAL PROPERTIES OF  THE  TISSUES.           33

somewhat analogous to that found in the interior of the bones, and
in the adipose tissue, and which has some resemblance to vegetable
oils.  The follicles of the internal membranes of relation, form the
mucus,  which  appears to  be  nothing  more than a modification of
gelatin.  It is in this way also, that the kidneys fabricate urea; the
liver, adipocire; the breast, milk, &c; without mentioning the more
or lesss extraordinary forms, which  animal  matter can assume in
inflamed parts and on suppurating surfaces.  It is worthy of notice,
that if all these varieties become the prey of some carnivorous ani-
mal, its digestive powers and  the secondary assimilation soon con-
vert them into gelatin, albumen, and fibrin.   These, therefore, are
the forms of animal matter which principally merit our attention;
and that, too, so much the more, as to them  alone nature has attach-
ed what physiologists have denominated vital properties.
                       CHAPTER III.

   OF THE  VITAL PROPERTIES OF  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 particular, it is easily
discovered to consist in a simple  shortening.  Physiologists 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  physiolo-
gists have attributed to the  living fibre both sensibility and con-
tractility.   But, if the true meaning of  these two words  are to be
understood thus, "the fibre 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, in saying that the fibre is sensible, we  imply that it has con-
                             5 
34
VITAL PROPERTIES OF THE TISSUES.
 tracted.   I see no reply to this argument.  The truth of this  re-
 mark  has  long been felt; but it has been combated by objections,
 which have prevented its  universal  admission.  These objections
 will be solved as we advance.
   Contractility exists in different proportions, in the various forms
 of animal matter.  Fibrin possesses it in the most eminent degree;
 consequently, when nature wishes that an apparatus should execute
 extensive movements, she places in it a great proportion  of fibrin.
 This last possesses inherently 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, in  reference 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 fibrin, whether it consti-
 tute a part of a muscle, or circulate in the interstices of the tissues;
 but it cannot be exercised in this latter state until it ceases to be sub-
jected  to the movement of the circulation.   The state of life is,
 therefore, opposed to the complete condensation of the fibrin of the
 blood, as it is to that  of  the  organized  fibrin;  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 mole-
 cules of  the  fibrin,  which were  before  scattered in that fluid,  ap-
 proach each other and separate from the serosity, carrying along
 with them, in their interstices, a large  quantity of gelatin, 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 albumen  remains in the serous fluid, which the fibrin seems to
 express from its pores, by being condensed like a sponge; as if this
 matter was a dissolved flesh,  containing the other fluids in its inter-
 stices,  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.
  The muscles do not  lose their  contractile power by separation
 from the body: it continues to be developed by a number of mecha- 
VITAL  PROPERTIES  OF THE TISSUES.
35
nical and chemical agents, and still more powerfully by the influence
of galvanism.   It would be useless to endeavour to distinguish this
property from that evinced in the muscular tissue through the in-
fluence of vitality; it belongs essentially to that form of animal mat-
ter called fibrin, and can only be destroyed by its spontaneous or
artificial decomposition.
   The fibrin of the muscles,  when considered in a state of life and
organization, is often impelled  to a degree of contraction greater
than that manifested in its habitual state, which necessarily depends
upon its  chemical composition.  In this way movements of a certain
magnitude, the voice, and more especially locomotion, are produced.
The nerves are the natural conductors of those influences determin-
ing the 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 fibrin of the muscle,
does not change in the least degree the nature of their contractility.
Hence the words animal contractility—sensible organic contrac-
tility, do not express different properties, but can only serve in the ac-
tual state of the science to represent two circumstances, under which
a property that is invariably the same is manifested. For example,
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 re-
mains, because the limb  is deprived of all communication with the
cerebro-spinal nervous apparatus.
  Next  to fibrin, the form  of animal matter, endowed with the
greatest share of contractility, is gelatin; but, unlike the former  in
regard to its homogeneity, it presents considerable  differences, ac-
cording 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 gelatin should be  more con-
tractile than it commonly is, she combines with it a small portion of
fibrin, 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 fibrin  has been discovered in the small veins,  in
the lymphatic vessels, and in a number of excretory ducts, the con-
                   v 
36            VITAL PROPERTIES OF THE TISSUES.

traction 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 mani-
fested with great promptness.
  If the cellular filaments situated under the peritoneum, and be-
tween  its duplicatures, are susceptible of becoming shortened after
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 en-
velops.
  The gelatin of the ligaments and aponeuroses does not appear to
possess extensibility or contractility; which,  however, depends less
upon the interlacement 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, though in a great number of in-
stances it is still 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 immediately its
pristine state, by means of a movement  of  condensation  directed
from all parts towards its centre and basis.   Such also is the direc-
tion of those  lines of medullary matter which converge towards the
mesocephalon.  We moreover observe,  in the encephalic apparatus,
duplicatures  and surfaces corresponding  to  each other,  and the
contact of which is rendered more easy by means  of a  serous
membrane analogous  to those  lining  the other  visceral  cavities.
This is sufficient to prove  that they execute gliding  movements,
and are even displaced to some extent, which can be explained only
by supposing the organized  albumen to be endowed with a decree
of inherent contractility.
   We do not discover an extensive or rapid contractility to be mani-
fested by the nervous cylinders denominated neurilemse which are
regarded as a continuation of the  meninges, or  enveloping mem-
branes of the brain; but we know, that these small tubes, joined
together and contained in the same envelope,  are formed of gela- 
VITAL  PROPERTIES  OF THE  TISSUES.
37
tin, which like that  existing in many other  organs, is endowed
with a slow contractility,  owing to its being combined with some
inorganic substances.   In  respect to the almost or quite fluid mat-
ter which is discovered in the interior of each of the little nervous
cylinders, I do not know  whether it is constituted of an albumen,
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 internal portion of the nerves, is of all
the tissues of  the economy, that in which the fibril form and con-
tractility are exhibited with the  greatest  difficulty.   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
respecting the mode of action of the nervous system. Every change
occurring 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  contractions in the
forms of animal matter which nature has entrusted 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 changes,  even when
they occur in the interior  of masses of fibrin, are entirely unknown
to us; how can we pretend, then,  to discover and investigate those
which take place in the interior 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 hereafter
see, are placed within the domain of vital chemistry, (chimie vi-
vanie,)  all  those discovered in  organized  animal matter, are
reducible to the exercise of contractility. This latter is consequent-
ly a  vital property.   It may, perhaps, be objected that it is not
purely vital, since it  continues to be manifested, for some time, in
portions of organized matter after they  have been detached from
the body;  but this must be viewed as a vain subterfuge; for such a 
 33           VITAL PROPERTIES OF THE TISSUES.

 property has been given to this matter, in order that it should aid
 in the exercise and maintenance of the functions which contribute
 to the preservation of life.   The name of vital must, therefore,
 still be applied to it.  Let us  now endeavour to determine  what
 idea we ought to form of sensibility.
   We have already seen local sensibility, or in other  words, that
 which is considered purely and simply in the fibre  contracting
 through the influence of a stimulating agent; that sensibility which
 is not transmitted to the mind, and of which,  consequently, we are
 not conscious; that sensibility, in a word, which Bichat has desig-
 nated 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 a stimulating agent.  It  follows, there-
 fore,  that we  cannot, with propriety, regard  it as a property of
 tissue; but, can we refuse the  title to that sensibility of which we
 are conscious, and in virtue of which we  experience pleasure and
pain ?
   Pleasure and pain doubtless indicate  to us  the movements that
 occur in our tissues, whenever these movements attain a certain
 degree of intensity; but are we to conclude  from this, 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 ex-
 ample.   A man punctures  his  finger;  the organic  contractility of
 the part is increased, or, in other  words, the movements are more
 accelerated 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 vital 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; at night a different state of the centre
 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
 different under these two circumstances?   Every  one, I am  con-
 vinced, 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 
VITAL  PROPERTIES  OF THE TISSUES.
3S
their natural chemical composition.  It is very evident, therefore,
that sensibility is not a property  that can be  placed on a parallel
with contractility.
  If sensibility, even that of which we are conscious, is not of this
nature, we can view it only as a condition of organized animal matter
manifesting itself in a transient manner; and it can be demonstrated
that this condition is itself subordinate to the different states of con-
tractility.   Thus, organic contractility has been exalted in the case
of the punctured  finger.  If the brain be  in a state of wakefulness,
and in health, the nerves which establish the communication between
the wound and that organ, excite in it an  increase  of  contractility,
analogous to that produced in the wounded finger,  and pain is felt.
It is not risking too much to assert that the brain undergoes an in-
crease of organic action or contractility: experience indeed proves
this, for if the pain be acute, the blood accumulates so abundantly
in that organ, that the face partakes of-its congestion, and the ex-
citement is very quickly transmitted  to  a number of nerves, by
which similar changes  are produced in the structure and functions
of the mobile tissues.   Hence this influence will excite convulsions
in the muscles—congestions of  blood in  the viscera and secretory
organs—super-secretions—extravasations—haemorrhages, &c.  &c.
phenomena depending essentially upon an acceleration in the con-
tractility of the smaller vessels, or in other words, on an increase of
organic contractility.   To this it will perhaps be objected, that in
those cases in which pain does not give rise to  these phenomena, it
is not productive of an organic excitement in the  brain.  In reply,
it may, however, be observed, that  pain invariably produces this
effect;  for even in those instances  in which the patient should pos-
sess sufficient command of himself to  suppress  all  complaints, and
not execute the  most  limited  muscular  movements, his  features
would  be  altered,  the  colouration  of his  face  would change; and
assuredly these are external organic movements,  the direct repetition,
not of those occurring in the wounded finger, since they do not fol-
low whenever the nerves of the hand no longer communicate  with
the brain, but of the organic movements excited by the pain in this
viscus itself.   But this stoic whom we thus represent as feigning to
be insensible to bodily suffering, experiences moreover painful sen-
sations  in  the epigastric  region.  Now  these sensations  indicate
changes to have occurred in the circulation of the interior of the
stomach,  analogous to those observed upon the  face: and of so 
40            VITAL  PROPERTIES  OF THE  TISSUES.

unequivocal a nature,  that his digestive functions  are affected   the
secretion  of bile is deranged,  &c. phenomena which necessarily
imply the existence of an alteration in the organic contractility of
that viscus.
  It will perhaps be maintained as a farther objection  to our opi-
nion,  that these disorders only take place when the  pain becomes
violent, and that their absence during slight pain or pleasure is suf-
ficient to show the exercise of sensibility without an increase in the
contractility of the brain.  I must confess, however, that I cannot
conceive how 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 an afflux of fluids towards the modi-
fied part.  I even  maintain  that the derangements of contractility
to which I have already alluded are, and can be nothing more than
the exaltation of these same changes of the brain, which prove its
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 during
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 super-
vene, and the brain will be so much excited, that the patient may
even  become affected  with convulsive movements.   The same
occurs in a man who is kept in a  state of sleep during the inflam-
mation of an internal organ.  Both these individuals at the instant
they awake will complain of pain in the inflamed part; but they
will both declare that it  completely idisappears  during sleep, al-
though  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 disap-
pears during sleep, we are naturally led to the conclusion that pain is
not an invariable result of the excitement of this organ, or in other
words, that the organic  action of the brain  may be powerfully ex-
cited  by a focus of irritation situated in some other part of the  body,
although  there docs  not necessarily result  a development of sensi-
bility. From all this;  we may once more draw the conclusion, that 
VITAL POWER.
41
 sensibility cannot be regarded as an inseparable property of the tis-
 sues, 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 wThich, as
 we shall have occasion to demonstrate in our pathology, constitutes
 a true disease.   As this phenomenon  will again fix  our attention,
 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,  develop-
 ment, and preservation of the individual.   Does it reside  solely in
 contractility, the only property  of tissue which, of all those admit-
 ted by authors, we have acknowledged ?
   The power which presides over the formation, development, and
 preservation of the body, is that which  accomplishes  the  assimila-
 tion of nutritive  substances—extracts from them gelatin, albumen,
 and fibrin—regulates the  form, consistence, volume, and  duration
 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

  * The author has not fully stated the proposition of physiologists concerning
 sensibility. They do not contend that it is the property of a nerve, or of a brain,
 or central mass, separately, but of the nervous apparatus embracing expanded
 extremities, conducting cords, and receiving centres.  To say that sensibiUty is
 no vital property, because it is suspended during sleep, would lead to our deny-
 ing voluntary muscular contractility to be a vital property on the same grounds,
 since it is also quiescent in the sleeping  state.  The nervous system, like the
 muscular one, requires appropriate stimuli for a display of its peculiar vitality.
 But nerves are conductors of stimuli, and  exciters of muscular contractility with-
 out there being sensibility, of course without there being a nervous or percipient
 centre.  Their property on such occasions, as in vegetables, the lower animals,
 and in the viscera, supplied by the sympathetic, is called by Dr.  Dutrochet
nervimotility, and the state of transmission of stimuli, nervimotion.—Thans.
                                 6 
42
VITAL  LAWS.
animal  matter which the vital power is alone capable of creating.
Contractility, therefore, can only be viewed as one of the products
of this latter; as a means it employs  to execute those movements
necessarily co-operating to the maintenance of the functions.
  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 this latter, and next  employs  it as an
instrument for the  purpose of procuring  materials  with which to
work continually in  the composition of the living body.  Con-
tractility and sensibility of relation, which, however, I have proved
cannot be placed on a parallel, are consequently evident proofs of
the existence 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 modification
occurring in the molecular affinities, which preside over the che-
mistry of inanimate bodies; in other words, it  manifests itself by
chemical phenomena—but of a chemistry proper to each living body.
This vital chemistry,  (chimie vivante,) is the most  remote of the
phenomena which strike our senses:  doubtless it is not the vital
power, property speaking, but rather its first, invisible, and immar
terial instrument with which we are made  acquainted by the exer-
cise of our reasoning faculties alone: in a word, it  is the instrument,
by  means of which the vital power creates in its action  on matter,
the secondary instruments  which are purely material, and percepti-
ble to our senses, and in which we can discover what we denomi-
nate the vital properties of tissue.  To me it appears evident that
we  cannot extend further our researches into the vital power, with-
out launching into the boundless ocean of hypothesis.
  The vital laws consist in a certain number of general phenome-
na,  common to all the tissues, and  discovered with  so  much  con-
stancy 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 livin°-
man.
  1. The first circumstance, constantly noticed, is, that contractility
is modified, or in other words, made to deviate in a greater or less 
VITAL LAWS.
43
degree from its actual mode, by all external bodies applied to  the
animal economy.   Are we to view these modifications as the result
only of a  pure and simple augmentation or diminution of the con-
traction or motion, whatever it may be of our tissues?  Be this as it
may, there always exists 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 solids—in other words, when
action or motion is augmented in a part, the fluids or moveable or-
ganic matter are attracted towards it; from this has arisen the axiom,
ubi stimulus, ibi fluxus.  But  if  the contraction, although  in-
creased, 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 contrac-
tion exists.   This constitutes the state of spasm.
  III.  Whenever the organic movements of contractility are in-
creased, and  the  fluids  attracted, in any region of the body, the
density, and even the volume of this  part increase, and it assumes
dimensions which are determined by appropriate tissues.   These
constitute the vital erections, the degrees of which are as various
as the form and vitality of the organs.  All elongations and tume-
factions, not effected by muscular action, or 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 physiolo-
gists still  believe, any expansive power inherent in the elementary
fibre.   Vital erections are continually  excited  in  the economy;
since all prominent organic movements—all those which determine
locomotion, must be numbered among them.  When  they have
attained a certain degree of intensity, they are denominated irrita-
tion, 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;  phe-
nomena 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. 
 14                       VITAL LAWS.

  Hence, as a summary of our former remarks, we shall say, that
 contractility and vital chemistry are the fundamental phenomena of
 the animal economy, and that whenever they become more appa-
 rent 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; then there  is usually a diminution of vital phenomena in
 the affected part;  or else  they are changed into a  state of constric-
 tion, by which the fluids  are repelled; in other words, into an or-
ganic spasm; or, finally, they attain the degree of inflammation and
 of sub-inflammation.
  In  all we  have  hitherto said, the vital phenomena have  only
 been viewed 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 to any degree of intensity without being transmitted to other
 parts; but here many differences are  remarked, either in relation to
 the primary seat of the vital erection, or to the part to which it has
 been  transmitted; and all dependent on  the peculiar  nature of the
 different organs.    In  those not incrusted with  calcareous phos-
 phates, the vital erections are more rapid in their progress, and at-
 tain sooner that  degree  of  intensity, at which  the  transmission
 towards another point must take  place,  than where such incrusta-
 tion  exists.   In  parts abounding with blood-vessels, and  with
 nerves, the vital erections occur with still greater  rapidity,  and are
 much sooner  transmitted.  If we examine them  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 pre-
 sently 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,
 passing from the different organs to the cerebro-spinal mass, are in-
 variably found to exist.   In proportion, therefore, to the abundance
 with which an organ is supplied with these nerves, will be the ra-
 pidity with which the irritations arising  in it are transmitted either
 to  the cerebral or spinal  centres, or to  other organs equally well
 supplied  with nervous cords; whilst, on the contrary, the irritations 
VITAL  LAWS.
45
of organs, in which the number of these  cords is limited, are inva-
riably of tardy and difficult transmission.
  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, or 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, se-
condarily, a vital erection similar to the first.  But this requires
explanation.  When I maintain that irritation is identical in its na-
ture, notwithstanding the difference existing in the tissues in which
it manifests himself, or in the changes it produces in them, I wish
merely 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 as-
sertion.
  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 encephalon and spinal
marrow, as well as in the other»tissues to which it has been reflect-
ed  by these organs.
   IX. The agents which evolve 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
allow them to be  diminished, or  rendered less apparent, then to
reappear with a greater degree of intensity than  before.   We are
consequently compelled to recognize, in perfect animals, the exist-
ence 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 the
agent which gives to the germ the faculty of appropriating to itself
nutritive materials, and employing them for its growth.   It con-
tinues to fulfil the same object during the whole course of life;  and
whenever it is withheld,  other stimulants fail to produce their ac-
customed effect, and death is  the consequence.   The properties of
the tissues continue,  it is true,  to manifest themselves  for some
time; but they no longer suffice for the maintenance of life; and are
finally destroyed by chemical decomposition, when all the pheno- 
46                      VITAL  LAWS.
mena capable of recalling to the mind the idea of life disappear.
The embryo is  supplied with  caloric  from all bodies that possess
more than it, and, as in the  case of 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 capa-
ble of exalting  the phenomena of life.   The  chief  of these are
destined to the maintenance of the functions, more especially those
that  contribute  to the nutrition of the  animal.   Their  action  is
direct, or else through the medium of air or light; and they are in
constant relation  with the  different organs on  which they are to
operate.  At any rate, whatever  may be  the agent or the organ
which receives its impression, the result of their relations is invari-
ably productive  of 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 data to physiology, pa-
thology, or therapeutics.
  XII. The causes of the diminution of the vital phenomena are
either positive or negative.  The most prominent one is cold, which,
according to natural philosophers, is nothing more than the absence
of caloric, and it must, consequently, be classed among the nega-
tive 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 princi-
pal 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 ex-
perience pain in the part exposed to  cold,  and  this pain  becomes
a stimulating agent, that reanimates all the vital phenomena.   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.
   XIII. Among the  other causes of the diminution of  the  vital
phenomena, we must placethe subtraction of nutritive materials, as 
                         VITAL LAWS,                      47

well as of the fluids, as of 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 im-
pression of cold, viz. exaltation  of the vital phenomena, is always
less powerful.
  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 them, notwith-
standing the general diminution of the quantum  of strength and of
vitality, a super-excitement.
  XV.  The positive agents that occasion a diminution of the phe-
nomena of life, are much less known than the negative.  They
have been  denominated, by a particular sect of physicians contra-
stimulants;  but I believe  them less numerous than is imagined.
As we  should not class among them such as act by  subtracting
caloric  from  the living body, I am  of opinion  that they are re-
ducible to a very small number.   Brown thought that their only
action upon the body would consist in 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  appropriated by the vital
power for the purposes of nutrition, I am inclined to believe that it
is endowed with a peculiar mode of excitation.   The same remarks
may be made in regard to water.  Acids  cannot be viewed in any
other light than as excitants; since, when introduced into the sys-
tem 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 at the temperature of the body; a condition
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 vital and che-
mical laws, in  the influence of caloric, and of all the external bodies
which are  applied to the external and internal surfaces of the body,
 •n order to be made use of for the purposes of respiration and nutri- 
4S
VITAL  LAWS.
 tion, we must next examine these same laws in their relations with
 physical ones.
   XVI. Physical laws are modified, in the living economy, by those
 of vitality.  The attraction of masses is first presented to our obser-
 vation : let  us  examine it as it affects the whole body, and each of
 its parts.  This power tends to fix the weight of the living body to
 the surface of the earth;  but by means of  muscular contraction a
 part of its effects is annulled, and the animal is thereby endowed
 with the faculty of elevating himself in part, or in totality; whence
 result walking  and leaping.   Whenever the action of the cerebral
 centre is suspended, as for example, during  sleep, the power of at-
 traction resumes all its empire, and the body remains immoveable
 upon the  surface of the ground.  If, by some muscular effort, the
 animal body has removed itself from that surface, it is once more
 attracted towards it as soon as this effort is  exhausted.   When the
 point of support fails it,  the  attraction of  the centre of the earth
 draws the body immediately  towards  that part  of its  surface,
 which is  nearest to  that centre, observing constantly a perpen-
 dicular line.  As the living body is endowed 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
 rebound 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 attrac-
 tion  on the entire mass of the body, are also observable in each of
 its parts, when  these are viewed in relation with one another, 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 fol-
low: this constitutes  another vital law.  We have already noticed
 one, by virtue of which the fluids, circulating in the  interior of the
vessels, are  diverted  from the direction which the contractility of
these latter tends to impart to them, in order to flow towards those 
VITAL  LAWS.
49
parts where irritation  is developed;  from which  results what we
have denominated vital erection.
  When the contractility of the vessels is diminished, a less degree
of resistance is offered to the power of attraction; under such cir-
cumstances the fluids tend towards the lowest portion of the vascu-
lar system, in which they circulate.   Hence arise those passive en-
gorgements—those congestions  from debility, which must be dis-
criminated with accuracy from engorgements and congestions, 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 favour
the efforts of attraction.   This effect is first  resisted by muscular
power; hence locomotion is performed  with much greater facility
in a light atmosphere,  as, for example, that of mountains,  than in
the heavy air of  low countries.*  Owing to the same reason, this
pressure of the atmosphere upon the surface of the skin occasions a
condensation of the body, and diminishes its bulk; but this tendency,
as it regards the visceral cavities,  is  counterbalanced  by that por-
tion of the  same atmosphere which penetrates into  the lungs and
digestive tube; and as the introduction of air into these cavities is
the effect of muscular  power, it follows that  the latter contributes
in this instance 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. It
is in this way that the skin  is suddenly covered with sweat, when-
ever a man, after accelerating his  circulation  by violent  exercise
in the open  air, enters, without resting, a room, the atmosphere of
which is lighter than that in which he was placed the instant be-
fore.
  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  our pathology and therapeutics.

  * Admitting the fact, which can only be understood as referring to moderate
elevations, since we know that on very high mountains locomotion is sluggish
and languid, the explanation of our author is not, we apprehend, either physio-
logical or correct.—Tbans.
                               7 
50                       VITAL LAWS.

  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
that are modified by the power of life:  this affords  us an opportu-
nity of pointing out new vital laws.
  Electricity and galvanism manifest,  upon the animal  body, ex-
citing effects, observed primarily in the nervous  system,  and se-
condarily in the tissues to which nerves  are distributed.  These
agents traverse the nerves, and determine an increase of  contrac-
tility in the fibrin of the muscular, and in the gelatin of  the vas-
cular  apparatus.  They occasion  muscular contractions and vital
erections, against which volition cannot exercise the least obstacle.
When applied slowly, and in a limited quantity, electricity increases
the mobility and power of the  muscles—accelerates the circulation
to such  a degree as to occasion  frequency of pulse, and a  considera-
ble  increase of caloric; it revives, with so much energy,  the power
of absorption, that lymphatic engorgements  are sometimes dissipated
in the space of a few  minutes.  Hence the first vital law observed
in relation to the effect of electricity, is a very manifest increase of
contractility, and of its transmission 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 of
contractility alone.
  XXI.  Whenever electricity acts with greater energy and sud-
denness, its effects, like those of galvanism, are more marked, and
attended by violent convulsions in the muscular system—profuse
extravasations, secretions, and excretions: it is  in this way that
galvanism excites hemorrhages, brings on a return of the menstrual
discharge in women, and, when it acts in the direction of the diges-
tive canal, occasions the sudden evacuation of the excrements. These
modifications are merely an excess of those we have already noticed
in the preceding paragraph.
  XXII.  The excitement oi 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 extinguished,
and the spontaneous decomposition  of  the body takes place with
much greater rapidity than after  ordinary death.   It is worthy of 
           HISTORY OF THE  FUNCTIONS OF  RELATION.         51

remark, that caloric acts in an analogous manner; and that all deaths
occasioned by an excess of irritation, whatever  may be  the  agent
producing  it, invariably dispose the body to a speedy decomposi-
tion.  From these circumstances we are led  to class galvanism and
electricity among the most energetic excitants of the  animal eco-
nomy.
            CHAPTER IV.

HISTORY  OF THE  FUNCTIONS  OF RELATION
                     General Observations.

   Physiologists, of the present day, are all agreed in admitting
in animals, two grand series of functions: the one destined to pro-
mote their relations with external bodies; the other consisting in
those acts, the combination of which contributes to the maintenance
and preservation of the individuals, and of the species.   The first
series is referred to the encephalo-spinal nervous apparatus, viewed
in its centre,  and in its sensitive and motific expansions;  in other
words, to the  brain—its prolongation occupying the spinal canal
—the nerves of what I denominate  the external senses, and also
those of the locomotive, respiratory,  and vocal muscles,  which are
all attached to the  skeleton.   The second  series,  or  the  functions
of nutrition and reproduction, are assigned to the thoracic and ab-
dominal viscera.
   This division, which at first view seems so clear and satisfactory,
offers, nevertheless, great difficulties  when we endeavour to apply
it to  the  study of physiology; because the  phenomena of relation
are far from being  limited to  the tissues, which authors  have de-
signated as their domain; and because those of  nutrition, which
commence in the viscera, are continued into the nervous and loco-
motive apparatus.
   The same  difficulties  have arisen when  physiologists endea- 
52
HISTORY  OF THE
voured to study each function in particular, since there is no ap>
paratus which 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-
gether in the animal economy; consequently, we are often 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 in the living state.
   Hence arose the unconquerable difficulties  encountered by the in-
genious Bichat, in  his attempts to draw a satisfactory line of de-
marcation, between the functions of relation, which he denominates
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  they con-
stitute 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, begin the history of our functions by  noticing
the relations  which connect us with external bodies; I  shall trace
those bodies in  their approach to, and progress through ours; and
study the influence which they exercise  on  our  organs, until that
point at which reasoning  and  induction can no longer  afford me
assistance.
  I shall premise a summary view of the functions  of relation, and
next examine them  in the  different media through which nature
calls them into action.

        Summary View of the Functions of Relation.

  I assume man to  be in a state of perfect organization,  and defer
the study of the development of his  organs until this subject be-
comes naturally linked to those I shall have already examined. 
                   FUNCTIONS OF  RELATION.                  53

  Placed in the midst  of the universe, man lives  and preserves
himself by virtue of his relations with  external bodies.  In order
to be able to derive from them the means of subsistence, and dis-
tinguish 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-
dowed 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 are first presented to
the action of 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 corres-
pondence with the external surface, and if the centre of perception
is not as  yet apprized  of them, there results from these wants no-
thing but a vague  sensation of uneasiness, difficult to define, but
productive of self-agitation  without any evident motive.   Such
probably are the motions of the foetus, especially  when it approaches
the period of its expulsion—such are doubtless the  cries it utters
after birth, and the irregular movements of its little  limbs.  We
may moreover place on the same line, the uneasiness,  sighs, and
emotion  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 are placed in relation with the external surface, the senses
with which it is endowed give information to the centre of percep-
tion, which, immediately recognising them, reflects back the sensa-
tion, and the animal clearly 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 per-
ception, the movements necessary to the gratification of the wants  are
commanded and executed without delay. Hence  the newly-born  in-
fant directs instinctively its mouth towards the nipple, as soon as the
breast of its mother is presented, or even is placed within its 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  is developed and  sufficiently exer- 
54                     HISTORY OF THE

cised, and the memory 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 mind of the ob-
server?   In order to answer this question, it is necessary to  trace
the impressions from the external sensitive  surfaces to the interior
of the viscera.
  The acts  which, in virtue of 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 energetically  felt.  If, on the
contrary, the stomach be full or diseased, the perception is disagree-
able;  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 respect to the
sensations relative to the propagation of the species—to the impres-
sions of heat and cold, and  even to respiration; for we experience a
reluctance to breathe a disagreeable and unwholesome 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 perception 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 vis-
cera.
  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. 
FUNCTIONS OF RELATION.
55
directed, by the centre of perception, to the genital  organs alone?
Reason rejects the admission of this unity of direction towards this
or that organ; for it would lead to the supposition, that the impres-
sion is weighed  and judged by the centre of perception at the in-
stant it reaches the brain; whilst we have just  proved, on the con-
trary, that it has no influence on it until  after the viscera  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 a 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 one
being excited by one animal, and the other by another, I would
answer, that the difference is only the result of the slight shade
produced  in  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, judged of 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 suddenly two tigers of different sexes; if it  be  not  at the
period of rut, (as always  happens in our climate, where these ani-
mals never breed,) they will become furious, and,  as was observed 
5b
HISTORY OF THE
 a few years ago in the M6nagerie of Paris,  when attempts were
 made to excite the two large tigers of Bengal to the act of copula-
 tion, they will mangle each other; and doubtless, had they met dur-
 ing the season of their love; and  in  their native climate, the acts
 excited  by  the impressions mutually received would have been
 widely different.
   But to conclude:  since the same impressions give rise  to acts
 varying according to the condition of the viscera, we are led to the in-
 ference that they are  invariably reflected at  the same time to all;
 and that such among these as are  more immediately interested,
 act the most powerfully upon the mind, and  determine the degree
 of the sensation and extent of the actions necessary for the  centre
 of relation to  have executed by the locomotive apparatus.
   Among the many demands made upon the centre of perception,
 by those viscera interested in the approximation or removal of bo-
 dies that have acted on the external surfaces of relation,  and the
 actions which  in consequence the centre determines, or tends to de-
 termine, 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 gratifying it, nothing but
 instinct is manifested.  Consequently, instinct alone acts in animals
 of the lowest  order: we hardty recognise any thing more, even in
 those endowed with the most perfect organization,  at the moment
 of their birth;  and man himself  cannot be adduced as an exception
 to this rule.   In proportion, however, as his  brain enlarges, con-
 sciousness is manifested—intellect 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 manner peculiar to him; he experiences another series
of wants in  appearance unconnected with those which have for
object the maintenance of life;  and yet  the impressions produced
by them, operate upon the nervous system in  the same manner as
those that are referrible to  instinct.
  In contending 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 ad-
vance  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, following the direction of the nerves dis- 
FUNCTIONS OF RELATION.
57
tributed to these latter:  finally, that the movements which take
place in the viscera, when they experience the effects of the impres-
sions, are perceived by the centre of relation, and produce  in  it a
sensation, whence results desire or aversion.
  These movements, when considered in a purely physical point
of view, cannot be regarded otherwise than  as a play of contrac-
tility, 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 repeated
in the viscera, which are thereby consulted; and consequent on  this,
the nervous centre again  experiences a  new  perception, which  is
always the effect of a vital erection.  Finally, it is by means of such
excitation that the brain acts upon  the nerves of the muscles; and
that these last are excited to contraction by the nerves.
  Directed by the centre of perception, the muscles execute the
movements necessary for the gratification of the wants.  External
bodies are placed upon the internal  surface of the viscera; and from
this moment a new series of relations arise between  these latter and
the centre of perception, 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
judges 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 differ-
ently from what it would be were this viscus empty: the same re-
mark is applicable to the other wants.   We  may consequently ob-
serve 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
                               8 
5$
EXAMINATION OF THE
these details, presenting in succession to the attention of my readers
the external surfaces, by the aid of which we are placed in relation
with foreign bodies.
                      CHAPTER V.

EXAMINATION OF THE EXTERNAL  SURFACES  OF RELATION, OR
                  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 relate to the connexions which, on the one part, exist with ex-
 ternal bodies, and on the other, with  the  centre of relation.  The
 second belong 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 system.
 In the former, it acts, therefore, as  a  sensitive  organ; and, in the
 latter, like a secreting or exhaling one. Although these two series
 of vital phenomena  are intimately linked together, we shall only
 offer in this chapter a complete development of the former, reserv-
 ing 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 discover-
 ing in  them some modifications of vascular contractility.
  All  its  functions  being  equally  the  result of the  structure of
the  part, I shall give a succinct description of it.  The basis  and
principal tissue of this  envelope  consists in a fibrous  net-work 
EXTERNAL SURFACES OF RELATION.
50
composed of filaments which leave between them spaces of greater
or less extent, according to the region which is examined: it 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-
phatic vessels—to nervous  filaments,  and  to cellular tissue; the
whole of which,  after having  penetrated  externally through the
derma, are finally expanded upon its external surface.  On examina-
tion, we discover in it, first, a mucous net-work, which  has been
regarded as  entirely  fluid, and denominated a mucous body; but
which,  when discovered to  be  a true  organic tissue, received the
name of reticular: secondly, eminences which have been desig-
nated by  the term papillae.   The  reticular body and the papillae
are nothing  more than the vasculo-nervous apparatus of the surface
of the skin,—an apparatus which no anatomist has hitherto succeed-
ed 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 papillae are endowed with a greater de-
gree of consistence than the reticular or mucous body, in the midst
of which they form, particularly in those regions of the skin where
the sense of touch is most delicate,  a prominence, more or less ap-
parent; whilst, in other parts, it is very difficult, and even impossi-
ble, to perceive them.
  It is invariably observed, that those parts of the skin in which
the papillae are most numerous, are supplied with a greater quantity
of nerves of relation; from  this circumstance many  have  been led
to imagine that they consisted in nothing more than nerves termi-
nating in a kind of pencils  or tufts; but a  more attentive exami-
nation enables us to discover in them so large a quantity of blood,
that by some authors  they have been  regarded as purely vascular.
This leads me to believe, that these papillae 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 latter that the fluids of insensible and
sensible perspiration  are exhaled;  the difference between which
in all probability, is merely in the former being exhaled in too abun-
dant a quantity to be transformed entirely into a vapour at the moment 
00
EXAMINATION OF THE
of its elimination.  As respects the papillae, it is certain that they
are destined to the sense of touch.
   In some regions 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.
   The hair takes its origin under the skin, in small capsules, having
the form of sacs,  and which some anatomists have regarded  as 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 cylinders 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 secretion,  which coagulates
and hardens after its formation.  It serves to protect the cutaneous
surface from the action of external bodies, and to moderate the im-
pressions produced by the touch, which otherwise would almost
always be very painful.
  The epidermis is formed neither of gelatin, mucus, albumen, nor
fibrin;  but  consists of a peculiar animal matter, analogous to the
nails and to horn, and  which,  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 appropriated
for certain  uses.
  The more we read and meditate the authors who have investigated
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, which  are  only  vascular  bunches;  2. between  these
pimples and the epidermis, a deeper whitish  layer, consisting, ac-
cording to them, of white vessels;  3. over this layer a dark coloured
line resulting from small  bodies that cover the summit of the buds,
and  which have  been designated by the  name of gemmulse;  4.
finally, just beneath  the  epidermis, a  second colourless layer, con-
sisting of serous  vessels, and  denominated  by  them  superficial
whitish layer, which is thought to be  charged with the function of
serous exhalation. 
EXTERNAL SURFACES OF RELATION.
61
  Other anatomists admit in the skin:  1. the derma; 2. the papillae;
3. the epidermoid membrane of the  papillae, which is the deep
whitish layer of the preceding writers; 4. a coloured layer; 5. a
horny layer, which corresponds to the superficial whitish layer;
6. and  lastly, the epidermis.
  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
tfinatomie Generate, and from which I have extracted the preced-
ing details.  Be this as it may, I conclude, from these  researches,
what I have  already  advanced,  that there exists on the surface of
the skin a capillary tissue,  which is vasculo-nervous, cannot be dis-
sected, and the papillary portion of which,  being the most plenti-
fully supplied with nervous matter, is intrusted with the functions
of touch,  and the sympathies of  relation;  whilst all  the  rest  is
devoted  to the various secretions and exhalations  on  the  cuta-
neous  envelope.  We must also admit the existence, 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 account 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 pressing  on, and grasping them when not  too
voluminous—of their consistence,  volume, &c.   From these sen-
sations there result clear ideas, which  furnish to the mind mate-
rials for judging of the external and physical qualities  of bodies;
but the skin does not decompose nor analyse them, in order to con-
vey  to us an idea of their  chemical  properties,  and enable us to
foresee their effects  on the system  as nutritive materials: 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  sometimes acts  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- 
62
EXAMINATION OF THE
 sure  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 heart,
 causes a sensation of voluptuousness in the epigastrium, and even in
 the interior  of  the  muscular tissue.   Under these circumstances,
 organic phenomena are  associated 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—sluggishness of thought—ten-
 dency to sleep, and  languor of the muscular apparatus; the circu-
lation becomes more regular—pain is  mitigated or removed—the
 entire extent  of the skin partakes of the modification of the por-
 tion touched,  and a mild heat and  more uniform temperature are
 diffused over  the whole surface of the  body.   Such are often the
 effects produced  by  the touchings of  the magnetisers, who  derive
 from them their power of fascination, and the occasionally real suc-
 cess  they obtain in nervous irritations, when occurring in sensible
 and delicate individuals.  The tepid  bath often procures nearly analo-
 gous effects.
  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  instances,
 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:
accelerated action of the heart, involuntary agitation, and  even real
 convulsions, which may  suspend the functions of respiration  and
circulation, produce thoracic and encephalic congestions,  and even
death. 
EXTERNAL SURFACES 0F RELATION.
63
  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
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
of by the centre of perception alone and a priori; but after this
latter has  reflected them to the  sensible parts of the  system,  and
particularly to the viscera.  If we wish to see here, in the clearest
manner, the influence exercised by the viscera upon the determi-
nation of the  centre  of perception, and the  alternate triumph of
the mind  over the viscera, and of the viscera  over the intellect, let
us suppose a person endowed with lively sensibility to be 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 procure  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 sensation
carried to excess;  and it is always the result  of its very energetic
repetition in the principal viscera.  As regards titillation,  it  acts
also in the same manner;—the impression which it produces is con-
veyed to the brain, which reflects it to the epigastric centre; and it
is the sensation which the brain perceives in this region, that com-
pels it to  command those  hurried  movements  of which I have just
given a sketch.   This mechanism is proved in the  following man-
ner.  If a person sensible to titillation be attacked with apoplexy,
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 opportunities 
64
EXAMINATION OF THE
 of noticing this fact, in my daily visits at the Val-de-Grace.   The
 man attacked with gastritis, and whom  I could touch without in-
 convenience at the first visit,  often  becomes ticklish the next day,
 When, by means of a single application of leeches, the irritation of the
 stomach has disappeared; and  if he  experience a  relapse he can
 again suffer his sides to  be felt without having any inclination to
 laugh or struggle.   A slight attack of gastritis produces often the
 contrary effect.
   The sensation of titillation may also be annulled by a point of ir-
 ritation situated in another tissue—as for example by pneumonia. In
 this case the centre of perception, being attentive to another sensa-
 tion, is not affected by the former one. The same thing occurs in pro-
 found meditations and grief; while, on the contrary, if we enjoy a
 lively disposition, the effects ©f 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 with-
 out 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 this organ, are invariably the effects of the sensations
 which  it perceives secondarily  in the viscera;—finally, that the or-
 ganic movements are in all instances influenced  both by the sensa-
tion, 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
 distention—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 sen-
 sitive surface; but  pain, independently of this  cause,  may be pro-
duced 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 bv ano-
 ther perception, and 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 following are
 the demonstrative proofs of this fact.
   When the digestive organs are in  a healthy condition, the  pain 
              EXTERNAL SURFACES OF  RELATION.            65

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  in-
flammation, the pain is  felt much more acutely.   An intolerable
sensation originating in  the epigastrium,  gives rise to  impatience,
grief, anger, and fury; and, however strong may be the determina-
tion of the patient to remain tranquil, he yields in most instances
to the acuteness of these new feelings, and abandons himself to im-
petuous movements.  It is in this way,  that gastritis perverts the
moral sense, 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 of by the  centre of perception.   These preliminary posi-
tions 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 to each other;—both are destined to place us
in correspondence with  bodies at a certain distance from us;—both
enable us to procure clear and distinct ideas, and consequently sub-
serve efficaciously our intellectual faculties:—finally, one of these
senses can supply the deficiency of the other, and furnish us with
nearly the same ideas, 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 cavity formed
                               9 
 66                  EXAMINATION OF THE

 by the cranial and facial bones.   Its principal and fundamental part
 consists in a nervoso-vascular expansion, denominated retina.   It
 would be  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  membrane known  under the  appellation of neurilema—A
 membrane which only exists  in  the conductors of the nervous
 apparatus,  and is not found either in the  cerebral substance,  or
 in the sensitive expansions.  The retina consists of a tissue  impos-
 sible to dissect, but which is certainly composed of nervous matter
 and sanguineous capillaries.  This  structure appears to us to be
 similar to that of the cerebral substance, to which the sensitive ex-
 pansions bear considerable resemblance—as we shall prove hereafter.
 A large nervous cord, passing from the brain to the retina, establishes
 a communication between both  these  tissues: it consists of a white
 substance presenting a linear disposition, and  containing but few
 vessels; 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 tissue,
 containing  no nervous matter, and of  a black  colour.  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,  while the open-
ing is in front between the two eyelids. The external surface of the
 sclerotica  is connected with  various  muscles, some cellular  tissue,
 and a mucous membrane; its internal surface is lined by the choroid
coat.  The cavity formed by the retina is filled with the vitreous
humour, which constitutes a large portion of the mass of the eye;
and is retained in position by a  laminated and extremely fine tissue
as transparent as itself.  This produces the humour in question,  in
 the same way that the arachnoid, pleura, pericardium, peritoneum,
and the synovial  capsules  give  rise to 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 vitreous we find the crys-
 talline humour, which is much less  abundant,  but  of  greater den-
 sity;—having the appearance of a small transparent globe,  set  in
 the anterior part of the  larger one, which is the vitreous humour, 
EXTERNAL SURFACES OF RELATION.
67*
and immediately behind the opening by means of which this appa-
ratus is made to communicate with the external bodies, destined to
produce sensation.
  This opening, which is denominated the pupil,  is situated in a
membrane placed transversely,  and like  a kind of diaphragm,  in
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 tm: it is
composed of a  fibrous vasculo-nervous tissue, of  the class called
erectile; it adheres by its circumference to the part  where the scle-
rotica terminates, and where  is inserted a solid horny coat, 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 transpa-
rent tissue, seen between the opening of the lids, and behind which
the iris and pupillary aperture are discovered.  The space situated
between this cornea, the iris, and its aperture, constitutes the ante-
rior 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 vitreous humour, in a laminated tissue. It is for this reason, capa-
ble of being renewed, when,  in consequence of an accidental punc-
ture of the cornea, it has been evacuated; whereas, on the contrary,
ths crystalline and  vitreous humours, which  cannot be  evacuated
but with their secreting tissues, can never be re-produced.
  I shall not dwell on the  peculiarities  of structure  of  all these
tissues, nor 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 princi-
pal 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 orbicular 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 
*6.*                 v EXAMINATION OF THE

 eyelids, which  consist of a kind  of moveable curtains,  placed  by
 nature 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
 surfaces.   At the edge of the eyelids,  the skin changes into a mu-
 cous membrane, called conjunctiva: this latter really deserves the
 name; for after being reflected behind the skin of the eyelids, and
 lining the internal surface of the tarsi and a portion 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  the  gland, open on the conjunctiva, and de-
 posit on it the secreted humour which lubricates the two correspond-
 ing surfaces of the conjunctiva, and the external surface of the cor-
 nea. It serves to facilitate the  gliding of the eyelids over the globe
 of the eye.  The lachrymal gland, moreover, 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 having
 described the mechanical phenomena of vision,*  we shall content
 ourselves with studying this sense in its relation to vitality; a plan
 which offers the greatest degree of interest to the physician, who
 endeavours to discover in physiology the explanation of pathologi-
 cal phenomena.
   We shall first examine the local phenomena of vision—in other

  * I refer more particularly to the Treatise on Physiology by M. Magendie, and
 to the Memoirs on Vision, which he has published in his Journal de Physiologic
 Experimental. 
EXTERNAL SURFACES OF RELATION.
69
words, those that take place in the organization of the sense; and next
trace the results of the sensation in the brain, and the different ap-
paratus of the economy.

Of the Local  Phenomena  of Vision.—Of the Sympathies ob-
               servable in the Ocular Jlpparatus.

   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 the
retina, 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 separate
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 as those of respiration,
with instinct and the intellectual faculties.  When instinct  is not
absolutely in need of them, they are placed at the disposal of the 
70
EXAMINATION OF THE
 will; but, under all other circumstances, they are removed from its
 influence.
   In every instance in which we observe muscles under the control
 partly of the will, and partly of  a sense, whether internal or exter-
 nal, we may rest assured, that these muscles are supplied, both with
 cerebral and ganglionic nerves.  This is observed to be the case, as
 regards  the ocular apparatus:  ganglia,  constituting  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 dege-
                      nerate into Disease.

   An excessive stimulation of the retina  may carry its vital erec-
 tion 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  predisposition favour its
 progress,  invade all the others.   In our pathology, we shall point
 out the disorders occasioned by these phlegmasiae.
  The eye, when deprived for  a  length of time of the influence of
 the ordinary degree of light, but at the same time powerfully exer-
 cised by the will, acquires, occasionally, so great a degree of ex-
 citability, that the individual 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 greatly
 dilated, and the iris sometimes loses,  to such a degree, the erectile
 faculty, that, if the eye be exposed to the light of day,  the pupil  no
 longer contracts, which, combined with the extreme susceptibility
 of the  retina,  gives  rise to a state of blindness, often of difficult
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 its insertion into the sclero-
tica, converge towards the pupil; these lines, which may be consi- 
EXTERNAL SURFACES OF RELATION.
71
dered as so many small cavernous bodies, manifest a perpetual dis-
position to contract,  and can only be elongated, advance towards
the pupil, and diminish its diameter, by means of the affiux of blood
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, is engorged and disorganized
in all its tissues; whilst, on the contrary, when allowed to remain
without exercise, it becomes dry, stiffened, withered, and atrophied.
Such as we have detailed them are the causes of the diseases of this or-
gan, viewed independently of the influence of the principal viscera;
but the irritations it contracts by theaction of a too powerful degree of
light, are susceptible of being transmitted to these latter, and more
particularly to  the brain.   The external air can  disorder the con-
junctiva 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 certain  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 lumi-
nous rays that are reflected from each object, as is observed  in  the
camera obscura.  It is impossible to deny,  that the rays penetrate
through the pupil;—that, in passing through  the transparent con-
tents of the eye, they converge and diverge in various degrees; that
they fall in pencils on the retina: but all this does not appear to me
to explain the almost infinitely numerous shades of vision.  All that
is satisfactorily demonstrated is, that in consequence of the stimula- 
7o
EXAMINATION OF THE
tion exercised by the luminous rays upon this nervous expansion, a
perception takes place in the cerebral centre; and this will suffice to
enable us to prosecute the researches which form the principal ob-
ject 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 bo-
dies.   These judgments are expressed by language in a clear man-
ner, and  memory can invariably retrace them with equal clearness.
This  is  the intellectual part:  but  the  different bodies, with the
existence of which w7e 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 to many,  and that we remain almost indifferent to  some
others.   From this results the difference existing in the  acts deter-
mined 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 offering  my views until I shall have presented  a de-
scription of the organs intrusted 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 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 penetrate
as far as  the nervous matter of the acoustic expansion;  and this lat-
ter, 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, 
EXTERNAL SURFACES OF RELATION.            73 '
but by tissues which serve to protect it from its immediate contact.
The portio mollis of the acoustic nerve, which alone gives the spe-
cific sensation, (for the portio dura is only a nerve analogous 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, like the pulpy substance of the  brain, disposed  in lines, is
extremely soft, and of a white colour; it floats in a gelatinous fluid,
and the membrane which  separates 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 re-
mark 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 matter,  together with  a small portion of  free
albumen or gelatin.
  The vestibule is the point of union of the two  laminae 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 tem-
poral bone; the air  finds  access to it through a canal on its inter-
nal side, which communicates with the posterior  nares, and 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 canal;  but which,
during life, is closed by an elastic  membrane, similar to that of the
orifice corresponding with the vestibule.   Finally, a fourth  open-
ing, situated at the posterior and inferior part of the cavity, leads
into cells, in the mastoidal portion of the temporal bone: it is  not
closed, but the cells 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.
   In this cavity are found the small bones of the ear: they are  four
                               10 
 74                 EXAMINATION OF THE

 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 ap-
 plied to the  former,  and  the incus to the second; whilst the mal-
 leus and the os orbiculare are intermediate.  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 circumstance, 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 outwards 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 proportion
 as this envelope advances into  the external auditory canal, it be-
 comes thinner,  and finally assumes nearly the character of the mu-
 cous membranes.
  From what we have already said  it may be perceived, that the
 Eustachian tube and the meatus auditorius externus 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 terminate externally 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 essential 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  access of air  to the
 cavity of the tympanum, by the perforation of the membrana tym-
 pani.   These two canals  are intrusted, 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
 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. 
EXTERNAL SURFACES OF RELATION.             75
                Of the Mechanism of Hearing.

  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,  and its  vibration occasions  another in the air con-
tained in the cavity, which 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 mastoi-
dal cells contributes to the perfection of the sense, by increasing the
vibrations communicated to the foramen ovale.
   Hearing may, however, be exercised independently of all  these
accessories, since certain animals are not  supplied with the  cavity
of the tympanum—and the sense may likewise be perfect in  man,
notwithstanding the perforation of the membrana tympani, and the
destruction of the small bones of the ear—finally, children in whom
the mastoidal cells are not yet developed, hear as  well as adults.
These cells, the extent of which increase with  age, and  thus aug-
ment the power of the vibrations, are perhaps a necessary compen-
sation for the stiffness  of the membrane protecting the  labyrinth,
and for the diminished sensibility of the acoustic nerve.
   All animals  possessing long ears, direct them towards the place
whence the noise proceeds,  which adds very much to the delicacy
of the sense  of hearing, by collecting and concentrating in the mea-
tus  auditorius  a  greater proportion of air  in a state of vibration.
 Man is deprived of these advantages, and can  supply  their defi-
ciency only by means of artificial  acoustic horns.

 Of the Manner in which the Local Phenomena of Hearing de-
                      generate into Disease.
   When too intense, noise may, by causing a  violent irritation of
 the auditory apparatus,  produce in it inflammations and haemor-
 rhages; or occasion without the intermediate action of these affec- 
76                   EXAMINATION OF THE

tions, a disorganization of the pulp of the acoustic nerve, whence re^
suits a paralysis producing deafness.   When the sensibility of the
organs in question remains in a state  of exaltation, after extraordi-
nary commotions, the individual retains the perception of a conti-
nued  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 by means
of  speech, singing, or music.  We  even transmit to  our fellow
creatures, through the medium of the sense of sight,  and by the
aid of the characters  of writing,  musical  notes, or gestures, a part
of  the ideas obtained 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 re-produced and
communicated by those individuals only, whose frames are organ-
ized in  a manner adapted to this kind of sensation.  A similar re-
mark is applicable to a number of noises,  which leave behind  them
nothing but confused ideas; such, for example, as the voices of ani-
mals, the accents of which, although  we hear  them perfectly, con-
vey rarely to our mind a definite meaning.   Whenever we hear a
foreign language spoken, it at first sounds to us like an idle noise;
but as it represents ideas analogous to those of our own language,
 we insensibly accustom ourselves to associate it with them: whilst
 on the  other hand, it is impossible for us to connect any thing iden-
 tical with the sounds of  various animals.   We acquire  on this sub-
ject only notions, more or less approximative, and often more hypo-
 thetical than real: the same may be said of many other  noises. 
EXTERNAL SURFACES  OF RELATION.
77
  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 fossae 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 cornets, 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 summit
of the olfactory arch.   The degree of delicacy of the sense is pro-
portioned  to the extent of the ethmoid bone, and more particularly
of the cornets  situated beneath it, as may  be  remarked in herbivo-
rous,  and  in some carnivorous animals, and more particularly in
the species of the dog which is employed in hunting. As the nasal
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 
7S
examination  of the
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
overcharged, with mucus; for  when the nostrils are dried or filled
up with mucosities, the sensation is  almost  annulled.  It appears,
therefore, that the odoriferous particles are blended with the mucus,
and applied to the membrane on which the  sensation takes place.
This operation is very far from being as prompt as that which pro-
cures 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 se-
veral oscillating movements in the air in the nasal cavities, by exe-
cuting 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  circumstance  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 on the olfactory surface may be so power-
ful as to give rise to inflammation.   Its primary effect  is to stimu-
late gently the membrane, and to promote the secretion of mucus.
When  long-continued, it produces a state  of dryness and heat,
which  may be changed into a phlegmasia.  This  sense, when too
powerfully excited, likewise loses, in many instances, its delicacy,
as is observed in individuals who make an habitual use of snuff, and
who are thereby rendered insensible to smellslesspowerful 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 ap-
prizes  us of  the nutritive properties  of bodies, and  apparently of
their chemical composition; whilst,  on the contrary, the senses of 
EXTERNAL SURFACES OF RELATION.
79
touch and sight merely afford us a knowledge 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 communicate 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 so little influence on the mind, it is in re-
turn 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 limited degree with the geni-
tal organs, whilst it modifies them very powerfully in many  of the
mammiferous animals. From these relations result a great number
of phenomena, in which are discovered many causes of disease. We
shall examine them in connexion with those of the other senses.

             Section VI.—Of the Sense of Taste.

  Structure qf the Organs intrusted with this  Sense.—The por-
tion of the mucous membrane intrusted 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  papillae, which
are made up here, as  in every other part, of nervous matter and
sanguineous capillaries.
  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 hyoides;  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
longitudinal  bands, as well as transverse oblique  ones,  depending
on the preceding muscles.  This truly admirable arrangement af-
fords it the  power of being moved backwards,  upwards,  down-
wards, and to each side—of being elongated and flattened when
protruded from the mouth—of being shortened and swelled so as 
80                 EXAMINATION OF  THE

to form a large mass, which is directed backwards and upwards, and
applied to the roof of the palate;—in a word, to execute move-
ments in all possible directions.  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 ob-
stacle from the wants of the viscera.
   The parietes  of the  cheeks,  which are contiguous with the
tongue, and the lips placed exteriorly to the double dental arch, are
formed of muscles, covered over by  the skin, and blended with a
fatty tissue; whilst the internal surface  of these parietes 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 containing, between
two muscular bands situated  laterally and  denominated  pillars, a
large  gland.  These bands are attached superiorly 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 re-
gion 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 with 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 communicate
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-
paratus, as they do not afford a subject for any peculiar physiological
remark.   Indeed, it is of little importance to the functions of these
organs, that blood should flow into them from any arterial trunk in
particular:  it is  sufficient,  that some should  be  contained  in the
neighbouring vessels, in order that these organs may be enabled to
attract into their capillary tissue  the  quantity requisite for their
vital erection;—now every one  knows, that the  carotid arteries,
which are very near the heart, supply a large quantity of blood to
every part of the face. 
EXTERNAL SURFACES OF RELATION.
SI
   Qf the Mechanism and Sympathies of the Sense of Taste.

   When the centre of perception has taken cognizance, by receiv-
ing the  impression from the other sensitive surfaces of the presence
of nutritive substances, it commands the movements necessary for
their prehension, and aliment is  applied  to the  sense  in question.
The delicacy of taste varies in  the different 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 substances incapa-
ble of injuring 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 giving a relish for aliments, and
particularly drinks.  Those that  are pleasant to the sense, are press-
ed 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,  lips, and parietes  of the mouth,  in all parts,of this cavity;
and submits it to the action of the different teeth, in  order to effect
its division, a process depending on the muscles  of the lower jaw.
Solid aliments procure at first but a confused sensation; as  soon  as
they are triturated and mixed with saliva, the sense of taste becomes
more delicate : there is now some change in the flavour of the mass,
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  alimentary bolus 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 is therefore con-
nected to the gastric sense by more intimate relations than the rest
of the mouth; hence  we frequently retain in that cavity substances,
which, owing to the  disagreeable and nauseous sensation they occa-
sion 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
already  noticed in that of sight.  Thus, in  respect to taste we ob-
serve: 1st. Sympathies exercised on the mucous follicles and sali-
vary glands, whence  the afflux of mucus and saliva : this phenome-
non is purely organic.  2d. .Sympathies exercised on the muscles
                              11 
82                   EXAMINATION OF THE

of the tongue, parietes of the mouth, and the elevators of the lower
jaw. These latter only take place through the medium of the cere-
bral centre, and ought consequently to be included among the phe-
nomena 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, the operation is suspended.  When
the appetite is  keen, this distraction occurs with greater difficulty;
in proportion as the former is gratified, the latter 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 instinct
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 circumstances, instinct
may dispose  of them, as is observed during sleep, in the delirium
of acute phlegmasiae in  which the brain participates,  in those cere-
bral irritations which produce hysterical and epileptic convulsions,
and other diseases of a similar nature.  In the greater number of
such cases, the muscular movements are irregular; but they can also
be regular, since we observe somnambulists,  and persons affected
with delirium, walk,  repeat  the manoeuvres of their profession to
which they were accustomed, feign prehension, mastication, deglu-
tition, and  converse on the subject of the acts which they imagine
themselves to be performing.   In all these instances the  will is in
action; but it is so 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 exclusive manner.
As soon as the visceral  irritation has been appeased, the will regains
its empire, and no longer acts but by 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 oceur; but 
EXTERNAL SURFACES  OF RELATION.
83
we reserve them, together with those of the same order belonging
to the other senses, for the detailed history of the functions of re-
lation.

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 inflammation of these organs,  In con-
sequence of a too  long-continued exercise,  this sense may, inde-
pendently  of the  satiety of the  stomach,  become blunted;  but
it is never  permanently  paralyzed, unless subsequently to 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
bitter,  acid, saline, &c.   Memory  cannot,  however,  reproduce
gustatory ideas in the absence of those bodies which have occasion-
ed them.  Neither are we able to  make persons with whom we con-
verse understand them either by figures or words. Hence we must
confess that this sense, when compared to those of sight and hear-
ing, furnishes few materials to  our intellectual faculties.   In com-
pensation,  however,  as we shall have occasion to remark when
tracing the history of the internal functions, it exercises considera-
ble influence on the stomach, and addresses itself clearly to  instinct.
Taste,  indeed,  is a purely  chemical  sense; it  decomposes  bodies,
and causes instinct to  foresee their influence on the digestive visce-
ra.  As we have already seen, this property is principally enjoyed
by the  basis of the tongue:  and  to a certain degree by the velum
palati;  since, at the  moment when the aliments are presented,  in
order to pass the isthmus of the fauces, we experience an eagerness
or a reluctance  to  swallow them,  according as they are more  or
less proper to gratify the wants of nutrition. 
34
OF THE ENCEPHALON AND
                         CHAPTER  VI.

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

   Description of the Brain.—The brain, towards which all sen-
 sations converge, and whence all volitions depart, consists, in a great
 measure, of albumen.  We discover no gelatin or fibrin, except in
 its vascular coats and in its meninges; but the portion of animal
 matter presiding more  particularly over  the  sensitive functions,
 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 of-
 fers no such appearance. The two  are intermixed, the gray portion
 appearing to support and  give  origin  to  the white.  It would in-
 deed 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 separate 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, 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 nu-
 tritive matter of the nerves.
   The gray substance is  in closer relation with the blood-vessels
 than the white; hence it occupies  almost the whole of the  peri-
 phery of the cerebrum and cerebellum, and receives a very  large
 quantity of  blood  from a vascular net-work,  denominated pia
 mater, which invests it  over its whole extent.  In some parts of
 the periphery of the brain, and throughout the whole of the spinal
 marrow, the white substance is situated  externally, and adherent to
 the pia mater; but numerous  and  large  vessels  are  discovered to
 originate in that membrane,  and  pass  between 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 Wood-vessels; but the gray  receives a greater num- 
ITS SPINAL PROLONGATION.
S5
ber 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 having examined the relations existing between these two
substances, 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, pass
through 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
apparatus,  and their arrangement was studied with care.  Dr. Gall
is unquestionably the only anatomist who has  hitherto done this
with success; and  I cannot do better than conform to the descrip-
tions 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 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-
tise pyramidalia, pass through  the pons varolii; they enlarge as
they ascend, and  become  the crura, or  peduncles of the brain.
They soon divide into bands, and pass through two masses of gray
matter, one of which is very improperly  denominated thalamus
nervi optici, and the other corpus striatum.  We say  improperly,,
because the optic nerves, in their passage  to the anterior tubercula
quadragemina, pass along the lateral portions of these bodies with-
out being lost in their substance.   These tubercles, themselves, con-
stitute part  of the  cord in  question, and after ramifying  in the
masses  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 these masses; they are next enlarged,
and  spread out in the shape of a fan, and constitute a white mem-
brane, which unites closely with the gray substance of the periphery.
This membrane, which from its adhering to the gray substance, is
externally of the same colour, presents a white appearance inter- 
36                 ov THE  ENCEPHALON AND
 nally, and conveys to the mind the idea of a kind of balloon, di-
 vided into two segments called hemispheres, 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 con-
 stitute the convolutions of the brain.  It is by means of this arti-
 fice, that the membrane is enabled to be contained within the limits
 of the cranial cavity.  This arrangement is shown to exist in hydro-
 cephalus, and we may, with a little  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 un-
 der them in order to form what  is called the corpus callosum. Pro-
 ceeding afterwards posteriorly and inferiorly, these fibres form succes-
 sively the septum lucidum,  the fornix, as well as the anterior and
posterior commissures; but  they are not continuous with the crura
 cerebri, for the purpose of returning to the corpora pyramidalia.
   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 peri-
 phery of the cerebellum. We cannot doubt, that the union of these
 two substances, which constitutes what was formerly  denominated
 the  arbor vitas, consists of  a membrane  folded on itself;  but Dr.
 Gall has  not as yet succeeded in unfolding it.
   From this, of which the cerebellum  is formed,  proceed,  accord-
 ing to our author, white fibres, the origin and relations of which
 with the  expansion of the  corpora restiformia,  are not  known.
 However this may be, these fibres, in  converging towards each
 other, form  the pedunculi of the cerebellum, and finally unite at a
 raphe, on the inferior surface of the 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- 
ITS SPINAL PROLONGATION.
87
midalia: consequently the mesocephalon is formed of transverse
fibres, proceeding from the cerebellum; of longitudinal fibres, aris-
ing  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
cerebellum.  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-
lon, which are  now regarded as the intra-cerebral nervous appara-
tus,  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 elsewhere than at this point, which, as  the most essential, is also
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  encephalon
situated above the medulla  oblongata; and that it ceases, as soon as
the part in which  the  nerves of the eighth pair are inserted is de-
stroyed.   [See the Experiments of Legallois.]  Now, as it ceases
also, when an incision is made below this insertion, (op. cit.J I
thought myself justified in  drawing the following conclusions, in a
memoir inserted in the Journal Universel des Sciences Medicates.
   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 
ss
OF THE ENCEPHALON AND
 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 commu-
 nicates with the nerves proceeding to  the inspiratory muscles, re-
 spiration must equally cease.
   After this reasoning, I drew the following conclusion. If there be
 but one centre of perception and volition, it must be situated at the
 point where the feeling of the want of  respiration is felt, and from
 which emanates the volition determining the action of the respira-
 tory 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  reasoning
 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 in
 this argument  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 opposing fact,  I am still inclined to adhere  to them;
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,
ceases to contain any gray substance;  but consists of large nervous
cords, supplied with their neurilema, and which escape,  together
with this envelope, through the foramina of the lumbar  vertebrae
and of the sacrum.  Consequently, from the  dorsal  region, the
neurilema exists in the spinal canal, and does not, as in  the superior
regions, commence only at the foramina.  This  assemblage of lum- 
ITS SPINAL PROLONGATION.
S9
bar and sacral nerves is no longer 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 pair,
so long as they are contained in the encephalic cavity.  These
nerves  have  no other  envelope than a very delicate coat derived
from the arachnoid, until they pass out of the  cranium; after this,
they are contained in a solid sheath, furnished by the pia mater,
and embracing the small cylinders of their neurilema. Finally, the
acoustic nerves, which  never leave the  osseous  cavities, present
appearances precisely analogous to  the white lines of  the brain,
although it is reasonable to suppose that they are covered with a
thin layer of the same nature as the arachnoid, and such as we ad-
mit to exist in the ventricles, and between the laminae of the septum
lucidum.
  We are justified in believing,  from these  observations, 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 are designated
by the name  of meninges.
  The one which is nearest to the cerebral matter, is nothing more
than a vascular net-work, derived  in great measure from the  sub-
divisions of the carotid and vertebral arteries,  which supply blood
to the encephalic apparatus. This net-work contains likewise veins,
which, however, are of small size, because they deposit their blood
in large cavities denominated sinuses.  A cellular, or rather lami-
nated tissue supports these  vessels, and it is this assemblage which
constitutes the pia mater.
  The pia mater is covered over by the arachnoid, a transparent
membrane, of the nature of the serous tissues,  and exhaling and
absorbing a serum, which appears  in the  form of a vapour only.
According to Bichat, the arachnoid is a sac without opening,#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
                             12 
90
OF THE ENCEPHALON AND
 the convolutions, without  penetrating between them.  It is also
 found on all the pedunculi of the cerebellum-—on the medulla spi-
 nalis—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 external
 one in order to form various folds, known under the names offalx
 cerebri and tentorium cerebelli.   These  folds serve to support the
 two principal encephalic divisions, and contain  the  sinuses already
 spoken of, which consist in a sort of canals performing the office of
 veins, that receive the blood from the smaller veins of  the pia ma-
 ter, and deposit it in the jugulars,  by which it is conveyed to the
 heart.
   Such is  a general  sketch of the structure of the cerebral appara-
 tus.  The  arteries which proceed to the brain  and spinal marrow
 are surrounded  by nerves,  called ganglionic, of which we shall
 speak elsewhere.  The existence of  lymphatics  in the substance of
 the brain, has long beendenied; but the recent researches of pro-
 fessor Lobstein, of the faculty of Strasburgh, have led some anato-
 mists 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
 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 hemispheres 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, septum lucidum,
 fornix, and the commissures.   All these  internal nervous  assem-
 blages, are  doubtless  nourished by the gray substance  in which thev
 originate.   Derived from this substance, which is their matrix and
 support, such of these apparatus as form in conjunction 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 
ITS SPINAL PROLONGATION.
91
them arise by the four pedunculi already mentioned. In respect to
the central apparatus, he does not view them as converging towards
the medulla; but rather as independent of it; he  acknowledges,
however, that they  communicate with the former  in the membrane
forming  the convolutions of the brain; which necessarily supposes
that the medulla 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 in-
tellect, the propensities and instinct.  He  even  goes so  far  as to
designate, under the generic name  of organs, the  regions of the
encephalic cavity, occupied b)' each of these apparatus.   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, affections, and  propensities. It now remains to de-
termine  whether these white lines are the principal agents  of these
phenomena,  or whether they are not rather the simple conductors
of the sensations and volition, which  would then  have their seat in
the gray substance.  This question  appears to me obscure; 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  induced to place
it in the superior part of the medulla oblongata. 
92
SENSATIONS—INSTINCT.
                       CHAPTER VII.

 EXAMINATION OR STUDY OF  THE  SENSATIONS—INSTINCT—THE
                  OPERATIONS OF  INTELLECT.

  In a state of health, and when there  does not exist any feeling
created by a morbid  condition of the system, every sensation origi-
nates from an impression made on a surface of relation.  I have said
that these surfaces were of two kinds: the external, consisting of the
generally received five senses; the others internal, which  are in
course composed of the mucous membranes, and sometimes of their
appendages.  We have seen above, that the wants originated from
the latter series, 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 impression is  made on an external
sensitive surface, it  is  reflected by the  cerebral centre to the inter-
nal or visceral senses, whence  returned to the brain, it gives  rise to
another sensation, which impels this organ to action.
  But the operations of the centre, though all determined by the
same cerebral point, are presented to us under two aspects;  1, acts
relative to urgent wants; these belong to the domain of instinct: 2,
in acts relative to remote wants, by which 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.  When we seek gratification of an urgent
want, we give rise to the operations of instinct; when we wish for
the gratification of a remote want, we have those of intellect. Both
imply that the  portion of the  brain  destined to feel the wants and
command the acts, is sufficiently developed, and is not  in a  patho-
logical state.   Let us first examine the operations and the pheno-
mena of instinct. 
SENSATIONS—instinct.
93
     Sect. II.—Of the Phenomena of Instinct in general.

  By some physiologists it is maintained that the brain alone pre-
sides over the instinctive operations; because they invariably remark
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 apparatus 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, seeking nourishment for and
protecting and defending their young, depositing their  eggs  in a
certain place, and fecundating them, and 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
should solicit them from the brain,  is  not constantly  the same.
Whenever the stomach is full, or diseased, the acts requisite for
seeking and seizing aliments are suspended.  If we remove the tes-
ticles, the acts relative to generation, and we already know how
numerous they are, can no longer 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 be-
come 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 sight occasions gradually an obliteration of the ideas which were
furnished  by that sense.  If this fact be certain, it serves to confirm
my proposition, by proving that  the brain acts only in concert with
the other viscera.   But  let us again direct our attention to genera-
tive desires.

  * This voluntary tribute of praise from one distinguished physiologist to an-
other, is worthy of attention, as contrasting with the slang and ribaldry lavished
on Dr. Gall by self-constituted critics  and small-brained readers of encyclopae-
dias.—Thaxs 
94
SENSATIONS--INSTINCT.
  If, when a hen is 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 in-
cubation is suggested to the hen by a sensation which the brain per-
ceives  in  the abdominal viscera?  Similar observations have not
been made on insects; but who will  assure us that experiments for
this purpose will riot be devised?  Let  individuals who cultivate
the science of zoology, or  the  veterinary  art, take the trouble of
making local bleedings from the vulva  of females of quadruped
mammiferous animals, at the time of  their incalescence; let them
apply a great number of leeches,  and they will see whether the ar-
dour of these animals  for copulation is not in some  measure dimi-
nished.
  It is said that migratory birds are guided only  by their cerebral
organization; yet it is certain they do  not arrive on a fixed day, and
that if the opening 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 such differences not to occur, as
the migrations of these birds cannot be the  effect of reasoning, 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 sub-
ordinate 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 digestive and genital or-
gans, 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 their  object the avoiding any imminent
danger.  These acts are founded on self-preservation, which is itself
based on pleasure and pain.  Every thing that causes pleasure de-
termines the animal to approach the external agent  capable  of im- 
SENSATIONS—INSTINCT.
95
parting it; whilst, on the contrary,  whatever causes pain gives rise
to 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 different kinds of pain; but still
they are pains, such too as are perceived very plainly by the cere-
bral centre, (if we judge of them  from our own species,) in the or-
gans situated in distant parts of the  body; as for example in the
chest, in the heart which is agitated by palpitations, in the cutane-
ous envelope,  and more particularly in the abdominal viscera. Now,
we have just  seen that the other instinctive 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 and viscera.
  The physiologists who refer all to the brain, answer these objec-
tions by saying,  that every  visceral  sensation, accompanying in-
stinctive acts, is nothing more than an accidental irradiation of the
cerebral excitement, which traverses the  nervous system  without
any distinct object; and that, consequently, it cannot  be the imme-
diate cause of these operations.   I have already anticipated this
objection, by proving, that the acts relating to nutrition and gene-
ration 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 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 sensations are not  the causes, but the for-
tuitous accompaniments of anger and fear.   To this I will  answer
by new facts, as common and simple as the preceding.   If it be de-
sired 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 ac-
customed mildness,  remove that inflammation.   If you  wish to
impart courage to the greatest coward, it is only necessary to stimu-
late his stomach by means of a substance agreeable to the internal
sense residing in that viscus, and particularly by means of ferment-
ed liquors.  We discover  examples of these modifications even
among animals.  Hydrophobia 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 
96
SENSATIONS—INSTINCT.
 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 and inspire them with courage, and per-
 vert entirely their natural disposition.  Even  if the physiologists,
 to whom I am opposed, were to assert,  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 they to main-
 tain such a proposition, they would do so without foundation; since
 nothing can overthrow the proofs I have given, to demonstrate that
 the  brain invariably acts in  concert  with the internal  organs  for
 which the  bodies stimulating 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;  such certainly  take  place, but they do  not
 destroy 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 they
 are not of  necessary occurrence,  and in a great number  of cases, in
 which the want  is moderate, cannot  be detected;  whilst on  the
 contrary, those that reside in the genital organs and stomach inva-
 riably 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 impressions from the external surfaces of rela-
 tion, by such agents from without 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 secon-
 dary sensations proceeding to it from the viscera. Hence, in all these
 cases,  it is keenly solicited  to  execute  the acts required  by these
 wants; and it is these same acts which we refer to instinct.
   Still, however,  it does not execute them in all cases; and hence
 arises  a difference among the acts which depend on instinct, well
 worthy of attention. Thus, there are some which the centre is com-
 pelled to execute instantaneously; others which it can defer during a
 longer or shorter space of time; others, finally, from which it can ab-
 stain entirely. In proceeding to the investigation of these three or-
 ders of acts, we shall finally succeed in  discerning the passions, and
 the intellectual faculties. 
PHENOMENA OF  INSTINCT.
97
   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 others,
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.play 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 notice that
which is produced by the want of fresh  air.   This is  less urgent
than the former, and we are able to 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;  bat 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 bo-
dies, are always the most urgent, and cannot be avoided.   Thus, it
is not in our  power to  prevent  vomiting,  and the attitudes  it  re-
quires; and we can only retard for a time the voluntary movements,
which are to concur in the expulsion of fecal  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
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 pre-
                              13 
98
PHENOMENA OF  INSTINCT.
cipitate movements, which are referred  to anger, fear, and other
passions, of which we shall soon speak.   We are able to  resist the
instinctive impulses to the execution of these acts, but alas! we too
often give way to them.
  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 excessive  heat,—to place ourselves in such a posi-
tion  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 on this interesting  series of instinctive suggestions;  but what
I have said must suffice for the correct understanding of them.
  The acts solicited by  the want of reproduction are likewise sin-
gularly multiplied, comprehending as  they do the movement ne-
cessary for the approach and union of the sexes.  These may un-
doubtedly  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, more particu-
larly  among females,  solicits it in many cases,  with a degree of
energy of which reason is incapable of annulling the effects.
  Though this  faculty affords us the power of  retarding or pre-
venting, 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 
PHENOMENA OF  INSTINCT.
99
we are unable to suppress,  in an acute  gastro-enteritis, the volun-
tary movements 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 advan-
tageous for inspiration 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 violence 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, te-
tanus, &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 these depravations  were all 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 energy;—I allude to great public  calamities.   From those who
have detailed the terrible event by which the crew of the frigate
La  Miduse 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 dis-
gusting 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 con-
fessed it in detailing their torments.   It must be allowed, however,
that examples of such forbearance, are few in number, and depend
upon an  extraordinary increase of the influence  of the encephalic
nerves on the centre of perception; but  which, however great, does
not prevent the solicitations  of instinct.  I refrain  from sketching
the examples of cold indifference towards  other men, and of fero-
cious egotism observed  in many unfortunate situations; as for ex-
ample, in the retreat  from  Moscow.  It is precisely  under these
circumstances, that we notice the diminution of the influence of the 
100
PHENOMENA OF  INSTINCT".
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 matured, should have  re-
sisted 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 disinterested-
ness, 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 na-
tions, where instinct, uncontrolled by the cultivation of the mind,
is displayed 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 the opinion  has been
advocated by a modern writer, who has placed instinct exclusively
in the nerves of the great 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  apparatus, which are charged with the execu-
tion of the  intellectual faculties.  Thus the greater the development
of these apparatus, the combination of which constitutes the hemis-
pheres of the brain, the less powerful is the influence  of instinct,
and vice versa;—so that it entirely predominates among the animals
of the lowest classes, in which the hemispheres are very  small, or
even entirely wanting.  The cerebral centre receives the  influence
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 
PHENOMENA OF  INSTINCT.
101
instinct,—unless, indeed, inflammation should have increased the
influence 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 observed
in the phenomena of instinct.  These relations, doubtless, are inex-
plicable, depending, as they do, on first causes; but their effects
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 others; that is to say,
as soon as their external surfaces of relation are placed in contact
with certain bodies of nature, they experience a  stimulation, which
is repeated in the brain, as well as in the internal nervous appara-
tus,  and which determines certain acts; whilst  the  same surfaces
of relation are insensible to the  action of other  bodies, capable  of
producing impressions on an  animal of a  different  conformation.
Each organized being possesses, therefore, peculiar relations, found-
ed upon its own vital affinities, and exerted only between it and a
certain number of external bodies.   These last, on being placed be-
fore it, are recognised by virtue of the internal stimulation, and the
centre of  perception immediately commands the acts which are re-
quisite for approach to those bodies, that they may be made subser-
vient to the wants of the animal or of its young; or kept away 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 apparatus, which, in other beings, confer the faculty of ob-
serving and modifying the impression received, they can only obey,
undeterred by considerations of danger which they  cannot  feel.
This may be exemplified by a  fly plunging  in honey, although it
must remain in it, and perish.   No sooner has a man deposited his
excrements in  a field, than  a number of  insects,  in the neigh-
bourhood, precipitate  themselves  upon them, for the purpose  of
depositing their  eggs.   Have they reflected  that this matter was
the most proper for the nutriment of their  young?  Certainly not.
They have received an internal  impulse, occasioned  by the exhala-
tion 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 
102
PHENOMENA OF  INSTINCT.
Hence, they are known to seek, on the chenopodium foetida, and
other bodies accidentally impregnated with putrefactive vapours, a
place which is incapable of serving for the incubation 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 se-
veral 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 for itself suitable flowers; it will
construct hives, and fill them with  honey; whilst its queen will de-
posit her eggs in each cell, without being disturbed in this occupa-
tion by the presence and attentive observation of man;  because they
are deprived of those cerebral organs which could render them sus-
ceptible of being thus alarmed.  The same remark is applicable to
the greater number of  insects; whereas, the spider, which is pro-
vided with these organs, will remain  in its hole,  if an  individual
has already touched its web,  and will leave  the fly, which has be-
come entangled, struggling in it.
  The bird,  provided  with better  developed intra-cerebral appa-
ratus,  will,  notwithstanding  its instinctive impulse  to seize its
food, or to carry some to its  young, abstain from it whenever it is
noticed by man; as if it were conscious, that by obeying first im-
pulses, its life, or that of its young, incurred some danger.  Many
other animals, more closely allied to man, will refuse  to perform,
in his presence, those acts that  are  necessary for  their propaga-
tion.   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  apparatus  capable of procuring to  them  the instinct ot 
PHENOMENA  OF INSTINCT.
103
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 recognising the aliment by
means of the touch,—seizing it and thrusting it into the digestive
canal.
  Among fishes  we discover many sorts of  instinctive impulses,
but their object is not the same as in insects, because their sensitive
apparatus 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.  No sooner have these
been recognised by the external surfaces of relation, than the centre
of perception determines the acts  of prehension and deglutition.
The carnivorous fishes do not spare individuals of their own species,
and devour both their females and their young.  Certain instinctive
impulses guide them in recognising the kind of water and the nature
of the soil proper for their preservation,  and likely to supply them
with  their food,—whereas  others direct  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,  but  never to anticipate or
retain the recollection of it.
  If we  now retrograde toward the mollusca,  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 loco-
motion for seizing it; the care  of their preservation is  reduced to
the closing of their shells; and as these animals are hermaphrodite,
and 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 mollusca, as the snails.,
are compelled to go far in search of their food:  although hermaphro-
dite, they require each the  co-operation of one  like itself, in or-
der to fecundate, and to be in  its turn fecundated.  From this
arises the necessity of more developed  nervous apparatus, which
•n fact they possess; and notwithstanding the slowness of their 
104
PHENOMENA OF  INSTINCT.
movements, they have a sufficient quantity of brain to see danger
and endeavour to avoid it.
  The ophidia and  batrachia are much  less  imperfect.  Nature
has provided them with a well-formed head, and with intra-cephalic
apparatus,  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.  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 rather
the 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 apparatus
allows them to perceive the approach of their enemy, to  appreciate
the danger by which they are threatened, and to postpone the gra-
tification of the want of nutrition, in order to obey that of self-pre-
servation.
  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 be-
come its  prey.   The bird is terrified; it cannot abstain from looking
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 few  shepherds  have not had occasion
to notice.  The public papers have  lately  detailed the manner in
which  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 per-
ceived its prey, it unfolded itself, and looked at it fixedly, with open
mouth.   The  goat, after hesitating  some time, as if undecided be- 
PHENOMENA OF  INSTINCT.
105
 tween the instinct of self-preservation and that attracting it towards
 the  monster,  precipitated itself head foremost into 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 it could an
 animal of smaller dimensions, seized it by one foot,—enveloped it in
 its folds,—broke its bones,—smeared it  with its saliva; and next
 seizing it again by the muzzle, succeeded in swallowing it whole.
   What a multitude of diversified acts, equally commanded by im-
 perious  instinct! But why should one  surprise us more than an-
 other?   They are all alike founded upon the necessity of the pre-
 servation of organized  beings;  only 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,
 when this latter is deprived of other means requisite for seizing it.
 It is generally admitted, that a number of animals are born only to
 be devoured:  such are, among a thousand others, the larvae of in-
 sects, 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 the acts of instinct, which  tend to deliver up a prey
 to its enemy, are as natural as others, the object of which is to avoid
 danger or gratify an appetite.   Now,  it appears evident,  that,  in
 order to attain 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 con-
 course of visceral  stimulations with those arriving from the intra-
 cephalitic nervous apparatus;—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 organized,
 fear, instead of attracting the prey towards its enemy, induces it  to
escape; or when the same sensation obliges the carnivorous animal
to abandon  its  food, reflection has  no  greater agency in these acts.
They result from the circumstance, that the instinct of self-preser-
vation, being more developed, evidently overpowers all the others;
—the differences in instinctive acts being  always in direct relation
with the conformation of the nervous system.  In a word, it is always
the relations, established between the bodies in nature and animals,
which are operative in these circumstances; but which can only be so
                            14 
106
PHENOMENA OF  INSTINCT.
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 only occur in animals, in which the nervous matter is
separate from the rest; and let us remember, also, what has been said
above, respecting the manner in which instinctive 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: now, the impulses of this bird, as well as every
other, to build a nest, depend upon  the same organic cause.   It is
true, that  they all derive,  from  the conformation of their encephalie
nervous apparatus,  the  faculty  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 only called into action 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
somewhat different modifications  in  the  instinctive impulses; 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 possesses predominant instinctive faculties,
and many are susceptible of being so modified, in this respect, as
to become useful to the human species.   This last prerogative re-'
suits  exclusively from  the  predominance of the cerebral hemi-
spheres; for it is impossible  to  obtain  these modifications  in ani-
mals badly provided for in this respect.  The buffalo,  among the
herbivorous, and the lion,  tiger, hyena, &c. among the carnivorous
animals, are not susceptible of being educated. So soon as, by their
wants, the centre of relation is solicited, they are compelled to 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 ob-
servations of  man.   It  appears,  therefore, that  their intra-cephalic
apparatus, and which are at best small,  are  exclusively subservient 
PHENOMENA OF INSTINCT.
107
to the orders of instinct, and that the tricks to which they have re-
course 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 the domesticated
class; for  it  almost invariably  happens, that the instinctive  im-
pulses which predominate in them, are likewise those over which
the intellect, whatever it may be, with which they are endowed,
exerts the greatest degree of influence.  The  horse, for example,
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 by the voice and signs of  his master.  The noble
animal  seems to  understand, that  it is in  this way he  may make
himself useful; and accordingly submits himself to all that is re-
quired of him.  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 ho-
nour, to which he often sacrifices even life itself.  But the intellect
of the horse is not limited to this.  He enjoys, even to a considera-
ble degree, the faculty of memory; and when he succeeds in com-
prehending  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 equestrian  exercises of  the  celebrated
Franconi.   The horse, at the same time, is docile  and  timid; but
he becomes sometimes courageous, and even  intrepid, when sus-
tained by the presence of man, and particularly when marching with
his like. It is from this circumstance, that our own species has been
able to  reap so much benefit from his  services; but,  although he can
distinguish his master, 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 considerably, according to the greater or less develop-
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  notable differ-
ences.
   The  dog, the sea-horse, and the elephant,  are  perhaps, of all 
108
PHENOMENA OF INSTINCT.
 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 susceptible
 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, distinguishes the degree of importance
 and consideration of each, and  never  fails to have more deference
 for the master than for all the rest.  The  caresses he receives from
 the former are more grateful to him than  those of any other.   He
 experiences  pleasure  in accompanying  him,—in rendering  him
 service,—in devoting  himself  to him,—in sacrificing even his life
 to be agreeable to him.  If he receive  a merited chastisement 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 man-
 ner 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 forced away.  He pays a deference  to old age, protects infancy,
 and disdains to  take revenge on 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
 modifies them by causing certain parts  of instinct to predominate.
 Thus the greyhound, whose  head is very small, manifests very little
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 
PHENOMENA OF INSTINCT.
109
necessary to have recourse to the severest chastisements to compel
him to employ this sense to the profit  of the huntsman.  The in-
stinct of the  shepherd's dog, by which he guards  and guides the
flock without any reference to his own appetite, is really surprising;
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 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 colours, &c.
   It is owing to their strength and disposition to  fight, that the
mastiff and the house dog are enabled to render us such important
services; it is also in this respect that education may succeed in
modifying instinct.   Danger does not alarm the terrible animal;—
caresses—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 of
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 
no
PHENOMENA OF INSTINCT.
 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 an 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, re-
pose, sleep, protection from agents threatening their existence, is
 gratified, they  are not kept awake by the anticipation  of another
 state, by a reflection on  themselves,  or by the necessity of contem-
 plating 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 reflecting
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,
 which in their respective species 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 pursuing the prey, whilst others place themselves
 in the path it  must follow, with a  view of throwing  themselves
 upon  it at  the favourable moment.  They may likewise offer in
 proof of their opinion, the simulated flight of the wolf with  a view 
INTELLECTUAL FACULTIES.               HI
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, which, when exhausted with fatigue, will start out a
young one, take its place, and allowr the dogs to pursue the latter.
All these examples, and a thousand others of the same  kind, are
familiarly known to huntsmen, and those who spend their life in
observing animals.
   All this, doubtless,  points out a certain degree of intellect; and it
is not without cause,  that the brains of birds  and mammiferous
animals are provided  with hemispheres.  But this  intellect is in no
respect 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 animals the character we have assigned to
man in his love 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.   Nothing shall prevent
me, however, 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 far-
ther, and expose our views relative to the characteristics  of human
intellect.
   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-
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 observes
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 ways in which he 
112
INTELLECTUAL FACULTIES.
felt, whilst he observed himself occupied with his feelings.  From
this study he derives an idea of his own existence, independent of
every other object in nature;—he distinguishes himself in the midst
of creation, and, paying regard  only  to  his own existence, com-
pared with all that is not himself, he pronounces the word /, and
says I am; and if he views himself in action  he  says,. / act, I
do, fyc.
  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 successive
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 oc-
casions 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 on himself, or, if
you will, on this same self, we may  say that judgment  is nothing
more than reflection.  Hence, sensation, reflection, and judgment,
are absolutely synonymous, and present to the physiologist nothing
more than the same phenomenon.
   The will, or that faculty in 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,
(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 have this feeling.
  Such  is the manner in which  I view the intellectual faculties;
and, as my senses do not enable me to  perceive similar  operations
in animals, nor to discover them by means of induction,  I am jus-
tified in affirming,  that, at least  in my opinion, animals are not 
INTELLECTUAL FACULTIES.               113
endowed with the power of reflection; that, consequently, their
intellectual  faculties cannot be placed on a parallel with ours; and
that their ideas also are of a different order.
   After an attentive  examination of the subject, it will be found,
that reflection necessarily implies the faculty of contemplating na-
ture; since  man cannot  reflect otherwise than in  feeling himself
sensible of  what passes around him.  Animals not being  endowed
.with this faculty, are of course deprived of the power of reflection,
which attribute, consequently, becomes the exclusive characteristic
of man.
   Some persons might,  perhaps, attempt to invalidate the correct-
ness of the opinion already advanced,—that judgment invariably
implies the existence of memory, by  objecting, that individuals, in
whom  this  latter faculty predominates, are not greatly distinguished
by the rectitude of their judgment.  To this I answer, that if the
sentient faculty be powerfully employed in  recalling to the mind
old perceptions, it is less so in being impressed  with the relations
they may bear to 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 pleasure in feeling
 the impressions of external agents; and, as we are in absolute need
of emotions,  this  class of 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 organi-
 zation, which facilitates the  recurrence of old impressions, by the
 pleasure they  experience from their  sensations.  Some, on the
 contrary, and always in  consequence  of the peculiarity of their
 organization, occupy themselves with studying the effects which
 these sensations produce upon them;  that is, they derive more plea-
 sure from  the  exercise of the faculty of  reflection, or  from the
 secondary sensations,  than, as in the case of the others, from the pri-
mary ones.   These latter are not, however, limited to this pleasure;
 they continue to  reflect on the sensations they experience, though
less profoundly than the former; that is to say, their consciousness
is more seldom reflected on itself.  But, however this may be, the
 mechanism of the phenomena is the same in both instances;—im-
 plying always the return of past sensations and the comparison of
 these with  present  ones.   The only difference,  therefore, consists
 in the  former class of  these individuals being  less retentive of
 sensations  than the latter.   Some are so fortunately organized, as 
114              INTELLECTUAL FACULTIES.

to possess, in a high degree, the faculty of recalling past sensations,
as well as that of retaining others of every kind, with a view of sub-
mitting them to reflection.  But, as the pleasure of reflection, or rather
of the sensations which these individuals procure to themselves, is
greater than that resulting from the sensations produced by exter-
nal agents,—reflection giving them a degree of superiority 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.
  After all, the  aptitude  for  reflection, and  the pertinacious exer-
cise of this faculty, are not sufficient to constitute sound judgment,
which though it implies their existence,  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  persons whose  brains are unduly developed; 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 become
inconsistent in their conduct, so that it 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;  and yet this result is not continuous. It offers
considerable intervals, during which the  cerebral action is not anni-
hilated, but  only withdrawn  from the empire of self.  This I pro'-
pose to prove by facts, showing at the same time, that physiologists
have greatly erred in their definition of sensibility, when they sim-
ply say, that it is the effect of the action of the nerves and brain,—
in  the same way that locomotion is the effect of the  action of the
muscles,—digestion of the functions of the stomach,—respiration of
the action of the lungs, &c.
  To the brain is assigned the duty of sending back, by means of
the nerves, to the various  parts of the body, the stimulations  trans- 
                   INTELLECTUAL  FACULTIES.          *     115

mitted to it by the same channel: this  operation is purely organic.
It is in  this way, that the  brain establishes sympathies between
the different organs, and  makes them subservient to the preser-
vation  of  life:  this  constitutes its constant function.   It begins
to perform  this  during  fetal  existence;  and in  the  period  of
utero-gestation it has no  other.  As soon as the child is born, it
speedily manifests its susceptibility of experiencing pleasure and
pain; this is an extension  of the function  performed by the brain
before  birth.  After  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 suscepti-
ble of it, but nothing indicates its actual existence.   His  brain
continues to grow; and when it  has attained a certain degree of
development, the  observer  may notice the first rudiment of con-
sciousness:  this constitutes a further extension of the cerebral func-
tion.   The child once more falls asleep, and this second effort, like
the first, is annulled; but  as we recollect its having enjoyed con-
sciousness, we say that it possesses it.  Finally,  the child attains
the age  of manhood; at this period sensibility and  reflection are
manifested in their full vigour;  but, as soon as they have been ex-
ercised for a certain period, they ai"e made to disappear by an im-
perious law.  Man  falls once more asleep, and, although, during
this time, he ceases to exercise  these faculties,  the brain continues
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 stimulating agent, not only the limbs are moved,
but the heart and other  viscera receive an impulse, by means of
which  their movements are precipitated.   They become injected
with blood,—their secretions take place more actively;—in a  word,
a number  of sympathies  depending on the  brain are  called into
play.
   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 are intermittent."  Consequently they

  * To admit the intermittent functions of the brain and nervous system gene-
rally, is no new demand on the  faith of physiologists. One of the leading distinc-
tions established byBirhat, between the animal and organic lives, or the functions 
116
INTELLECTUAL  FACULTIES.
cannot properly be defined to be the 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 or-
ganic reflection,  or the transmission of stimulations from parts re-
ceiving 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 it, as is manifested by the phe-
nomena which we denominate  sensibility, and the intellectual ope-
tions resulting from it: whilst at other times he is not conscious of
it. During the early periods of his life, when in the uterus, he does
not possess this consciousness;  he acquires  it afterwards,  but loses
by means of sleep, and reacquires it, periodically; finally, he is de-
prived of it during attacks of apoplexy, and epilepsy,—and 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 pa-
thology, as it destroys those arbitrary divisions by which the differ-
ent shades of the  same  function  are usually separated.  It shows,
that a point of irritation, as for example an inflammation, acts always
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-enteritis, sensi-
bility  and mental  reflection  are as  yet unimpaired; the patient is
conscious of his  condition, and refers, himself, the uneasiness  he

of relation and those of assimilation, was the alternate states of action and repose of
the former, over which the brain presides, and the continued action of the latter, the
centre of which is the heart.  The office  which the author attributes to the brain
and nerves, viz. of organic reflection, or the reception and transmission of stimu-
lation has never been disputed to them: but he errs in calling this their principal
function.  It has been proved by Bichat, Wilson Philip, Flourens, and others,
that for the exercise of sensibility, it is sufficient if that part of the brain where
the nerves meet, that is, its basis, be preserved.  The great body or mass of the
organ may be removed, without impairing sensibility, showing, 1. that this yital
property does not reside in the whole brain,  or the major part of it;  2. that the
object of the cerebral organization  is for other higher and more varied func-
tions, with which sensibility  may be associated as evidence  of vitality, but not
proof of unavoidable official connexion.—Trans. 
INTELLECTUAL  FACULTIES.
117
experiences, and even his fever, to the pain of his stomach; because
he very plainly observes, that these phenomena are aggravated 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.  Yet  still  the unfortu-
nate  being continues to  be agitated by  the same movements as
before;—they are even more intense, amounting as they  do some-
times to  convulsions.  What would we think  of the  physician,
who, after admitting with the patient, at  the commencement of the
attack, that the fever and muscular agitation depended on the irri-
tation of the stomach, should affirm  that  in  the  latter stage these
symptoms were no longer the effect  of  this cause;  because the pa-
tient no longer complains of pain, nor  regulates any  of his move-
ments?  For my part I am inclined to believe, that this  physician
would be in the wrong;  but it  appears  to  me,  that  all  difficulty
may be obviated  by saying, "the stimulation of an  inflamed sto-
mach, being transmitted to the brain, and to the whole  nervous
apparatus, gave rise, from the  commencement of the attack in this
patient, to the acceftration of the pulse,  and to the convulsions he
experiences;  but the changes which  have supervened, in the con-
dition of  the encephalon, having  suspended all  the phenomena of
consciousness, the patient is no longer sensible, as at the commence-
ment of his disease, of this transmission."*
   It is for this reason, that  I regard  contractility as the only vital
property  of the tissues,  and sensibility  as one of the results of the
play of this property;—a result  which is  not continuous nor neces-

  * Here the author confounds sensibility with consciousness—a mistake which
pervades his whole reasoning on the subject.  We would ask how the convul-
sions alluded to in the text are brought on, if not by the transmission of the gas-
tric stimulations to the brain and their subsequent  reflection from the latter to the
voluntary muscles.  This may take place in sleep or in advanced disease—it is a
process accomplished by two nervous chains of reception, and return, which have
a common centre; it does not call on, or imply  consciousness; and yet it is an ef-
fect of cerebro-nervous action, to which no other name can be so appropriately
affixed as sensibility.  It may take place with an  exceedingly small centre, too
small for the display of intellect, or even of any variety of instinctive acts, and in
the higher  order of animals is not incompatible, as remarked in a former note,
with the  ablation of the greater portion of the encephalic mass.—Tkaxs. 
116               INTELLECTUAL FACULTIES.
 sary to the existence of animals, as is proved in the fetus, in zoo-
 phytes, &c;—which is subordinate to an inexplicable  condition  of
 the brain;—a result, finally, which appears to  me so astonishing,
 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 im-
 possible 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 together all
 the movements, and maintains life, even during a long time, with-
 out the  manifestation of thought,  and consequently of sensibility.
 What then is the condition of the brain which produces these phe-
 nomena? I know not,  and consequently will repeat, that sensibility-
 consists in an immaterial, and, at least for me, incomprehensible
 result of the exercise of our functions.
  But I have said that sensibility  is a forced state;  and my reason
for  saying  so is, that  it cannot  continue  long.  The  proof of its
 being painful to nature is its suspension, and even if by  the power
of volition, we prolong  it  beyond the limits s+ie has imposed, we
become diseased;  Whereas the  exercise of contractility is  never
 interrupted.  It will perhaps be objected,  that every  immoderate
 exercise 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 sensi-
 bility 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, by the  action of
which they are rendered evident, I must next examine them in re-
ference to the external objects, by  which we find them manifested;
 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.   In  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 intel- 
INTELLECTUAL FACULTIES.
119
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 on the result of impressions made on  these internal senses,—im-
pressions which are more or less powerfully repeated in the neigh-
bouring nerves and in the other tissues, and which are analogous to
those produced on the external senses,  that the centre  of relation
operates.  Wre 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 detail,
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 placed in
contact with the different surfaces of relation.
  When the impression is produced on the external senses, by a
substance which interests  very nearly  the viscera,—such, for ex-
ample, as an aliment,—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, hearing; smell, or  touch, the  viscera are instantly
agitated.   A  secondary  impression,  starting  from  the  latter,
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 becomes
stored with recollections, the centre of perception obeys the sugges-
tions of the viscera. In this state man approaches still to the nature
of animals;  but after a while his intellectual organ becomes perfect,
—he acquires  abstract ideas, and he soon attains that point at which
he no longer judges of impressions solely in reference to his actual
 wants, but rather agreeably  to  the prospect  of  a future  pain or
 pleasure,—which 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 
120
INTELLECTUAL FACULTIES.
 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 enjoy-
 ments of a purely intellectual life.   The idea is  even to him a
 source of pleasure 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 similar nature.  A mother is  solicited by the
 want of nourishment; but the love she bears her child causes her to
 anticipate more pleasure in gratifying the wants of this beloved be-
 ing than in providing for her own.  The aliment she could have
 made use of herself, is therefore given to the child;—and this sacri-
 fice procures to her a degree of enjoyment, well calculated to com-
 pensate for the privation 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
 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,  be-
 cause every one feels how painful they must be.  From this consi-
 deration there result praises and a degree of'respect,  which become,
 for the one who has had the courage to subject himself to these pain-
 ful trials, a source of pleasure, of which, as  being intellectual, all
 men are not susceptible.
   Courage, which consists in despising death, is founded on similar
enjoyments, when not inspired, as it generally is,  by anger, or the
instinct, of self-preservation, &c.  One man exposes himself to dan-
ger, 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
enem)r;—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  enjoyment 
INTELLECTUAL FACULTIES.
121
purely intellectual, which will ensure him the admiration of men,
or the good will of the Deity, for whom he had the courage to sa-
crifice himself.
   The domain of the intellectual faculties is immense.  Very often
we see men 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,
artists, warriors,  diplomatists, deprive  themselves  of their sleep,
and renounce all sensual pleasures,—the sources of  which are con-
stantly before them, if it  be  not to  enjoy one day  the esteem and
admiration of their fellow citizens, or more simply, in order to  pro-
cure themselves, at a period more or  less remote, the means of gra-
tifying 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 follow,  that
in all these cases they  have succeeded in creating for themselves an
intellectual enjoyment, which appears to them a sufficient compen-
sation 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

  * The author, in this and the two following paragraphs, seems to have adopted
the doctrines of Helvetius, rather than exhibited the inferences naturally follow-
ing his admission of the brain being a congeries of organs devoted to the exercise
of the intellectual faculties, the affections, and the propensities. Warriors,
artists, diplomatists and literati, have a direct, immediate pleasure in obeying re-
spectively the impulses of their inherent faculties of love of battle and bloodshed,
of colours and external forms, ambition, and causality, or following out a series
of mathematical inquiries,—all distinct from and independent of any subsequent
conversion of toil, exposure or deprivation  to the purposes of personal aggran-
dizement, or family settlement and emolument. There is no conceivable propor-
tion whatever between the intensity of application of a mathematician, for ex-
ample, and  his ardour for discovery, or love of praise, and eagerness to acquire
renown.  Where vanity or ambition prompts to unusual and continued intellec-
tual exertion without the gift of genius or inherent talents being allowed to the
individual, insanity, not renown, is his reward.  As no man can be reasoned into
ambition who has not this  sentiment by nature, so  neither can a  man acquire
reasoning faculties by any and all of the incentives of ambition. Whoever doubts
this, let him consult the history of genius in all ages; or watch for a single term
the progress of a class of youths at college.—Trans.
                                  16 
122
INTELLECTUAL FACULTIES.
must also be admitted, that the pleasure they experience, either in
thinking they are about making a discovery, or in making it, is the
pivot of, and compensation for, the  pains they take and the priva-
tions 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
man's actions, and sufficiently explain the efforts he makes to resist
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
presented 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 appara-
tus 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  portion
of the animal matter against the other.
   When the centre of perception undertakes this  resistance,  the

  * If sensibility be purely intellectual, it ought not to have been so often asso-
ciated with instinct by the author.  But, not only is it connected with this lat-
ter, but with what may be called automatic impulse.  Suppose an impression
made on a sensitive surface or expansion, in an animal of the most simple nervous
organization; it is transmitted to the origin or root of this nerve, whence ema-
nates, with the promptness of an electric shock, an aurar or influence along an-
other nerve, to some moving portion; as in the case of a worm, which touched
with a pin, will writhe itself under the offending stimulation. Again, while a dog
is looking at me, if I raise the cane in my hand, as if to strike him, the impres-
sion on his sense of sight transmitted to the brain,  calls into action this organ;
and the muscles of the limbs, in obedience  to the instinct of self-preservation,
are in rapid motion for flight.   Finally, suppose a person, walking quietly along,
sees another with uplifted hand ready to  strike him; he raises his own arm in self-
defence, and remonstrates with the assailant for his unprovoked violence.   In all
these three cases we have only one common process, viz. sensation, allied, in the
firsts with mere contractility; in the second, with instinct; and in the third, with
intellect. Sensibility, evidenced as it is by sensation, cannot then with propriety
be called purely intellectual.—Trans. 
INTELLECTUAL FACULTIES.
12rf
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 phe-
nomena 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
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 them.  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, the earth, a field, an edifice, an instrument, the use
of which is  unknown to us, or of a book, a table, a mathematical
proposition,  a hieroglyphick, the characters of an unknown  lan-
guage, the sound of thunder, or 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 interest 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 reflec-
tion will suffice, however, to show, that they are much more exten-
sive than they appear at first sight.   Thus we may conceive in man
the existence of a state,  during  which these impressions will act
powerfully on the viscera; whence the aspect of the sky will ex-
cite emotion in an individual long deprived of it,—after  a tedious
voyage  the  mariner will be rejoiced at  the sight of land,—an un-
known instrument may arouse our curiosity, and produce in us agi-
tation, if we suspect that it can serve for the gratification of a want,
or cause our destruction,—a stone which is about falling may make
us start 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 gives  rise to fear in a timid
person,—a table on which one of our  most urgent wants  is ordi-
narily gratified, will excite in us a return of the sensation of  hun-
ger,—the sound of a torrent grieves the fatigued traveller, who by 
124               INTELLECTUAL FACULTIES.
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 inti-
mately connected with some one of our most urgent wants.  The
sight of a man who gratifies the desire of urinating is very  indif-
ferent  to the  one  whose bladder is  empty; but under other cir-
cumstances, this want, to which  no attention was paid, is keenly
fell.  Hence,  it may be plainly seen, that I could multiply greatly
these  examples, and prove that  the sight  of a hieroglyphick, an
arithmetical rule, and even the characters of an  unknown  tongue,
may be  the  cause of  acute sensations,  referrible to the viscera.
Now, is not the impression in all such cases judged differently from
what it would be were we to experience  nothing in the interior of
our organs?  The  viscera are consequently consulted on those im-
pressions 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, but 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, differ-
ence of sex, &c.   "These impressions are judged of 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 ether effect than  that of ren-
dering  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 
INTELLECTUAL FACULTIES.
125
—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
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 referrible 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 trans-
mitted to the bladder, it must  be  also in the other, and the only
difference will  consist in the manner in which the bladder is modi-
fied by it.   In  both instances, the impression is the same in refer-
ence 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
transmitting the sensation of a want; but I have selected the  blad-
der,  because I  have already spoken of the other internal  senses.
They are always  modified by the ideas which stimulate our brain: 
126
INTELLECTUAL FACULTIES.
 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 sensations relative to nutrition,
 depuration, generation, &c. they still  send  others to it,  during the
 exercise  of the intellectual functions.  It  is under these circum-
 stances that we can appreciate to what degree the exercise of thought
 agitates the whole of the nervous system.   What appears very re-
 markable is,  that all  the viscera do not correspond in an equal de-
 gree with the stimulations of thought.  Every time we are excited
 in discussing a question, even the  most abstract, and consequently
 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 perspiration, 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 latter 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 much quicker,
 self-love more excitable,  and the transports  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, compassion,—sorts of modifica-
 tions of our consciousness, which are equally observed in the exer-
 cise 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, the great, the  regular, the sublime;  of virtue, vice, jus-
 tice, oppression, tyranny, and all the most subtle ideas of compari-
 son between the qualities of bodies,—in a word, all that constitute
 the immeasurable domain of human intellect,  are linked in the most
intimate manner with the nerves of the viscera, and exert an influ-
ence on the organic movements of their different tissues.
  It will perhaps be objected, that these passions are only developed
when the intellectual  operations are exercised with  the  greatest 
INTELLECTUAL FACULTIES.                 127
degree of energy;  and that the viscera, by which they are nourished,
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 undergoes, through the  viscera, these  latter could not respond to
it  and recognise the ideas which may interest  self-preservation or
any other instinctive want. The proof that they participate in these
irritations,  is,  that they are agitated,  and  very actively too, when
the intellectual operations are exercised in even  the calmest man-
ner.   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 experiences pain
in the epigastric region,—his heart is agitated,—his 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 suf-
ficient that he should experience some difficulty in solving his prob-
lem, in order  for him to become irritated, and his self-love to be
revived.   If he  calculate 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 operations?   If they are  ready  to do
so, how could this occur, were they not agitated on the occasion of
the stimulations which the brain receives in the most tranquil exer-
 cise  of thought.
    It is therefore very certain, that  the nervous apparatus, even that
 of the viscera, is modified by  intellectual operations.*  This ques-

   * This remark is worthy of especial attention, since its application so intimately
 concerns the health, and  even comfort of the studious literati, and of all those
 addicted to much and profound meditation. We regret that the author did not
 present the fact with its simplicity of physiological explanation,  divested of me-
 taphysical hypothesis.  There is no necessity for the intervention of the passion
 of self-love to cause a commotion in the viscera, consequent on  the exercise of
 the intellectual faculties.  In admitting the correctness of the language of the
 text, that "all that constitute 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," the explanation is
 most simple and ready.  The anterior portion of the cerebral hemispheres, that
 on which depends the performance of the functions  purely intellectual,  is  in
 these, cases strongly and fixedly excited, and this excitation is transmitted to the
 continuous parts of the encephalic apparatus, and from its basis passes by means
 of the spinal marrow and nerves to the viscera.  It is in this way that prolonged
 thinking and meditation,  however calmly conducted, and free from  every per- 
12S
OF THE PASSIONS.
tion is not purely speculative; so far from it, its solution is indis-
pensably necessary towards forming a correct idea of the relations,
and explaining the 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
intellectual faculties and the passions, and in determining the phy-
siological nature of the latter.

                 Section V.—Of the Passions.

  Potior, I suffer, or more generally, I 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 roused, 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 it sufficient  to say,  that a
man feels, in order for all to comprehend  that his brain  is in a
state of action.  Did  he  only mean,  that  the sensations  which
accompany the passions are felt in the different viscera? If such has
been his purport, I think he is perfectly correct in his  view;  but
it appears to me, that  in asserting that, during the exercise of the
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 opera-
tions.
  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  referrible 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

sonal feeling of self-love or ambition, keeps up an irritation in the digestive and
pulmonary apparatus, which is but a reflection  of the  prior one, or vital erection
in the cerebral organs at the anterior part of the encephalon.—Tra>-s. 
OF THE PASSIONS.
129
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,
without being too much or too little excited;—this constitutes the
natural state  of  our economy.  The  diseased  state, on  the  other
hand, occurs 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 mo-
ral.  Physical causes give rise to  what  are called physical plea-
sures and  pains;  whilst  moral  causes occasion moral pleasures
and  pains.  The latter series are felt by the  same organs as the
pleasures  or  pains  produced by physical  causes; consequently, for
the physiologist, these  feelings  are  all   physical, since  he  can
only perceive in them a modification of the living tissues.  Where-
fore, then, do we  admit moral pleasures and moral  pains?  Be-
cause we have  regard  to  the agent by which  they are  produced.
When  these causes  consist  in  the  exercise  of our intellectual
faculties,—in other words, when a result of thought, we call them
moral; consequently, by moral pleasures  and moral pains, we un-
derstand  a state of contentment or uneasiness, perceived in  the
viscera by the centre of relation,during the exerciseof thought, which,
as we have seen, is always accompanied by a modification of the or-
gan^—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 deposited on our internal surfaces
of relation; and all those bodies which  have occasioned a solution of
continuity in our  tissues, excite  in our organs a state of irritation,
similar to that produced in them by moral causes, and thus give rise
to the perception of physical pleasures and pains, analogous to like
sensations produced by  moral causes.  Let us now see how these
considerations will  lead us to a knowledge of the  affective move-
ments, and of the passions.
                              17 
130                    6F  TnE  PASSIONS.
   We are fond of the causes of our pleasures, and we hate those 01
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 instru-
ments by  which we have been wounded,  a sentiment of aversion;
and  for the  aliments or odours which have been agreeable to our
senses, 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, aversion, or disgust;
but these causes, or, in other words, the individuals from whom we
derive pleasure or pain, are sometimes the object of a violent pas-
sion, 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 them, and under  such circumstances,  our
dislike or our fondness,—our hatred  or  our  love,  are often di-
rected towards the individuals by whom we are surrounded,  as if
they were the moral causes of our pleasures or of our sufferings.
Moreover, although we may be apprised of the physical 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 ob-
jects of the  one or other of these passions, the individuals with
whom we have been, or still are, in habits of intercourse.*
   Consequently, our affective movements, and  our passions, which

  * There is abundant matter, in these two last sentences, to furnish text for a
volume of ethical commentaries.  The author, whatever time shall prove to be
the extent of his merits in other questions of physiology and medicine, deserves
the gratitude of his fellow men, for presenting in such a variety of points of view,
and in such strong colours, the modifications imprinted on the mind by the con-
dition of the viscera.  The impressions produced on the surfaces of relation, and
the sensations and thoughts ensuing therefrom, will give but a very imperfect
measure of the state of the mind, if we are ignorant of the irritations affecting it
from the body generally.  Charity then receives, in a knowledge of  the many
internal causes of irritability, an additional motive  for making large allowances
for transient petulance, inconsistency, and angry resolve.  Morals can never be
efficiently taught without a full knowledge of the agents of hygeine, and of all the
stimulations emanating from the viscera and received by the brain.—Trans. 
OF THE PASSIONS.                    131
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 move-
ments 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,  moreover, results, that these  states of feeling 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 series of ideas be
changed,  by means of new impressions, when the affective move-
ments 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 these states;  and, on  the other hand, when both
these are the effect of the irritation of the viscera, produced even by a
physical cause, if this be removed, it will no longer direct the thoughts
towards the series of ideas which contribute to keep up the affective
movements, or the passions.   It is easy to conceive, however, that
Such cures cannot take place, if, in consequence of its intensity, or
its  continuance, the physical irritation which  maintains the exist-
ence  of the  passions, has  destroyed for ever the  healthy organiza-
tion 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 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

  * The term passion has been, as we think, very appropriately restricted by the
phrenological school, to express the exalted or morbid action of a propensity
or sentiment. It does not properly indicate an innate quality of mind, but merely
an occasional mode or manner of its manifestation.  Thus  self-love is  an innate
sentiment, which within proper bounds gives dignity to its possessor. But when
acquiring more energy and indulged in all its impulses, it degenerates into the
passion of pride and becomes imperious and repulsive. So of courage, firmness.,
hope, cautiousness, &c.—Trans. 
132                      OF THE  PASSIONS.
 nature; since their seat is the same, and  they are 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.
   The first of the passions,—that from which all the others emanate,
 is self-love.   It is founded on the instinct of  self-preservation, and
 on that of the propagation of the species;  for both are blended to-
 gether; 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 prospect  of again expe-
 riencing it, is loved;—all that produces the contrary  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 re-
 marking,  that when we think we are the objects of our hatred, we
 still love ourselves.   It has been asserted  that this explanation de-
 stroys every principle of morality; but  than this, nothing is more
 false.  Of what  import, is it, when we do a meritorious action, whe-
 ther it be or  not on our own account?* Is it  the less useful to so-

  * This is not perhaps either the most prudent or the most philosophical man-
 ner of  presenting the question.   To say " that whatever contributes to the wel-
 fare of individuals, contributes, in like manner, to that of the whole species," is
 a proposition demanding large reservations and  a somewhat elaborate explana-
 tion. It would be safer for us to invert the maxim,  and to advance that whatever
 contributes to the happiness of the  whole species, contributes generally to the
 welfare of individuals. We say generally; for at times a sacrifice  of the individual
 seems to be required  for  the good of society, and that without any crime or
 notable misdemeanour on his part.   The moral harmony is  thereby cherished
just as  the harmony of creation is sustained by occasional destruction. But con-
 ceding that individual gives social happiness, we are always forced to admit that
 a person in quest of this blessing cannot hope to attain it, unless he act on data,
 derived not merely from his own first instinctive wants or the suggestions of self-
 love and vanity, but also from the other innate faculties and external circumstances
 creating and sustaining his intercourse with his fellow creatures and society at large.
 All of a man's actions are m one sense resolvable into self or personal gratification,
 since all are the result of feelings and motives personal to and inherent in him. But
 these feelings and motives are various, often balancing, if not  conflicting with
 eacli other, and susceptible of being modified in a most opposite manner  by
 foreign or external agencies. Hence, we cannot agree with the author that self-
 love is the first of the passions, that from which all the others emanate.  Helvetius,
 in his work De I'Esprit, while adopting this principle, and endeavouring to show
 its applicability and correctness,  has, we think, carried it, very unintentionally
 of course, and with great gravity, ad absurdum.—Trans 
OF THE PASSIONS.
133
   ciety? We must not indeed apprise all men of the secret motives of
   their actions, because  some false and vicious minds would draw
,   deductions from them unfavourable to social order. But it becomes
   the duty of legislators, who are aware of this motive, to place
   n^an in such circumstances, that it shall produce all that is good and
   useful to mankind; for they must be aware that whatever contributes
   to  the welfare of individuals, contributes, in like manner, to that of
   the whole species.  Let them create such motives of action as will
   prove of general utility, and let them do so either by means of their
   laws, or of habits  which men shall contract from the earliest periods
   of  life, and which will become the foundation 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  phi-
   losophers all profound discussions on the subject, and  content  my-
   self with considering the passions in their relation with the organs,
   the functions  of which  they may, more or less,  contribute to de-
   range.
     Our passions are, as we have just seen,  susceptible of a  grand
   division.  Some are founded on pleasure,—others on pain; but as
   pleasure and pain  may succeed to each  other in the same passion,
   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 may be its effects on  the system, I cannot view it,
   properly speaking,  as a passion.   The words contentment, satis-
   faction, happiness,  only  express modifications of joy, or  of  that
   sensation of well-being, which accompanies  all the passions founded
   on pleasure.  However this may be, joy, contentment, satisfaction,
   happiness, all  are founded on agreeable sensations which we per-
   ceive  in the  viscera, and  which can only be  felt when the latter
   are not 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, 
134
OF THE PASSIONS.
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 but
one single object,—when its image every where pursues, and un-
ceasingly  haunts him,—when grief, anger, and jealousy,  are easily
elicited, 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 originating in the want
of a pleasure,  becomes compound or mixed, whenever it attains a
certain  degree of intensity;  because the agreeable sensation, in
which it is founded and nourished,  is  interrupted by painful  pas-
sions.
  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 for  sustaining it, reside in the thoracic and abdominal viscera;
hence the expression of paternal or maternal breast.  The different
seats of this passion may be demonstrated in a similar manner as in
those of the preceding one; and  in attempting this we shall show, that,
like love,  it is 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 be-
comes  conspicuous in animals, since  by calming  the organic action
in the abdomen 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 be-
come unconcerned about her young.   As soon as a cat, which mani-
rested the warmest affection for her  kittens,  experiences  the desire 
OF  THE  PASSIONS.
135
of rutting, the condition of her viscera changes; the vital action is
diverted, by the turgescence of the genital organs, from the diges-
tive viscera and lacteal glands; her kittens become troublesome to
her, and are driven away.   In animals,  love  for the young has
always a natural 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 ele-
ments: 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 irritation in the breast, and  in the digestive
organs;—the second  element, 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; but when they become strong, these sensations disappear.
In  what portion of the body does the  brain  of all these animals
feel such  sensations?   Judging from our  own species, and by in-
duction from those animals that suckle their young, I should be led
to admit^ihat it is always in the other viscera, and particularly in
those situated  in the abdomen.  It will,  perhaps, be  asked,  how
these instinctive sensations can take place?  To this I will answer,
that they are not  more difficult to conceive than all the others
which I have enumerated above; and I will add, that they are pre-
cisely of the same nature.   It is the will of the Creator, and the
sensations transmitted 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 im-
perious and lasting of the passions;  and this sort of demonstration
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 
136
OF THE PASSIONS.
 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 endow-
 ed with intellectual faculties, must have the same causes for loving
 their children when they have attained the age  of reason and ma-
 turity, as  those which increase and justify the tenderness her hus-
 band extends towards them. All I mean is, that woman is by  nature
 more impelled than man, to cherish the fruit of her love. Doubtless,
 also, the trouble, and the cares  her children have cost her,  contri-
 bute greatly  to increase her affection for them; for it is a fact, which
 cannot 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
 to our species those passions, which of all others afford us tie sweet-
 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.  The  passion is
 allied, therefore, at this period, to all the attachments  which 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 weakness.  It is upon similar motives that
 the bonds  of friendship are founded; for it  is always the moral
 pleasure resulting from our intercourse with another individual__
 the services we may obtain from him, or those we have rendered to
 him, and which flatter us with a return founded on gratitude, that 
OF THE PASSIONS.
137
 attach  us to  our friend.   We experience, it is  true,  at  first
 sight, an inclination, or, as commonly  expressed, a sympathetic
 feeling for certain individuals; but this sympathy, which is purely
 instinctive, is  only changed into friendship in consequence of our
 intercourse with them, whereby we discover 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 referrible 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
 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 refuse  to admit, that the brain is  not always free in the ex-
 ercise 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  self, which are very
 analogous to each other; they are both founded on the pleasure we
 experience in comparing ourselves with  others;  because this com-
 parison furnishes us with motives  for increasing our self-esteem.
 We then enjoy greatly our existence, and gradually accustom our-
 selves to find out opportunities for repeating this comparison: finally,
 this enjoyment is converted into a passion; since we  become irri-
 tated against every obstacle by which  we are  prevented from en-
joying it, and we hate every individual from whom we meet with
 opposition.   Pride differs from vanity in  its being founded  on mo-
 tives 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
                              18 
US
OF THE PASSIONS.
 its motives, is nourished by trivial things, and consequently 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  female sex:
 both passions are the effects of civilization.  The pleasurable sensa-
 tion which nourishes them, does  not at first appear to have a well
 defined seat in the viscera; but when it becomes  exalted, it is dis-
 tinctly felt at the epigastrium;—the heart seems to be enlarged,—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 increase; and
 finally disappear, together  with all the others, when we foresee the
 approaching  termination of  our existence.  In  these last  cases,
 pride sometimes degenerates into vanity; hence this passion is very
 often the portion of old age, and constitutes the principal moral en-
 joyment 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 found-
 ed on good motives, is nevertheless, a very fine and elevated feel- 
OF THE PASSION?.
139
ing.  Emulation is nothing more than this same desire of obtaining
an  enjoyment by  comparing  ourselves with our fellow beings.
Ambition, and the immoderate desire of grandeur and riches, which
must not be confounded with avarice,—since opulence is sought
after merely for the purpose of ostentation,—appear to me to be
founded on sensations of pleasure analogous 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 comparison.
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 senti-
ment 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 agree-
able so long as  no obstacle is offered to their enjoyment.   Is the
feeling of self-love peculiar to the human species?  However this
may be, it is very certain, that  we notice in many animals actions
which naturally  lead us to think they are susceptible of emulation.
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 courage, in
the same manner as man; and in the midst of his humiliation,  does
not even display the efforts he might have done had he not attempt-
ed to contend with a competitor.   Is it a motive of self-love analo-
gous to that of our species, which  serves as the exciting  cause in
these animals? Is it not rather the simple and powerful law of imi-
tation, 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 hesi-
tate 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 distinc-
tive mark of the human species. If we concede self-love to animals. 
140
OF THE PASSIONS.
 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 in-
 stinctive 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 modifica-
 tions 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 self-love are unknown to men
 who live  in a savage  state, and who even have  not, in their rude
 language, expressions capable of conveying the least idea of these
 sentiments.   Should  any one entertain doubts on this subject, let
 him consult the writings of travellers, and more particularly a work
 entitled Recherches Philosophiques sur POrigine 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
 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 allied to
 our own.   It is manifested by a fondness for play, for leaping, and
 even for violent exercises,  without  any very evident motives, and
 from the most trivial  causes.  It is owing to this propensity, that a
 kitten makes us admire its dexterity, its suppleness,  and the grace-
 fulness with which it  amuses itself with objects susceptible of a cer-
 tain degree of motion.  We discover in it that instinct which will
 lead it in  future to spring on the prey it is watching,  so soon as this
 latter makes the least movement with a view to escape. The want
 of muscular exercise is not less evident in children; it is founded on
 the pleasure they experience in exercising  their growing strength;
 it becomes converted  into a true passion; since the prospect of  en-
joying 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 
OF THE PASSIONS.                   141
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 exist-
ence.
   Such are, in  my opinion, the principal passions founded on  a
sensation 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 apparatus. 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
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 
142                   OF THE  PASSIONS.
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, so
soon as you shall have civilized these barbarians, and they  cease to
regard ferocity and unmercifulness  as honourable,  they will yield
to the example offered by those among them who possess  this vir-
tue, and the acts founded  on it will become  as  frequent as they
were before  of rare  occurrence.   I have  already said, that great
public calamities, such as famine, the privation of all habitual enjoy-
ments, 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  actions, is really na-
tural to man.
  I moreover said, that they depended on the  exercise  and de-
velopment of that portion  of the encephalon 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,

  * In looking around on our fellow creatures, and observing in many of them
the warm, prompt, and spontaneous impulse to deeds of benevolence  and gene-
rosity, without any hope of personal benefit and return, either immediate or
prospective, we are forced to believe in the innate nature of these sentiment*;. 
OF THE  PASSIONS.
143
 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  imitating
 those of instinct.   In other words, the visceral  sensations, the  pri-
 mary object of which consists in soliciting the gratifications of phy-
 sical wants, may become so perverted, through the influence of the
 brain during the exercise of thought, as to induce us to sacrifice the
 pleasure 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 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 the passions  founded on pleasure, we must
 next occupy ourselves with such as originate from pain.   We must
 repeat  here, however, that any obstacle to the pleasure which
 nourishes the passions we have just noticed, developes in  us painful
 sensations.  Hence, the passions founded on  pleasure  are rarely
 pure throughout the whole period of their duration;  the pain which
 so often interrupts their enjoyment, rendering them almost always
 mixed, and leading us sometimes to select other expressions to de-
 signate them.   It is thus that love,  when it meets, in a  rival, an
 obstacle to its enjoyments, assumes the name of jealousy.  Love

 While we admit that their manifestation depends on the encephalon, we cannot,
 however, agree with the author in saying that they are dependent on that portion
 of the encephalic apparatus destined to intellectual operations.  If this were the
 case, the energy and cultivation of the intellect ought to give the measure of be-
 nevolence and charity, which we know they do not.  A Howard, and a Vincent
 St. Paul, were not distinguished among their contemporaries for unusual com-
pass of thought, and depth of research; nay, some of the most benevolent of men
are remarkable  for their very restricted intellect.   We would say then, on the
 strength of general reasoning and positive demonstration, that the sentiment of
 benevolence is inherent, and we may add instinctive,  and depends for its mani-
festation on the development and exercise of a particular part of the cerebrum,
different and distinct however, from that other portion which gives the faculties
of intellect, such as of phenomena, comparison, causality, mathematics, painting,
sculpture, and the like.—Trans. 
J 44
OF THE PASSIONS.
 has many more causes of pain; they are, indeed, so multiplied, that
 it is sufficient to say of an individual, that he  is transported 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 fre-
 quently interrupted by pain.   Thus, the more  anxious we  are  to
 enjoy, the clearer we perceive the obstacles which threaten to in-
 terrupt our pleasures,  and  the more susceptible we are of expe-
 riencing pain on this  occasion.  It is in  this way, that the  enjoy-
 ments 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 sensa-
 tions, which transform them into mixed passions.
  The pain may be felt, although  we are not conscious of the plea-
 sure; 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.  In-
 deed, the passions founded on painful sensations, attain the degree
 in which we notice them, only because those who experience them
 have  felt  pleasure.   It is the regret for  the  privation of pleasure
 produced  by  the causes of  painful sensations,  which revolts us
 against these latter.   Were  he deprived of this comparison, 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 without regard to the cause; but his
 anger would be of short duration, and would not amount to a pas-
sion ; because, under such circumstances, he would only experience
the physical pain;  or  rather  he would not exercise his intellect in
the comparison of  the present pain with the past pleasure,—in the
prospect of future pain, and of the privation of future 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 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 
OF THE PASSIONS.                    145
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 intensity,—but  only
assuming the name of passions  when they become persisting and
chronic.   Having established this point, I now proceed to a consi-
deration  of the painful passions.
   Grief is a painful condition of self, attendant on all kinds of suf-
ferings, produced  either by physical or  moral causes;  it is, there-
fore, in reference  to the passions 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 chro-
nicity of grief.  We experience momentary grief; but sadness im-
plies an habitual state of suffering, nourished by reflection. Sadness
is therefore a passion.  It may cease with the causes that have pro-
duced it; but, when  they are persevering  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 accomplish-
ment of one object,—that of prolonging 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 the viscera, and  on the other in the brain.   The nerves,  both
cerebral  and ganglionic, are the intermediate agents.   In the pas-
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

  * 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,
itself, an actual pain.  This sadness is therefore mixed.
                               19 
146                    OF THE PASSIONS,
 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 disease
 is cured.   If  we remove melancholy thoughts, when  they consti-
 tute the sole cause of sadness, the gastritis will disappear, provided
 it has not attained the degree  of 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 parenchymse 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  natural  cause  of sadness.  Yet, it must be confessed,
 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 is diminish-
 ed to such  an extent, as no longer to occasion a degree of pain suffi-
 cient to compel  our  intellect to be occupied with  melancholy
thoughts.
  When sadness is the consequence of these chronic inflammations,
it still depends on the  brain, or rather  on the  intellect; that is to
say,  on the fear  they inspire in the patient, which  is the effect  of
his sensibility, and of the cultivation of his mind; but if we succeed 
OF THE PASSIONS.
147
in encouraging him, his melancholy will subside; whereas it is not
in our power to make it cease, by the same means, when it depends
on a well marked  gastritis, or on an aSute  phlogosis of the paren-
chymae, and  of the serous membranes.   This may  be  further
proved by the fact, that if you stimulate gently, by means of good
wine, the healthy stomach of an individual labouring under chronic
inflammation of the serous  or parenchymatous structures, his  sad-
ness 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  complaint,  but  I  would reply,
that these substances only produce  this effect when the greater por-
tion of the stomach is  not implicated in the disease, and when the
disordered part is neither very extensive 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 the
principal physical  support 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 as its com-
mon effect to chronic gastritis; whereas, it only occasions the other
phlegmasia? when it is carried to that degree  of intensity  which re-
sembles 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  privilege,

   * A most important truth this, which can never  be sufficiently inculcated on
the minds of physicians, and through them on every member of the community.
How many mournful examples have we  not,  of utter depravity in persons la-
bouring under the stimulation  of alcoholic, vinous,  or opiate  potations, who
sought to find in  them a solace  from cares; but who, on the contrary, were
plunged into darker gloom,  and  impelled to raise their hands to suicide and
murder.  Ignorance of pathology, always mischievous, has led to the most per-
nicious consequences in the treatment of depression of spirits and melancholy.
The associated irritations of the brain and gastric surface, which might have been
removed by simple diet and a moderate exercise, (in the way of revulsion,) of the
other senses, and of the respiratory and  locomotive apparatus, as by change of
scene, pure air, riding, or walking, are converted into incurable hypochondriasis,
or monomania, by the prodigal use of stimuli, tonics, and the like.—Trans. 
14S                    OF THE PASSIONS.
unless as general causes of grief, of exciting a state of sadness;  but
even then they only produce it in certain  individuals; whilst gas-
tritis gives rise to it indiscriminately in all, whatever be their cha-
racter, their fortune, and the moral  circumstances in the midst of
which they may be placed.  It must be  confessed, however, that
all inflammations being susceptible of a repetition in the stomach,
may become organic causes of sadness; but in these cases 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 elucidation  of our
proofs of the necessity of the concurrent action of the viscera and
brain, in  the  production  and maintenance of sadness.   They are
not,  therefore, foreign to our purpose, and  still less misplaced anti-
cipations 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
remedy 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 influence on
the brain,  capable of forcing it to react powerfully upon the nervous
apparatus of relation.   This doubtless is their most ordinary effect,
when they have not attained their greatest possible  degree of in-
tensity; for  when this  occurs, we once more observe immobility,
but attended with very different modifications of  the  organization.
All this deserves to be explained.  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- 
OF THE PASSIONS.
149
 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 intensity, the blood is precipitated with violence
 to the encephalon  and other viscera;—the face becomes pale,  the
 skin cold, and the muscles are agitated with convulsive movements.
 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 as-
 sumes a higher degree of temperature  and  redness; the muscles
 swell,  and  acquire a tenfold degree of strength;—the patient  vo-
 ciferates, gesticulates, 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 circum-
 stances he becomes allied to the most ferocious animal,—he  is ma-
 niacal and crazy,—ira furor brevis.
   Anger may depend on  a physical  cause; under these circum-
 stances, 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 occurring

  * 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
 eiTor.  Numerous proofs of this may be found in the .dnnales.   Besides, these
 cases of arachnitis are themselves in general nothing more than the sympathetic
irritation of the brain, carried to the degree of suppurative inflammation, &c. 
150
OF THE PASSIONS.
 in nervous subjects, with predominance of irritation in the superior
 portion of the digestive canal.  The patient experiences hallucina-
 tions,—he sees objects which irritate, frighten, or gladden  him.
 If,  under these circumstances, we  calm  the gastric  irritation by
 means of a local bleeding, before the brain has had time to become
 altered, these images will  disappear, and together with them the
 movements of anger, &c. which were their effect.  If, on the con-
 trary, we reproduce this irritation, by means of stimulating drinks,
 they will return.   In cases of poisoning with certain narcotics in-
 troduced into the stomach, such as alcohol,  opium, &c. we notice
 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 de-
 gree, anger and fury capable of leading to the most atrocious con-
 duct.  It is well known, that several of the  oriental nations, when
 under the excitement of opium, rush like maniacs on the swords of
 their enemies, and  there perish, or abandon themselves, after their
victory, to the most ferocious acts,—the natural effects.of the anger
 and factitious excitement produced with a view of inspiring them-
 selves 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 secondarily in-
 flamed, 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
reverse 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-

  * Medical wranglers will affect to smile, and allege, that every man who  is
angry is not affected with gastritis.  We know this; but we also know that indivi-
duals are often long thought to enjoy good health, whilst suffering habitually from
gastric inflammation: and that even under these circumstances they may become
extraordinarily fat. 
OF THE PASSIONS.                    151
phragmatic  region,  impetuous movements,  which  appear t<» be
directed  towards the locomotive apparatus,  as  if with a view of
calling it into  action; or rather the perception of these organic
movements, which constitute real pains,  tend to reproduce the agi-
tation of the paroxysm;—anger is then chronic.  Very often man
resists to a certain degree, and his anger may be in part  concen-
trated, and in part exhaled;  but, with a little attention, it will be
constantly found, that the sensations he experiences tend to seduce
self by leading 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 epigas-
tric 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 loco-
motive organs.  We shall examine, at a later period, the pathologi-
cal effects of this frightful perturbation.
   If anger be more concentrated, it is because the percipient centre
refuses to radiate stimulation on the locomotive apparatus: in such
cases the viscera alone  suffer, and always by the accumulation  of
blood contained in their tissues, arising from the circumstance, that
the muscles do not tend to attract it towards them, and thus to pro-
duce a revulsion.  Nevertheless, there is here a certain degree of
compensation; for the  immobility of the chest not occurring, the
blood does not experience so great an  obstacle in traversing 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 aot the less act than as if real, 
152
OF THE PASSIONS.
 upon the organs. Such, for example, are those who figure to them-
 selves they perceive an enemy who threatens, or imagine they hear
 a voice that provokes them.
   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 hallucina-
 tion; and as  I think myself  as much justified in treating of this
 physiological 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 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 absent,—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 halluci-
 nations;  in other words, the  centre of perception, accustomed  to
 associate the image of the foreign agent with the stimulation, will
 continue to produce this association when it will receive the percep-
 tion 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 hallucina-
 tions can only occur during sleep;  as the delirium of acute inflam-
 mation shows sufficiently well, that individuals may see imaginary
 objects although wide awake, and answer 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 indivi-
duals who are awake depenV on a pathological  state of the brain. 
OF THE PASSIONS.
153
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.   Such
influence is satisfactorily shown in those cases of delirium already
cited, 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
thought; 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 thus made sensible  on  it,  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 present
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
                             20 
154
OF THE PASSIONS.
 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-
 vening.  In vain shall I be accused  of prepossession on this  sub-
 ject ;  I 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, 1 could
 conceive  nothing in  physiology;  but time will clear up this ques-
 tion 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 referring 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 which
 are distributed 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 ques-
 tion before 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.
   I 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. 
OF THE PASSIONS.                    155
  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
experiencing it, the exercise of the intellectual faculties, whatever
these may be; but the organic sensations and movements by which
it is manifested, take place in the viscera, and sometimes in the whole
nervous apparatus. The different shades of fear are very numerous;
we first notice the sudden contraction of the diaphragm, which pro-
duces an involuntary inspiration; but the expiration is incomplete—
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  covered  with aspe-
rities—the hair which traverses it stands on end—cold is felt at first
over the whole surface, producing a chill, and occasionally it pene-
trates so deeply as to affect the muscles and cause a trembling.
  This passion shows itself in the  countenance in a peculiar manner
—many of the secretions are altered—cold sweat sometimes super-
venes—tears are shed in this passion as in grief, of which in fact it
constitutes a variety.   The  urine and excrements are sometimes
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 of
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 operate.   If the centre of perception be too intensely
occupied by it, and if the will cannot execute its purposes, all  loco-
motive 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— 
156
OF THE TASSIONS.
the individual falls into a state of syncope, and may even lose his
life; but if the influx of blood to the  brain, lungs, and  muscles, be
simply diminished, there results only weakness, paleness, a univer-
sal coldness, and the convulsive shivering of  which I have already
spoken.
  Such is fear, so long as it is a depressing passion: we readily per-
ceive, that it must be referred to grief  in general or to moral pain,
of which it constitutes, however, a peculiar shade.   It is also con-
founded, in certain subjects, with the first degree of violent anger;
for it often happens, that in imminent peril,  fear is first experienced;
but self-love soon 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 en-
ergy of muscular  action;  consequently,  it  can only take place
in those cases in which fear  has  not attained that high  degree of
intensity, 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,
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,
so that interposed with the first, shall  sometimes be the reaction
produced by anger, at  others the  internal movements which tend
to induce flight, we discover a considerable number of mixed pas-
sions, 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 physiological 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 ob-
jects of nature, and particularly with other men, are peculiar to our
species.
  Love and hatred necessarily constitute the  basis of  all our pas-

  * 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 fascination.  Vid. supra,  p. 104-5. 
OF THE PASSIONS.                     157
sions.   Pleasure is associated  with love, and pain with hatred.
Pleasure, which is the same as joy,* produces transports that are
manifested  by  acceleration  of the circulation,—redness of the
skin,—vital  erection of the whole periphery,—aptitude to  mus-
cular movements,—forgetfulness of some wants, and  particularly
of those  of  nutrition.   If,  under these circumstances, an indivi-
dual 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 passion,
and anger soon  acquires an extraordinary degree of energy.   It is
in this way,  that the pleasure resulting from an advantageous  com-
parison of ourselves with another individual, during the transports
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, re-
ferred 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,—with-
out speaking of the sometimes permanent congestions 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 give  rise to a secondary anger,—such as the
transports of despair, which may  occasion all the organic derange-
ments produced by the other kinds of anger, cause  flight, or be

  * It might be objected, that some pleasures are attended with remorse, and
consequently not with joy.  To this I answer, that in such cases there is an alter-
nation 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 me-
lancholy, 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 ob-
jection when I point out the different objects of hatred. 
158
OF THE PASSIONS.
changed into melancholy:—when this occurs, this new modification
produces 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 apparatus.
  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 ecstacy?  Is it  glory?   Whatever may be  the subject of
this latter, (and 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 allude to the transports ex-
perienced when  we escape from an imminent peril? If we except all
that is referrible 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  referrible 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
i passion in which there enters moral considerations,—or in  other 
OF THE PASSIONS.
159
words, into a true passion,  such as  it must be in order to govern
imperiously our intellect, you will not succeed without introducing
into it enjoyments of comparison. Now, when ever 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 which have no moral feeling, are,
nevertheless, susceptible of  the  most terrible paroxysms of anger,
when disturbed in their venereal pleasures.  This doubtless 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  is, that the  instinctive movement disappears
with  the  want; whereas, in  our species,  the  passion, nourished
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; and yet 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 dis-
played with so  much violence and tenacity against whatever is capa-
ble of troubling the sublime enjoyments of enthusiasts of all sorts?
Hence, no passion has caused the flow of so much blood as fanati-
cism, which might  be defined the pre-eminent abuse of the intel-
lectual 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 that  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  pas-
sions, or  else to some of the affective movements, I  have just enu-
merated.
  In  horror, which must be referred to fear, of which it constitutes
a very peculiar modification, we experience a sensation of coldness,
extending over the whole surface of the skin, and the hair stands on 
160
OF THE PASSIONS.
end in a very astonishing manner.  In some instances this organic
movement appears simple, as,  for example, when  we  discover
something hideous that displeases us, without, however, occasioning
a strong feeling of terror.  But the  reluctance we experience 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 thim-
ble, without experiencing convulsive agitations, and without jump-
ing and screaming.   We know that the rubbing of two dry bodies,
-—the sounds of a file, or of the harmonica fatigue to a most dis-
tressing 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 passion  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 entertain disgust is in
their mouth or stomach, in order that  this latter viscus should con-
tract with violence, and eject even blood.   Although 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 imparting 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 
OF THE PASSIONS.
161
 from the surface of the body, and is so often superadded to cerebral
 irritations, 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, and by habits of social relations;  but in some in-
 stances 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
pleasures 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
                              21 
162
OF THE PASSIONS.
interior as on the exterior  of the  body.  I allude to the move-
ments producing tears.   We weep from various  motives;—some-
times tears result from the regret we feel for the loss of an indivi-
dual we cherished;—at other times they are occasioned by the dis-
tress and abandonment in which we are left by others.  The sight
of an unfortunate being,—the physical or moral picture of his dis-
tresses,—the idea that we might have  been the cause of these latter,
—the fear of torments, of death, of ignominy, of the humiliations
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 beloved ob-
ject,—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 coun-
terbalanced 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 series  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, impedes the movements of the
diaphragm, and thus causes a true dyspnoea.  This kind of con-
striction, 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 vio-
lent manner, the depression of the diaphragm and the elevation of
the ribs;—this gives  rise  to convulsive inspirations, denominated
sobbings.  During  this  time, the  constriction,  following  the
course of the oesophagus, rises towards  the pharynx;  nor is this
imaginary;—it  is in fact so real, that  deglutition becomes im-
practicable; 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 
OF THE PASSIONS.                    163
as that of the trachea, are dry and of a burning heat, which causes
the 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 constriction
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  flow is fairly  established, 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 dan-
gerous, as in other  individuals.  There are, indeed, a few who pos-
sess the weeping  faculty to such a degree, that the least pain, either
physical or moral, occasions the  flow of tears.  These persons ac-
quire by practice such a command over their lachrymal  glands,  as
to increase at will the secretion of these organs, by figuring to them-
selves, as we notice in  actors, griefs and pains they are far  from
really experiencing. However this may be in a correct physiological
point of view, we cannot help regarding the discharge of tears, when
not the result 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 
164                    OF THE  PASSIONs.
direction the reverse of that which the visceral movements to which
it has given rise,  tend to  impart to them.   It  might, indeed, be
thought, that these latter act on the muscles independently of the
brain.   We shall examine, in another  place, this question, the so-
lution of which constitutes one of the most delicate points of human
physiology.
  In pointing out the mixed passions, I have not,  perhaps, suffi-
cieritly 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, I can discover only two things of any
importance to the medical physiologist;—the sudden transition 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 pleasure  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 ob-
ject which gives rise to it;  and likewise if we recollect, that to fear
is to suffer actually from the anticipation of misfortune, and conse-
quently to hate either the object that is to cause this misfortune, 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 experiences it.
   I have already said, that both love and hatred were felt, in a vio-
lent manner, solely for our fellow creatures,—that these passions
were not at all directed 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 sensa-
tion 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 con-
tinue 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 ourselves.
   If we now examine what takes  place in  our organs,  when pain 
OF THE PASSIONS.                    165
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  circulating
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 from the suffer-
ing viscera;  and reciprocally, whenever pleasure is developed with
sudden energy, in an individual in whose viscera pain has concen-
trated  the nervous influence and the fluids, the expansion, towards
the rest of the organs, takes place with so much rapidity, that these
latter,  and the viscera themselves, experience very violent commo-
tions.   Hence, 1. In pain there  is concentration of action,  sensi-
bility, and fluids, in the viscera, with partial and impetuous irradia-
tions to the other tissues.   2. In  pleasure  there is a universal ex-
pansion of action, sensibility, and fluids, on all the tissues,—without
excepting the viscera themselves.  Such are the principal pheno-
mena  resulting from the alternations we are examining.   It is pro-
per, moreover, to  bear in mind the expansion occasioned by  anger,
and which  sometimes attains a much greater height than that pro-
duced  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 result-
ing from  it arises constantly from pleasure, when it becomes suffi-
ciently powerful to produce a general expansion.  We shall soon
examine the  pathological  consequences of these  contrary alterna-
tions;  when they succeed each other rapidly and frequently their
effects are terrible. 
L6G
                       CHAPTER VIII.

               OF 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 subject which  before  occupied us, we burst out a
 laughing, provided the new idea has nothing painful in it.   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 sud-
 den and  convulsive  movements of  expiration.  This mechanism
 depends, therefore, on the abdominal muscles; and, as the latter are
 supplied  with  nerves from the great sympathetic, I believe, that,  in
 a majority of  instances,  laughter is executed in consequence of a
 visceral influence. 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 laughter  appears to act directly on the muscles which exe-
 cute 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 tick-
 ling of the sides,  of the soles of the feet, in the irritation  of the vis-
 cera from  inflammation, &c. there is always a perception in the
 centre of relation, 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 pur-
pose, in order  to show the danger of these kinds of convulsions, to 
LAUGHTER.
167
direct attention to the contraction of the abdominal muscles; which,
when intense and continual, offers an obstacle to the dilatation of
the chest, and consequently to inspiration.  As regards the contrac-
tions of the muscles of the face which draw outwardly the angles
of the mouth, and enlarge this cavity, they depend upon the same
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.  It is, in fact,
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 accompany
it,  did not exist? Could  the brain laugh alone?  Certainly not;
any more than the other affections could exist, if the modifications
of the viscera, which render them evident, did not take place.  But
I have not exhausted this subject, and will recur to it.  Laughter
precipitates nervous action in  all  the senses, and in  all the muscles,
-—it accelerates the circulation, promotes perspiration, and, in gene-
ral, 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, when founded on plea-
 sure.—can, if in a moderate degree, excite a smile; for, in their great-
 est intensity, these modifications of self assume a serious nature,  as
 may be exemplified by love,  the most cheerful  of  all the passions.
 but which, in its most violent transports, ceases to be joyous.   At
 any rate, laughter has this in  common with smiling,  that like the
 latter, it implies an agreeable state of the mind.   Hence, the cheer-
 ful 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 in-
 dividual  may smile at will, and without any cause for joy.
    Fits of laughter are likewise simulated, and we may, to a certain 
168
ennui.
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
countenance, it is always, in my  opinion, the result of an idea pro-
ducing 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 characteristics cannot be
completely established.  Hence, the smile of those who are in this
condition has something sinister, which  distinguishes  it from that
produced by a continual state of joy and happiness.
  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 in-
fluence 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 exciting in
us a state of cheerfulness, melancholy, or fury; and the movements
which such modifications of the  mind produce, are sometimes ex-
cited  by  causes acting primarily on 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 comparison of  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 would
have  been applied very improperly;  or if we were to retain it, we
ought of necessity to admit, that this condition does not depend on
the same cause as in the human subject.  An animal languishes be-
cause it is deprived of the  stimuli which its instinct requires; this
state  is produced by the defect of nourishment, or exercise, or of an 
ENNUI.
169
habitual companion, of its female or male respectively, its young,
&c  The same species of languor is also  met with in man; but the
latter is subject to another kind of  sadness,  which  does not  arise
from such a cause, but merely from a deficient moral excitement;
and it is this which constitutes true ennui.
   In  my opinion,  ennui depends  on  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 approximate 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 ex-
citement cease to act, they begin to be weary.  We must, however,
establish  a  distinction between these individuals.  Those whose
memory is strong and well stored, from having read, seen, and ob-
served a great deal, find within themselves sufficient  motives for
occupation,  because  they exercise themselves in recalling to their
minds past ideas, and in comparing them with those suggested by
present objects.  Hence, learned men, and those accustomed to ob-
serve  and compare themselves with the various objects in nature,
are but rarely tormented with ennui; whereas, individuals destitute
of memory, or of a large share of reflecting faculties, and who are
only accustomed to the moral enjoyments they derive from con-
versation, reading,  and  sports, are ever unable  to please them-
selves, or to resist ennui.  It is in subjects of  this  description, that
 this state of things  becomes a real torment.   Whatever,  indeed,
 may be the extent of our  moral  means,  if  we are deprived  of
 things which we passionately desire, we are exposed to suffer from
ennui; because, the imagination being obstinately fixed on one ob-
ject, we rejeet every idea that could divert our  attention and pre-
serve 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
 attention towards subjects that displease  them, and to trivial  ideas;
 or who express in an insipid  and common  manner, ideas already
 familiar to them, and which they have before examined in a more
 extended and interesting  point  of view.  We are also  wearied
 whenever any one compels us to fix our attention on questions of
 which we are ignorant, or wishes to make us conceive and retain
                               22 
170
ENNUI.
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 ex-
citement proportioned to our faculties  and our wants.  In some
instances, however, anger, which is  awakened in us under 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 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 dis-
cover, 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, 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 ex-
tremities, whence  arises that sensation of uneasiness which  induces
us to agitate ourselves, and which I attribute 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  nu-
tritive 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 over this feeling, is,
that whatever be its cause, it is always  removed, at least for some
time, by the ingestion of aliments, and particularly of fermented
liquors.   Wine removes ennui and excites joy; jldsit laetitise Bac-
chus dator, said Virgil: but wine ceases to exercise that influence
whenever the sensibility of the stomach is too powerfully  excited;
for, under such circumstances yawning and ennui may still occur, 
ENNUI AND YAWNING.
171
although stimulants are in excess in the stomach.  Let us, there-
fore, 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, as well as from their
excess, and from a certain degree of irritation, the consequence of a
pathological condition of the stomach; and whenever any cause has
produced, in this viscus, a degree of excitement resembling that to
which ennui can give rise, 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 depends on the brain, and the second on
the nervous apparatus of  the  viscera.   But as, in conformity with
what I have said above, the latter might be classed among the hal-
lucinations, 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 suppo-
sitions are erroneous, and it is sufficient to have practised medicine
to be convinced, that dyspnoea has never  alone produced yawning.
 This movement is caused by a peculiar  sensation originating, or
 rather manifesting itself, at the bottom  of the throat, and at the su-
 perior 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, and in the muscles of the
jaw, os hyoides, pharynx, face, and neck; in  the platysma myoides,
 and  in all  those exercising  any 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 experience in them  a sort of thrill.  All these move-
  ments are attended with a degree of pleasure; insomuch, that yawn-
  ing may be said to be an agreeable convulsion.  But what is still 
172
ENNUI AND  YAWNING.
 more agreeable, is the inspiration, and especially the  expiration of
 that large 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 lan-
 guor, referred  to the region  of the diaphragm,  always succeeds
 yawning;  but when frequently repeated, we  experience  in  the
 stomach itself  a sensation of cold,  relaxation, and even debility.
 And  reciprocally,  when  this  viscus has been  cooled and relaxed
 by the  passage of chyme  from it into the intestines,  or by the in-
 gestion of cold water, the want of yawning is manifested, and the
 repetition of this phenomenon seems to  promote the  evacuation of
 the contents 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; on  the  contrary, 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 generally
 the result of an  affection  of the stomach, and of the surrounding
 plexus,  and never of a pathological state  of the lungs; unless, in-
 deed, this latter produces  it by a sympathetic  action on the epi-
 gastric region, as sometimes happens  after violent fits of coughing,
 which occasion a sensation of  uneasiness  in that part; but I have
 never remarked that pleurisies, pneumonias, and particularly aneu-
 risms of the heart, which are the most effectual causes  of the dimi-
 nution 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 instinct
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,
wrhat 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
require  for its relief the sympathetic  influence of an ample dilata-
tion of the pulmonary tissue?  I am  aware that the gaping of ani-
mals placed in vacuo, and of newly-born infants, is brought forward
in proof of the want of air for  the lungs themselves.  But against
this opinion it may be alleged, that pneumonia and other pulmonarv
congestions, do not give rise to yawning.  On the  other hand it may
be answered, that a deficiency in the stimulus of  air, cannot fail to 
SLEEP.
173
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 this process; but I believe, that  it does so
by producing a sensation  of uneasiness in  the epigastric region,
which also  is the most ordinary cause of this phenomenon;  since it
can, by itself, produce it; whereas, the want of  respiration has not
this effect, when the  stomach  is agreeably stimulated by ingesta,
although the  act of digestion  invariably increases  the quantity of
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, to be the repose of
those organs charged  with  the external  relations.   Accordingly it
is manifested by a cessation of the functions of the senses,—of those
of the muscles submitted to the will, and by the abolition  of the in-
tellectual and affective faculties.   Sleep, to be complete,  ought to
unite all these conditions; but being susceptible of numerous shades,
it is necessary,  in order to form a just  idea of it, that it should be
described.
   Sleep  is announced by diminished activity of the senses,  and
of attention, by the aversion to voluntary movements, and a kind of
languor, which is believed to be universal.  We experience in the
frontal region,  and especially about the  eyes, a sense of heaviness,
and, as it  were, of fulness; the conjunctiva becomes injected, the
eyes  appear  tumefied, the  upper eyelid  falls, and, if we attempt to
raise  it again, it appears heavy.  This congestion of the fore part of
the brain, is often accompanied with yawning, and  a feeling of fa-

  * 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 uneasiness
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 whatsoever, can
excite a chill, and that the cold stage of intermittent fever cannot be otherwise
explained. 
174                         SLEEP.
 tigue in the limbs, which leads us to stretch them in different direc-
 tions,  causing what is called pandiculations.   While we abandon
 ourselves to this feeling, we experience, in the muscles thus stretched,
 a kind of convulsive trembling.   When we feel an inclination to
 sleep, we experience a peculiar sensation at the epigastrium, similar
 to that of ennui and gaping; it is a kind  of languor which cannot
 well be defined.  Instinct leads us to seek the most proper posture
 for repose.   Respiration 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 im-
 pressions.   His intellectual faculties appear to have ceased to exist,
 nor can we discover any voluntary movement. In the first moment,
 or 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.   He soon loses every idea,  after
 having lost every movement, even those of the respiratory muscles;
 for although  the centre of perception does not cease to feel the want
 of respiration, yet as this deficiency is less  felt, the inspirations are
 few, and in proportion as they are retarded they become fuller;—this
 is what causes stertor.  Sleep, having lasted for some time, becomes
 less profound; the centre of perception feels, in addition to the want
 of respiration, the uneasiness which arises from a fatiguing posture,
 and the individual moves, then turns over,  but without, on that ac-
 count, awaking.  His memory begins to resume  its action: he com-
 bines  the ideas it retraces with the  confused impressions he receives
 from without, and also with the irritation of his  internal senses: he
 dreams.  Sleep becoming still less profound, the sleeper feels cer-
 tain wants, such as those of making water and of coitus. He awakes
 for 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 proportion
 as  the  want of sleep diminishes.  Light penetrates through the eye-
lids, noise is  heard, all  the wants are felt; that of exercise is  deve-
loped  last;—when this occurs the waking state is complete, and
 very soon a desire for motion engages man to quit his place of re-
 pose.
  If there be nothing opposed to the want  to sleep, man abandons
himself to it without feeling any thing;  but if efforts are made to
oppose it, he considers himself as deprived of a pleasure, and
threatened with pain: for  then he  strongly feels that state of Ian- 
SLEEP.
175
guor of which we have spoken;  and, finding it agreeable, he be-
comes irritated against the causes which tend to rob him of it. Pain
is also felt in the head, eyelids, eyes, &c. to the last of which light
is insupportable.
  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,  muscles, and  intellect, must necessarily 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 active,
and digestion is effected in  a much longer time than  during the
waking state.   The difference upon this point is so great, that ap-
petite returns many hours before  the usual  time,  in  those  persons
who abandon themselves to  unaccustomed watchings, and they re-
quire one meal more  than customary.  Thence the common pro-
verb, he, 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 examine 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 be-
cause the external part of  the body, being protected  by thicker
coverings, is warmer and more penetrated by blood than it  was be- 
176
bLEEP.
fore.  But eover the skin of a person who is awake as much as
of one who sleeps, his pulse will  be quite as full, and  more fre-
quent; hence circulation will be more accelerated.   One of the rea-
sons which give support to this proposition is, that we often abandon
ourselves to sleep, with a stomach filled  with  stimulating  ingesta.
In these cases the acceleration of the course  of the blood depends
on  the irritation of the gastric  apparatus,—an  irritation, which
having no revulsion, either by the action of the muscular system,
or of the intellect, or senses, must  necessarily be reflected to  the
heart and skin. Now 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 incomplete 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 preceding 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  in-
ferred, that nutrition is more active in the first  than in the second.
—This conclusion is erroneous.   Thus we have seen  above, that
digestion is  performed  slower in  the sleeping  than in the waking
state.  How then  could it happen, that  nutrition  should be  in in-
verse ratio  to the digestive  assimilation?  The absorption of the
chyle is retarded, as is  proved by the state of fulness of the  abdo-
men which we experience after awaking, and by the urine we dis-
charge several times before  the  abdomen is lessened in  bulk, and
appetite 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.   All adults,
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  di- 
SLEEP.
177
gestion.  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 are  fatter, it  is because  they have lost  less,
and not because they 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  consequently assimilated  less.   The  whole of this
amounts after all to saying, 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,  may be considered as the diminution of all the principal
and most apparent  phenomena constituting 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 s^me species.  This,
then, is the reason  why certain individuals  sleep so lightly, that
the least noise  is sufficient to awaken them ; and why  certain ani-
mals 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
exposed 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;  man)' 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
                              23 
1.16
*LEEP.
tranquilly, that they are ignorant of what a dream is; whilst others
pass their nights in talking, and agitation, and 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 wherr* awake; such are somnambulists who only
differ from other sleepers in 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 this state supposes always  a considerable
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 apparatus, preserve some degree of irritation,
while others lose theirs.*  The sensitive expansions, and their pro-
longations in the brain, are always at rest  in those kind of sleepers;
but  there are some, the portions of which correspond to the loco-
motive muscles, that are inactive, while those which belong to cer-
tain 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 things 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 apparatus is in a state of  torpor.   Nevertheless, it  is
certain that such  dreamers, and  somnambulists,  are not restless
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

   * More conclusive evidence in favour of the plurality of cerebral organs and of
their separate and in a measure distinct functions or faculties, need not be required
than is furnished by the phenomena of somnambulism and dreaming.  No adequate
or satisfactory explanation of these could be given on the supposition of the unity
of the brain and mind, since in such a case the torpor or quiescence in sleep must
be either complete, or entirely wanting, as in the waking state; whereas, in  ad-
 mitting that certain organs of the encephalic apparatus are torpid or asleep, whilst
 some are irregularly excited,  and others again completely awake and competent
 to the discharge of their functions, we have a consistent and satisfactory elucida-
 tion of the cause of dreams or disturbed sleep and somnambulism, with its asso-
 ciated acts, in which are evinced powers of perception and mental combination
 of a marked character.—Tbans. 
SLEEP.
179
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 are to be found whose health suffers from such; and it
is those with whom  the shortness and restlessness of sleep are the
effect 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, at-
tended with effusion) which causes too much,  and insanity, (chro-
nic cerebral inflammation, without effusion) which allows but little
sleep, or destroys it altogether.   Besides  this, we find many indi-
viduals  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 an
affection of the  heart.  The exuberant activity of the genital organs
disturbs the rest of many persons during the vigour 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 when  awake, but who
experienced the most violent erection during sleep; his penis,  as
soon  as he  fell asleep, rose with the rapidity of a spring which
straightens itself—(such were the expressions of the patient.)  This
erection was unattended with desire, and was even painful: it per-
sisted during the whole course of his sleep, which it rendered un-
easy, and more fatiguing than restoring; it happened without any
effusion of semen, and ceased the moment he awoke, with as much
rapidity as it came on when his  drowsiness commenced.   This un-
fortunate man  was yellow, thin, debilitated, digested badly, and
presented some signs of gastric irritation.   I  prescribed to him the
treatment proper for chronic gastritis, but I  have not learned  the
result of this plan.   I might conclude 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 my examples  from cases, unques-
tionably 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 characterise the state of life.
   Vet,  although sleep be a rest, we  have remarked that it is  an- 
ISO
SLEEP.
 nounced 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 that of
 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 much as exasperated at the  unmeasured want of
 it; (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 senti-
 nel over 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.
 Now,  the organization of animals is such, that the uneasiness which
 constitutes the want of sleep becomes an exciting cause for the orbi-
 cular of the eyelids, so that it is forced to act, while the rest remains
 quiet.   It will, perhaps, be said, that this is an  hypothesis; 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 na-
 ture 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 should  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 
SLEEP.
181
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 were in
need of locomotion.
  This does not appear to me  to be idle reasoning; it tends to de-
monstrate, that the state of activity of a small muscle during sleep,
does not  lead to the conclusion of the activity of the entire brain,
any more than the irritation of the stomach  during hunger would
necessarily imply a similar irritation  in the heart,—or the action of
cellular tissue, or 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
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, motility, and secretion;
so  that the engorgement  which  would  ensue in them, instead
of exciting, would  become the means of  preventing these pheno-
mena, by the effect  of a kind of antagonism, 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 demonstrated, 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 eyelids,  which must pre-
serve their action in order to prevent the  admission of light,—the
penetrating activity of  which  would always be opposed to sleep,
and would raise the cerebral irritation to the degree constituting in-
flammation. This is verified by the cruel  punishment inflicted  by a
removal of the  eyelids, the invention of which makes nature shud-
der, 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, these  take place, the  soporific state supervenes,
and innervation diminishes. Narcotics act in the same manner; and
I cannot  but applaud the fundamental propositions of an essay by 
1S2
COROLLARIES ON THE
M. Fallot, inserted in the second volume of the  Annates de la
Medecine  Physiologique,—propositions  that  are  deduced  from
those I laid down in L"'Examen des  Doctrines Medicates.  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
soporific 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 lead
us to doubt or confirm it, in a positive manner.  In the mean time,
the preceding are the principal among  the important facts relative
to sleep.   I might pursue the  examination yet farther, under the
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
prolonged sleep than individuals of a dry and nervous temperament;
—In short, that an undue exercise  of  the intellectual faculties pre-
vents sleep, renders it more restless, less renovating, and sometimes
destroys 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, the
intellectual faculties, and the passions.
                        CHAPTER IX.

  COROLLARIES ON THE  INTELLECTUAL OPERATIONS AND THE
                           PASSIONS.

  Before recapitulating  what I have said on the subject of the in-
tellectual functions, and the affections, and passions, together with
their effects upon the system, I ought to make here the formal de- 
INTELLECTUAL OPERATIONS,  &C.
1S3
claration, that I do not pretend to offer in this work a treatise on
ideology.   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 only 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 merely desire to point out the line of demarca-
tion between it  and the physical; though I am far from flattering
myself with ever being able to attain this object.  The following is
my view of the  question.
   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 whether
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,  customs, and manners deprived of every physiological
consideration;  politics and the  arts; the description and classifica-
tion of bodies; the description of nature; that of thought in writing,
and 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, music, and 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- 
184
COROLLARIES ON  THE
terests.   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 pl^siological 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, the nature of
the soil,  prevailing diseases, &c; but then they should avail them-
selves 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-
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 the faculty we possess of recalling those ideas,—
which  constitutes  memory; of foreseeing future  impressions,—
which is prescience, and gives rise to  prescient judgments; of feel-
ing those impressions more or less acutely,  and represent  them with
more or  less  force  and  truth,—which  constitutes  imagination;
they can, I say, examine whether abstract ideas of movement and
rest, of attraction  and repulsion, of formation and  destruction, of
growth  and  diminution,  of extent,  height,  and depression;—of
greatness and  smallness, of beauty and ugliness, of justice and injus-
tice, of divine, spiritual, and temporal right; of power, sacredness,
profaneness, hatred,  friendship, fear,  audacity, benevolence, harsh-
ness, sensibility, cruelty, pride, vanity, jealousy, envy, &c, repre-
sent qualities inherent in objects, or modifications of our conscious-
ness relative to general or particular,  real or imaginary 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 ques-
tions rather under such a point of view than  under any other;  in a
word, they may exercise themselves in discovering the truth under
the deceitful masks, with which the science of ontology, (that  des-
potic 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. 
INTELLECTUAL OPERATIONS, &C.             185
   1. 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 determinate desire; if he do not recognise 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 res-
piration, (c) of nutrition,  (d) of the  evacuation of the residue of
nutrition, (e) of exercise, (/) of rest and sleep, (g) of self-preserva-
tion, (A) 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 the want 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, (6) oxygenated air  for respira-
tion, (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 for-
tify  within us the impulse which directs us to gratify this  want;
(f)  a 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, (i) a
proper place for the expulsion of the product of this latter, and an
individual who can  assist the  woman in labour, (k) all animated or
inanimate bodies which can concur to the preservation of our chil-
dren.   These  phenomena have their source in  instinct.
   VIII. The external  bodies  in relation with our moral wants, are
as numerous as the objects in nature; for we do not content ourselves
with observing those which serve for our physical  wants:  our rest-
                               24 
1S6
COROLLARIES ON  THE
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 an
impression which is transmitted to the brain.
  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
his  system;  to repel 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 in-
tellectual domain, as serving to gratify the ivant 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. 
INTELLECTUAL OPERATIONS, &C.             187
  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.
  XVIII. 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, which
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 is
feeble, or of short duration, I name them inclinations,  tastes, dis-
gusts, aversions, affective movements, or simply affections.
  XX. Love and hatred have for their objects, either the impression
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 judgment, 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
procure 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 enjoyment purely intellectual, and which can only  exist in our
own species;  because, when  an animal  sacrifices itself to the pre-
servation of its young, it does not foresee its own destruction.  But,
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. 
1S8                 COROLLARIES  ON THE
  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 wants, we find (a)  for instinctive ones, first, the  love
of ourselves in that of the feeling of this want, when it is agreea-
ble,—as for example the desire of coitus; secondly, the love of our-
selves in 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 passion appears only  to have this cause  for its object,   (b) For
the want of  moral excitations or of thought;  first, the love of our-
selves in that of the sensations which exercise agreeably our intel-
lect, because  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 which  gratify our self-love; and, if
these causes be individuals of our own  species, the affection or pas-
sion appears to have them for  its object;  hence arise friendshipst
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 appears to have no other object
than them; hence arises the hatred for rivals who have some advan-
tage over us in science,  the arts, riches,  power, great actions, &c:
this is  called jealousy, and envy.  This hatred is almost always con-
cealed, because our  self-love is humbled by the confession of a feel-
ing 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 ac-
tions of our rivals, only because they are bad. 
INTELLECTUAL OPERATIONS, &C.
189
  XXVI. When we consider affections and passions in relation to
lime, we must refer them to  the  present, to the past, and to  the
future: (a) if we consider them in relation to the present, they are
such as we have just seen them in number XXV.  (6) Considered
in relation to the past, they enable us to observe, by the aid of me-
mory, first, as respects love,  the  remembrance of agreeable sensa-
tions, whatever may have been their cause,—a remembrance which
is an actual pleasure,  and which  produces the love of past impres-
sions, and that of their cause; secondly, for hatred, the recollection
of disagreeable  sensations,—a recollection which is an actual pain,
and  which produces a hatred of former impressions, as well as of
their causes; thirdly,  for  the comparison of former pleasure with
present pain, and past pain with actual  pleasure,  we find alternate
sensations of pleasure and pain,  producing alternately a love and
hatred of past and present impressions, and  the love and hatred of
their causes; hence arise regrets which torment us, as well as ran'
cour, inveterate hatred,  8,-c very complicated  passions, 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) Con-
sidered in relation  to the future,  our  affections and our passions
offer us by means of prescience, first, for love, the prospect of agree-
able sensations, whatever may be their cause, a prospect which is
an actual pleasure,  and which produces a love of the  impressions,
as well as of their causes; hence arises hope: secondly, for hatred,
the  prospect of disagreeable sensations, which is an actual pain, and
produces a hatred of future impressions, and a hatred of their causes;
hence arise fear and despair: thirdly, for the comparison of  pas'
or present pleasure with  future pain, and of future pleasure with
present pain, alternate sensations of pleasure and pain, which  pro-
duce alternately the love and hatred of past, present,  and future
impressions, as well as the love and hatred  of their causes; hence
arise passions extremely  complicated, in which  we again find re-
gret, rancour, fear, hope, discouragement, despair,  and all the
moral consequences they give rise to. Avarice is naturally referred
to this series; since this passion is composed of the fear of the future,
founded on the observation of the present and the recollection of the
past.
   XXVII. Joy is always the effect of  pleasure,  and consequently
of  love;  sadness is invariablv the effect of pain, and consequently 
190
COROLLARIES ON THE
©f 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 anger
being a sudden exaltation of hatred, forms a part of the movement
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.
  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 deter-
mined object,  it is less reflected upon others.
  XXX. Anger belonging to all kinds of hatred, whether produced
by past,  present,  or future causes, gives them always an impetus
more or less  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.
  XXXI. All the passions are susceptible of being communicated;
this  is the effect of imagination, or of the faculty with which man
is endowed of representing to  himself,  more or less keenly, the im-
pressions 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 enjoy-
ment and compassion; which  offer a new proof that we refer every
thing to ourselves, and that self-love is the sole origin of our affec-
tive movements and of our passions.
  1 will  develope more fully the following propositions, on account
of the discussions to which they give rise at the present day. 
INTELLECTUAL OPERATIONS, &C.            191
  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
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  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 de-
pend upon a want of thought, resist more powerfully this modifica-
tion.   It is thus 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 cmld it act, since its instrument
would be destroyed?  Now, the i?  struments put in action by the
brain, are not merely the muscle ; but it also excites  the visceral
movements, in  order to react upon itself, and determine it to  over-
come  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 
192
COROLLARIES ON THE
the viscera are irritated; it is sufficient that they be so, in order
that the brain should become also affected,—that  a  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-
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 alco-
holic drinks;  they will see him fly into a passion on the least con-
tradiction, which would scarcely have moved him had his thirst
been quenched by water only.  If they pretend, that alcohol acts
here upon the brain alone, they will advance an absurdity; for, in
certain gastrites, a broth, and a simple mouthful of meat, are suffi-
cient to produce  all the effects of intoxication.  If  this fact be not
sufficient to convince them, let them examine the same man suffer-
ing greatly from hunger, and they will find him as irascible as when
drunk, and often more intrepid and cruel.   Have they not then re-
marked, either in facts before  them,  or in history, the frightful ex-
altation of all the feelings of hatred  and  fary,—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 referrible to the intellectual operations,
which overpower instinct; but in producing this effect, the intellect
still excites the passions: this is the subject of the succeding propo-
sition.
  XXXVII.  The passions of a -turely intellectual origin, can only
be raised to a great degree o(\  ensity, by the organic sensations
and movements which the exeit se  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 denomi-
nated intellectual could not exist, are necessarily accompanied with 
                INTELLECTUAL OPERATIONS, &C.            193

sensations and movements in the viscera.   Consequently, in cases
of opposition offered by  the intellect  to  the voice of physical
wants, thought excites in t,he 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 different
from  that of terror, and that the visceral pleasure of gratified self-
love differs  from that produced by friendship, or maternal tender-
ness.   Why should these differences exist, if they were not neces-
sary?  And, if they are necessary, is it for any other object than to
react upon the intellect, and assist it in resolving on 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  indepen-
dence  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 exer-
cised 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 I have not the pretension of
judging ideas as such,—that is,  in their relations with the objects
they represent; I only consider them in connexion with the organs,
and it is right I should do so; since the movements of pleasure and
pain, of love and hatred, cannot exist  without  affecting the tissues,
and consequently without exposing the functions to some derange-
ment.   It is for this reason, that I have taken  the liberty  of class-
ing 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.
25 
£94
                        CHAPTER X.

OF THE MANNER  IN WHICH THE EXERCISE OF  THE  INTELLECT,
  AND THE AFFECTIVE  MOVEMENTS, AND THE PASSIONS, EECOME
  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 pheno-
mena 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,
at the present day, say unreservedly 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 attributing 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 a superfi-
cial, or at least of  an inattentive mind, and cannot mislead sensible
persons.  Nothing is wanting to the triumph of these dull wits, but
for them to announce to the public, on seeing the part I have attri-
buted to the encephalon, that their objections have made me alter
my opinions on the subject.   Now,  to spare them this new incon-
sistency, I refer them to my thesis  on hectic fever,  published in
1S03. I am, it is  true,  very far  from adopting, at present, all the
medical principles it contains, but I admit those propositions which
relate to the intellectual 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 per- 
             HOW THE  EXERCISE  OF INTELLECT, &C.         195

ceives 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 sufficiently  spoken  of myself; and will now resume our
subject.
  When examining the action of each  of the senses in particular, I
pointed out  in what manner  impressions  produced by external
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 parts of the tissue, through which  they  penetrate
to the interior.  It becomes us now to follow them  in this  course,
in order to discover, there, the causes of the 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 its location.  In other cases
we have no data for the solution of this question. We only know
that the organs intrusted with the principal  functions are affected
in preference, and that  they reflect the irritation upon the  other
tissues.   To  treat this subject with some degree  of method, it be-
comes necessary to establish the following divisions:  1. Lesions
arising from  the exercise of the intellectual functions without pas-
sions;  2. Those arising  from the exercise  of the intellectual  func- "
tions with affection or passion. It is also necessary to examine these
last, (a) in reference to  the vivacity of the passion, (b) according to
its nature; by  determining  which of the  lesions, among  those we
have just  alluded to, belong to each of  the passions in particular.

Section l.—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 the least disorder  in  the economy,  either on ac-
count of the  nature of those ideas which  do  not relate to the first
wants, or at least to wants actually urgent, or as an effect  of the in-
dividual constitution, there never arise sudden  perturbations; the
troubles are slight, and the organic alterations are only slowly form- 
196   HOW THE EXERCISE OF INTELLECT, THE AFFECTIVE

ed; 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 intellectual labours,  without any mixture of passions,
such as the abstract sciences, which  are very numerous,—the de-
scription and classification of the bodies in nature, or the products
of art,—the descriptive  sciences,—mechanics,—a forced exercise
of memory,—the labours of the copyist, the analyst, or the his-
torian; philology, bibliography,—in  a word, every thing which
only exercises thought by requiring a  lively and constant attention,
keeps up in the encephalon a state of vital erection  by  which it is
sensibly transformed 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 de-
veloped.   They appear very often under  the forms of insanity,
paralysis, idiotism, and even apoplexy.
  The nervous expansions of the domain of relation,  undergo a
simultaneous exaltation of action;—the individual becomes irrita-
ble, and  convulsions  are easily  excited;  the sight  is  altered by
the effect of inflammation or by a collapse which  terminates in
amaurosis, commonly  called gutta serena.  In time, the same irri-
tability is established in the ganglionic nerves; and the movements
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 originally
nervous become so; and  that those which  were so before, acquire a
degree of mobility, which fatigues the patients, and becomes the
torment of the  physician.
  Having  acquired  this degree of irritability, individuals easily
contract inflammations through the influence of food,  drinks, atmos-
pherical vicissitudes, &c.   These inflammations are rarely very in-
tense; but in return  they  are difficult to  cure; because they are
renewed very  easily, and  the  health becomes at last 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
digestion, accompanied with costiveness and with a remarkable Ian- 
         MOVEMENTS, &C BECOME CAUSES OF DISEASE.      197

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 is finally no longer in harmony  with
the stimuli necessary to support  life; hence result gastro-enterites,
with hypochondriasis, melancholy, &c.
  There are  some  robust  and plethoric constitutions which are
neither nervous nor  weak, by the influence of study: they only ex-
perience such effects as arise from a want of  exercise, joined  to a
too considerable hematosis;  hence plethora and obesity become the
torment of these persons,  when they have attained the term of their
growth,  and especially when they have arrived at the age of  man-
hood.  At this period the haemorrhoidal irritation and the  sangui-
neous  engorgement  of the viscera are established; whence result,
for the digestive  canal, gastro-enterites,  which do not  progress  be-
yond the small  intestines;—for the liver, a painful  tumefaction,
with excess of bilious secretion ;—for the lungs, a state of fulness
and dyspnoea:—for the heart, hypertrophy and aneurism;—for the
brain, a soporose and apoplectic disposition.
   In all those who study too much, the skin easily becomes affected
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 intellec-
 tual 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 are in a more immediate manner dependent.
 It is sufficient to have mentioned them here.
    Intellectual labours give  rise,  in early life,  to effects correspond-
 ing with the actual  state of the  individual constitution.   Thus the
 brain, the growth of which is not complete,  acquires, by the exer-
 cise of thought, an extraordinary energy and volume; the  moral 
198   HOW THE EXERCISE OF INTELLECT, THE AFFECTIVE

faculties become truly prodigious;  but this advantage is sadly com-
pensated for by cerebral inflammations, which give rise to hydro-
cephalus, 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
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 do 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 powerful 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 can  therefore produce, at the  instant we feel
them, violent  cerebral congestions,  capable of occasioning death, 
          MOVEMENTS, &C BECOME CAUSES OF DISEASE.      199

and this accident can take place without there occurring  any rup-
ture 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 dis-
section.  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 be-
cause sufficient attention has not been paid to  the state of the cere-
bral 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 encephalon, and  that this  fluid, pene-
trating too deeply into a texture of such extreme delicacy, has pro-
duced 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 ana-
tomy 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, love, or enjoyment, or by fright,
vve would not fail to refer to it the  cause of death, instead of attri-
buting this  latter, as formerly done, to an unappreciable  modifica-
tion of the whole extent of the nervous system.  Another circum-
stance that leads me to adopt my explanation, is, that every time our
feelings are extremely lively, we  perceive distinctly the cerebral
congestion,  which  seems to distend excessively 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 complete abolition of the
cerebral  functions, there is but one step, and  it is easy  to conceive
that it may with facility be passed.
   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 
200    HOW THE EXERCISE OF INTELLECT, THE AFFECTIVE

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 contraction
of the heart.
   Violent percussions on the epigastrium, the often horrible pain of
gastric  inflammations, may determine sudden deaths.  Hence, I
should not be surprised, if sudden fits of the violent passions were
to occasion death, by the nervous irritation  of the epigastric centre.
For this, it would be  sufficient, for the sensibility of the  mucous
membrane of the stomach to be exalted by  a state of inflammation,
at the moment  when thought  excited an  extraordinarily  violent
passion; because the irritation of the gastric papillae keeps the whole
of the abdominal nervous apparatus  in an  extreme state of irrita-
bility.  If this case could be suspected to exist by the commemora-
tive 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 is so sudden, that medical aid is
totally unavailing.
  Such are, in my opinion, sudden deaths,  purely nervous, which
may be produced by an  excess of the passions; but there are others
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  exhala-
tion of this  fluid, either in the  tissues of  the pia mater, which is
most common, 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 the membrane.  It is perfectly well felt,
that these kinds  of extravasations are very analogous to the rapid
hardening of the brain, of which we have already spoken; since
they are always produced  by an extraordinary afflux, and by the
deviation  of the  blood from 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 
MOVEMENTS, &C BECOME CAUSES OF DISEASE.
201
 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 fluid, constantly propelled by the torrent
 which comes from the vena cava, overcomes the resistance of the
 auricle. It is easily conceived, that if rupture be possible, aneurism
 is still more so, as has been but too often demonstrated  by observa-
 tion.  It is also seen, 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, lungs,  and viscera
 of the abdomen,  the two ventricles can no longer propel, in their
 respective arteries, the fluid with which 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 ask him, if he has never palpitated in conse-
 quence of any moral affection, and if this palpitation can be other-
 wise explained than by the direct influence of  the centre of sensa-
 tions upon the muscular tissue of the heart.  I will resume this sub-
ject, 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
 frequent 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 is it, that moral affec-
tions reverberate  with  the rapidity of lightning, in all the sensitive
tissues of the system.  Hematemesis is also the effect of  strong pas-
sions ;  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  hsemorrhagies, deter-
mined by  moral affections.
  If the blood can be extravasated, either by rupture, or by exhala-
tion upon the membranes of relation,  it can also be  propelled from
                              26 
202   HOW THE EXERCISE OF  INTELLECT, THE AFFECTIVE

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 manifest-
ed this kind of disorganization.  In a word, moral  affections  can
extravasate 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 de-
gree 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-
paratus; since we proceed from disorders that  are most promptly
produced  to those less so, in order  that we may conclude b}^ 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.  It is sufficient merely to indicate them here, since
they resemble those that are produced  by cold; and because we in-
tend  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 
         MOVEMENTS, &C BECOME CAUSES  OF DISEASE.      203

these organs.  Every one knows, that the milk  is suppressed  in
nurses, in consequence of the paroxysms of strong passions; and
that sometimes it becomes  so  irritating,  that children who  suck
plentifully of it are affected  with colics, and even  with violent gas-
trites.  We have studied the influence of the passions on the secre-
tion of tears; which are also seen  to become burning,  and so acrid
as to inflame the conjunctivae, the  eyelids, and even the cheeks.
   The saliva is secreted and even projected with much force into 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 poisonous
qualities capable of provoking convulsions, and even  madness, 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 epididy-
mis, and the vesiculse seminales; and the  mere influence of thought
suffices, in many persons, to determine its 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, and
especially in anger, that bile flows  abundantly into the duodenum,
whence it sometimes  passes into the stomach and produces vomit-
ing; or is poured into the intestines, stimulating them 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 deem 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 the will.   They  are
such; that the least affective movement  is manifested on the exterior, 
204   HOW THE EXERCISE OF INTELLECT, THE  AFFECTIVE

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 intermittent
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 mo-
bility,  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 agitating the
apparatus of external relations.
  The visceral muscles are far from being protected 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, bladder,  and  even upon the membranous
tissues of the bronchia?, and  the  pulmonary vesicles, are not less
conspicuous; since we often observe after violent emotions, vomit-
ings, which  in  some instances become habitual,—the discharge of
excrements,—sudden emission of urine, and a spasmodic constric-
tion of the bronchia?, which opposes itself to inspiration, and pro-
duces obstinate asthmas.
  After nervous and hemorrhagic  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 encephalon, 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 possi-
ble that in such cases the lymphatic affection is not the direct effect
of the  passion, but rather that of the  mucous  inflammation which
this latter has occasioned in the interior of the gastric organs.  But
how often has  it not been  seen, that  moral affections  determine
suddenly herpetic affections?  Does  not this prove that the exercise 
          MOVEMENTS, &C BECOME CAUSES OF DISEASE.      205

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 in-
fluence in the natural state.  The areolar tissues, the serous and syno-
vial membranes, may, in  some cases, tho lgh very  rarely, become
affected with a sanguineous exhalation produced by violent passions;
but moral affections only cause in them a sensation of pain, when
some previous 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, a'peritonitis,
and an arachnitis.  In all these cases,  the  inflammatory predispo-
sition  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 increased  by cold, and gout  is the consequence.
We may even conceive the production of a paroxysm of gout by
the effect of a passion, without admitting a previous gastritis, when
cold,  a contusion, or any other cause has predisposed a joint to ir-
ritation;  since the articular ligaments are in a direct correspondence
with the brain, by means of the nerves of the encephalic and spinal
domain.   At other times the  inflammation  has been developed in
the brain, pulmonary parenchyma,  or  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 necessity
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 best directed efforts of the art.
  The cartilages, fibro-cartilages,  periosteum, and  bones, are the
only tissues upon which the mind exercises no influence in a natural
state.   Long-continued  inflammations  are  necessary to  develope
sensibility in them,  and put them in relation with the encephalic 
206     HOW THE EXERCISE OF INTELLECT, THE AFFECTIVE

apparatus;  but when arrived at this state, they are placed under
the influence of the passions;  as may be shown by cases of exosto-
sis, 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 constitution.

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 not fatigue
the attention of our readers.
   All the passions founded on pleasure, possessing the property of
precipitating 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 completely
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 of 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  inconve-
nience of stimulating  the  heart with so much energy, that it be-
comes  aneurismatic, or undergoes a rupture which necessarity and
suddenly proves  fatal.  The extraordinary afflux of blood towards
the tissue of the lungs, may also, in these cases, give rise to hemor-
rhages and inflammations. It is  thus, that excessive  enjoyments
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 sufficiently of the con-
sequences of the sanguineous  congestions  they always  occasion  in 
          MOVEMENTS, ^C, BECOME CAUSES OF DISEASE.      207

the principal viscera;  yet this  is the most  important point; for
weakness is easily corrected  in  youth; whilst visceral irritations,
which have not been combated at their onset, constitute so many
germs  of languor  and destruction, necessarily increasing under
the influence  of stimuli  and tonics,  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 to  these kinds of excesses, finally end
by being affected  with dulness  of their eyes, which are  sur-
rounded with a livid  circle; their sight is  weak, the senses are
blunted, and the muscles so weak as to become unfit for the slight-
est exercise.   The influence of the emission of semen upon muscu-
lar 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 amorous enjoyments
to the athleta? whom they raised in their gymnastic establishments.
Venereal excesses have, among other inconveniences, that of affect-
ing, in  young subjects, the intellectual faculties;  their attention is
diminished, their memory weakened,  and the habit of only exer-
cising 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, Tis-
sot's work on Onanism.   Although he has  attributed 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 unfortunate persons, whose de-
plorable situation he has described ; yet he  has treated of the de-
basement 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 
 208    HOW THE EXERCISE OF INTELLECT, THE AFFECTIVE

 the passions founded on pleasure.  In many instances insanity is occa-
 sioned by the inflatioivof 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 encephalon 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 deve-
 lopment 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-
 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
 enjoyments to excess;  but then they cease  to be  included in the
 series of which I am now speaking, and their bad results must be
 assimilated to those that accompany  the abuse of the intellectual
 faculties, and of the passions above mentioned, or those 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
contemplation of which consciousness is arrested, whilst it forgets,
as it were, the locomotive apparatus and the external sensitive ex-
pansions, now in a state of diminished activity. The skin becomes 
          MOVEMENTS, &C. BECOME  CAUSES OF DISEASE.      209

 cold, perspiration is less, the muscles languish, and lose, when these
 passions continue long, a part of their contractility.   Under these
 circumstances, man lives,  in  some measure, within himself.  This
 sensation, which thus concentrates the  cerebral action residing  in
 the viscera, supposes that the organic activity 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 allow 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 re-
 action supervenes.  Circulation is then imperfectly performed; from
 which results a state of uneasiness and  agony in the lungs,  which
 produces sighs, determined by  instinct, and  solicited by the want
 of respiration.   This uneasiness must naturally add to that depend-
 ing on the melancholy ideas by which we are filled.   As the mus-
 cular coats of the digestive canal participate in the constriction  of
 the heart, and in the effects of the stagnation of the blood, the un-
 easiness is likewise referred to the epigastrium and to the liver, but
 rarely to  the small intestines; because, in the natural state, they are
 but slightly sensible; as to the  large intestine, no sensation is re-
 ferred to  it.  The stomach seems to be cool, as, on the contrary, it
 appears to become heated in joy.
   These phenomena, which are at first nervous, are soon accompa-
 nied with vascular lesions;—melancholy feelings, too intensely con-
 templated, and too much nourished by  the  mind, soon occasion a
 congestion in the viscera  in  which  they are seated,  or rather to
 which they are referred,—these parts 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 in-
 dividual affected with melancholy, after remaining for some time
in a state  of immobility, agitates himself instinctively,  and expe-
riences 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-
                             27 
-J 10   HOW THE  EXERCISE OF  INTELLECT,  THE  AFFECTIVE

suit  in the viscera, engorgements, which will be inflammatory in
sanguineous constitutions, and lymphatic  or  sub-inflammatory in
those of a reverse temperament.   Nervous mobility will always be
established 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 in-
flammation, sub-inflammation,  and neurosis;—all of which  will ter-
minate 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, epilepsy, and apoplexy.  Women,
whose generative apparatus is very nervous, will experience, under
the influence of similar causes,  the symptoms of hysteria: this affec-
tion, however, will not exist alone, but will be combined with irri-
tation of the digestive organs; and woe  to the physician who does
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
timid persons of both sexes, who have been  brought up in the rules
of decorum and  accustomed to dissimulation; whether the passion
consists in thwarted  love, of which such individuals endeavour
to conceal the least symptom, 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 be-
cause it occasions, in most instances, a nervous and vascular reac-
tion.  The individual affected with fear can, as we have already seen,
like the one troubled with sadness, perish in the  first  period of the
impression; but  if this  does not occur,  he becomes  agitated,  and
developes 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, 
MOVEMENTS, &C. BECOME CAUSES OF DISEASE.      211
 that  horribly painful  state denominated humiliation, and  which
 depends 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 does not react with the greatest degree of inten-
 sity.   I think I have  remarked, that under such circumstances the
 heart suffers considerably, becomes enlarged, and receives an impe-
 tus which leads it to hypertrophy, and to aneurism.  The brain is
 sometimes so powerfully irritated, as to give  rise to mental aliena-
 tion.  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 severely wounded self-love.
   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 secondary 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, this secre-
 tion dissipates the state of anguish which precedes and occasions it,
 and 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 agita-
 tion  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 un» 
^12    HOW THE EXERCISE OF INTELLECT, THE AFFECTIVE

easiness is only removed  completely by means of the  secretion of
tears.  The results of this uneasiness, and of the muscular contrac-
tions which are combined with it, are hemorrhages, inflammations,
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 inconveniences;
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.   Although it cannot be denied that
tears relieve temporarily, yet 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 most deplo-
rable state.
   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-
tion 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.  TKere exist, exteriorly, a sufficient number of
sympathies to enable him to judge of the sufferings of the concealed
organs.  He will make use of them to form an idea of the condition
of theste pretended sufferers, and will not confound mawkish with
true sensibility.

     .  Section V.—Of Painful Passions with Reaction.

   I have already said that the painful passions with reaction are
those which give rise to  anger  and  flight.   Flight soon  causes  a
movement of expansion, which at first  corrects the baneful  effect
of terror; when moderate, therefore, it cannot fail  to  be  attended
with advantageous effects; but when excessive, it has 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 treat-
ing of this passion;  it only remains, therefore, to discover their pa- 
          MOVEMENTS, &C. BECOME CAUSES OF DISEASE.       213

thological results.  The sensation which gives the first signal of the
explosion of anger, consists of an acute pain referred to the epigas-
tric centre; indeed, it is so certain that it exists in this region, that
vomiting of blood,—excessive secretion of bile,—the sudden absorp-
tion  of this latter which  produces jaundice a few moments  after,
and violent gastrites, are often its  consequences.   That these phe-
nomena are  produced  by the direct influence  of the  brain acting
through  the agency of the nerves, does not change the question
before us; for it is not the less certain, that the epigastric irritation
forms a part of the passion denominated anger, and that the princi-
pal seat of the former is in the stomach and its appendages.  Be-
sides, experience teaches us, that, when primitive, it directs the
centre of perception towards  the ideas of anger. This passion, when
physiologically considered, is primarily a simultaneous irritation of
the brain and epigastric centre; hence, the vital action of the brain
is often changed, in the most violent paroxysms of anger, into he-
morrhage or inflammation.   From this arise attacks of palsy, apo-   *.'■':
plexy, and phrensy, which often resist the  best directed efforts of
the art.
   F. Hoffman had  understood this truth,  as'may be learned from
his dissertation  De medicind emeticd et  purgante,  post iram,
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 such maladies, and advises phy-
sicians not to allow themselves to  be imposed upon, by the -bilious
turgescence which is manifested  in them.   For the removal of this
latter state, he merely employed  antiphlogistics—paying  regard,
as he did, only to the irritation  producing 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 chimerical beings,
which, under  the shield  of  high authorities, were continually in-
creasing  in number.   Let us continue  to exert  our efforts in over-
throwing 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—with-
out reaction;  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 
 214    HOW THE EXERCISE OF INTELLECT, THE AFFECTIVE

 force in its tissue,  and it will, perhaps, be liable to hypertrophy. If
 it be already debilitated and enlarged, in consequence of an aneu-
 rismatic state, some of its cavities may even be ruptured. The aorta
 will not be free from all danger, and the lungs also, becoming sud-
 denly engorged, may, perhaps be ruptured or become inflamed.   I
 have seen hemoptysis and violent pneumonia result solely from this
 cause.  The muscles,  agitated by a too precipitate innervation, may
 remain in a tetanic state, or preserve, 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 deter-
 mines attacks of, apoplexy,—it occasions the return of epileptic,
 hysterical, and gouty paroxysms,—it brings on with redoubled vio-
 lence habitual 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 gangre-
 nous, and occasioned 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 irri-
table 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  headache,—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 sen-
 sibility, which  demonstrates very evidently its  expansibly pertur-
 bating property.
   Those who endeavour to limit every thing to the brain,  make
 use of these facts in order to show  that anger does not act on  the 
         MOVEMENTS, &.C. BECOME  CAUSES OF DISEASE.      215

epigastrium in a different manner from what it does on the rest of
the tissues;  they have forgotten,  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 knee.   It is
always necessary, in order that these exaltations of sensibility should
occasion fits of anger,  for them to 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 because I  have,
within a few days, met with a new proof of it.  Besides, as it is
indispensable to prove the influence  of the viscera on the passions,
for the purpose of facilitating the knowledge of physiological pa-
thology, 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
and agreeable, to direct our attention to such as are  of a mixed cha-
racter.  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 we
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
resulting from the gratification of these wants, and from the enjoy-
ments of anticipation,  when we figure ourselves  at a future period,
and desire to obtain the means of appeasing them.  Are not unfor-
tunate 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 concen- 
216   HOW THE EXERCISE OF  INTELLECT, THE AFFECTIVE

tration 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  pri-
vation 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
past  pleasure is recalled  to the mind; and we suffer, the succeeding
moment, from the idea that we are  deprived of this pleasure.
  •The modifications we experience when jealousy is  nourished by
the fear of being deprived of our  present enjoyments, are of a simi-
lar 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-
pects the modification of our organs, to the loss itself; since we in
fact  suffer when  we foresee the possibility of  suffering.  Conse-
quently, whether jealousy depend  on wounded self-love or  arise
from an obstacle we meet to the gratification of another instinctive
want,—or  from wounded pride;—whether it has reference to the
past, present, or future, it  does not cease to be a mixed passion,
compounded of alternations of pleasure and pain.  We suffer from
the  idea of pleasures of which we  have been, are, or will be de-
prived; as well as from  the idea that another has enjoyed, enjoys,
or will enjoy them;—in the same way that we are gratified by the
recollection of pleasures of which  we have been, are,  or will be
deprived.  In a physiological point of view, emulation, ambition,
and  envy, are of  the same nature.
   In regrets, uneasiness, 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 dis-
cover in them the comparison of  pleasure with pain;  with this dif-
ference, 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 
           MOVEMENTS, &C. BECOME CAUSES OF DISEASE.      217

wants is in perspective; that is to say, that the avaricious man's en-
joyments are in the pleasures  of perspective.  We discover in  it,
however, an intellectual enjoyment, depending on the  actual con-
templation of the means for the purpose  in  our possession; such,
for example,  is the avaricious man pleased with the view 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 considerable; since the  miser sacrifices all  others to it:  and
this is a further proof of the unlimited power of the mind in modi-
fying the acts required for the gratification of our first wants. Ava-
rice is,  therefore, a purely intellectual passion: we  have directed
attention to its pleasures; the pains, by which it is rendered mixed,
are  the  results 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 destruction; and of which we make the
application to ourselves by observing them in others. We likewise
discover the pleasure depending on gratified self-love, when, always
impelled by the same  application, we perform acts of beneficence.
If anger intervene, as a means of reaction, in the pains of these dif-
ferent 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, his frame  undergoes, during the moments
of pleasure, a general expansion,  which is suddenly replaced by
concentration,  and vice versa.  From this results, in a very short
time, a vicious state of mobility, not only in the action of the  ner-
vous, but  also  in  that of the vascular  system.   The least  in-
convenience resulting  from this  state, is the  loss of equilibrium
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 appearance the
most trifling, occasion,  with an astonishing facility, all these derange-
ments. Moreover, every individual who has experienced for a length
                              28 
 2 IS          HOW THE EXERCISE OF INTELLECT, &.C

 of time the alternation of the mixed passions, loses the power of re-
 sisting atmospherical vicissitudes; so that he is constantly 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 act
 either to an inordinate extent, or give rise to effects totally unlooked
 for;—the nervous apparatus of the viscera, are  almost  always too
 sensitive;  because the passions  have excited their  vital properties
 to a height far beyond that suitable to  health;—the  most trifling
 irritations  of  their tissues, especially  of the mucous membranes,
 and of the brain,  occasion pains  and  extraordinary movements,
 which in other individuals are  only produced by the most extensive
 alterations.   It is this that constitutes 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 indivi-
 duals who  have long been tormented by the  mixed  passions, be-
 come hypochondriacal or neuropathic.   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 very difficult to ascertain the degree
 of alteration existing in  their  principal  organs.  It is on  this ac-
 count 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 such indivi-
 duals are affected, we shall find no difficulty in  understanding,  that
real changes may take place in deeply situated tissues; and  disco-
 ver in them a sufficient cause for the painful sensations of which
 these persons constantly complain: but, unfortunately, the sym-
pathies which ought to point out the concealed alterations, do not
correspond to the degree of these latter, and too  often disorganiza-
tions 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 1 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 
            MUSCULAR  APPARATUS OF RELATION, &C        219

from the abuse of the intellectual faculties and of the passions.   It
is not simply by the cultivation of the mind, that they can be pre-
vented; but particularly by the study of philosophy.  Philo^oph)'
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 philosophy for
which forms are every thing, and  which is made up of pure onto-
logy.  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 positive object; so far
from this, it can only consist in the love of truth,—of that sublime
and sacred love, of which it is impossible to discover  the least -races
in the numerous animals, which, together with the human family,
serve to people this vast universe.
                        CHAPTER XI.

  OF THE MUSCULAR APPARATUS OF  RELATION, AND OF ITS DE
                          PENDENCIES.

   The muscular apparatus of relation is naturally divided  into, 1.
the cephalic muscles, destined to progression,—to the displacement
of the whole body or of some of its appendages; 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 entire
apparatus.
   The muscles of relation are composed of fibrin,—of a laminated
tissue, gelatinous in its nature, and which is placed between  the 
220           MUSCULAR APPARATUS OF RELATION,
 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 quantity
 of calcareous phosphate,*—of ligaments, the gelatin of which con-
 tains a minor  proportion of salts,—and of the articular capsules,
 which exhibit  none in a healthy state.   Another  coat of  gelatin,
 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; and
 has received from Bichat the title of fibrous membrane. 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 fibrin 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
 nerves with which  the muscular fibrin is  supplied.   It is in this
 tissue  that the blood-vessels  are divided  and  subdivided, before
 penetrating into the fibrin; 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 abun-
 dance in this tissue, wonderfully contributes in  aiding  these func-
 tions.
   The aponeuroses serve to separate and contain the muscles, and
 to prevent their displacement;  they are further useful in  furnish-
 ing, to them,  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

  * This, though  the common belief, is not strictly accurate;  the essential differ-
 ence consists in the large proportion of albumen, it being 44.5 per cent, to 0.5 of
 phosphate of lime, and 55.0 of water, in cartilage.—Trans. 
AND ITS DEPENDENCIES.
221
 others they are imbedded in them. The muscles are always attached
 to the bones, which serve as levers for the various movements ne-
 cessary to be  performed.  It is for  this reason,  that the osseous
 apparatus is composed of various pieces, more or less moveable on
 each other.  Sometimes the bones are moved alone,  and constitute
 so many levers;  in  other  cases several bones are solidly fixed to-
 gether, so that the whole constitutes but one lever; as for example,
 the  head. The points of contiguity of bones are denominated 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  consistence;  some
 are  hard, cylindrical, and  hollowed in their whole  extent, 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  com-
 posed of lamine, more or less compact, which form their external
 surface; and  of an  areolar osseous tissue, placed between  these
 lamine, and filling up the intervening spaces.  This tissue is lined
 by a membrane which secretes an oily fluid, analogous to that con-
 tained 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, (the cylindrical,) destined to the movements of
 the middle of the limbs, are enlarged as they approach each  other,
 and  form surfaces, in which are  seen eminences  and  cavities, cor-
 responding to  each  other in  the most admirable manner;  these
 enlargements are denominated the heads of the bones. The medul-
 lary cavity does not  extend as far as the head, which is composed
 only of an areolar and  spongy  tissue,  covered  over  with a  more
 solid crust, like the flat and short bones, and which, like them, con-
tains in  its interstices a medullary substance.  From  this arrange-
ment, they acquire, by 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 denomi-
nated articular,  are themselves  lined  with  membranes  named
synovial,—kinds of  bags  without openings, which pass  from one
bone to the other  contiguous to it,—lining, at  the  same time, the 
»22           MUSCULAR APPARATUS OF RELATION,

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 con-
siderable resisting power.   It is always  remarked, that  their gela-
tinous 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
of the movements of twisting, compression, 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,
however, are not  as solid as those of the joints of the  limbs;  be-
cause they must also contribute to the different movements  of  the
column. Numerous muscles concur with the ligaments, to strengthen
the joints.
   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 cervical ligament.
   The muscular apparatus, and  its appendages, are put in relation
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 
\I\"D ITS DEPENDENCIES,
223
 associated, in their movements, with the wants of instinct and of
 self.   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 commu-
 nication 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-vsssels;  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 finally atrophied
 together with all  the soft  tissues  annexed to them.   The  bones
 alone, in consequence of the earthy phosphate they contain, are not
 diminished in size; but it appears to me probable, that their elemen-
 tary gelatin must finally be found  in a smaller quantity than in the
 health}7 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 to cor-
 respond with the brain and viscera.  In fact, their immobility 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 are diminished 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 more peculiarly on that form of animal matter denominated
fibrin,  exercise it without interruption;  they consequently always

  * All these remarks apply only to the cephalic muscles, which are exclusivtly
under the order of the will. 
224          MUSCULAR APPARATUS OF RELATION,
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 shorten-
ing, may be proved by dividing them; it cannot, therefore, be de-
nied to exist, and it would be ridiculous to regard  it as a different
property from that manifested under the influence of stimuli. This
continual action in the muscular apparatus, contributes to the firm-
ness of the body,—to the maintenance of the  organs  in  their re-
spective positions, and to the attitude.   This same action diminish-
ing after death,  the cadaverous  aspect is manifested, and that too
so much  the more evidently, as the  contractility of the fibrin is
diminished.
  The stimuli capable of exalting 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 fibrin which  en-
ters  into its composition; such, for example,  as the point of an
instrument,—certain   saline  preparations,—the  sudden  action  of
caloric, and sometimes even simple  commotion. But it is by means
of nervous influence, that its contractility is most easily and power-
fully called into play; or,  in  other  words, exalted to a degree sur-
passing that which is natural to it.  In the dead body, it is sufficient
to excite, by means of electricity or galvanism, a nerve distributed
to muscles, in order instantly to cause their fibres to contract;  but
as the  fibrin of these muscles  no  longer  communicates with  the
sources of life,  it soon loses its energy, and finally ceases to be  ex-
cited by galvanic or electric shocks.  The more this contractility is
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 
AND ITS  DEPENDENCIES.
225
 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 fibrin,—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 erec-
 tion.
   If the blood arrives more promptly at 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 of these
 parts.  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 a degree 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
 word,  all excepting those of respiration.  They present this re-
 markable  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.   It is in consequence of thought,
 that we see them take on extraordinary action, or simply reduced
 to that degree of contractility inseparable  from the animal matter
 of which they are composed.  But the cerebral influence by which
they are called into play, may originate  from various  causes.  As
we have already said, in the greater number of cases, it is produced
                              29 
226           MUSCULAR APPARATUS OF  RELATION,

by the operation of thought in an individual enjoying 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 object he has in view.
Such are walking, running, jumping, 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 mus-
cles to act, in consequence of an  imperfectly defined internal sensa-
tion; such, for example, are the movements executed during  cer-
tain states of uneasiness, 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 con-
sciousness have disappeared completely; such are the paroxysms of
epilepsy, and the violent forms of hysteria, &c.   In these cases the
brain continues 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
does not allow us any longer to apply to this irritation the name of
sensation.
  It may thus be seen that the  point of  resemblance between all
these cases is the irritation of the brain, which  is transmitted along
the nerves, and excites, in an extraordinary degree, the natural con-
tractility 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 ex-
istence is indeed most evident, since,  in a state of epileptic or other
similar convulsion, the movements in  the  limbs do not occur, when-
ever 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 
AND ITS DEPENDENCIES.                227
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 irrita-
tion  of these tissues was not  transmitted to it.   This fact, the cor-
rectness 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 situated
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 necessary con-
dition to the production of these movements; and it is conclusively
shown, that irritation is the only cause of these phenomena.
   The following may be laid down, therefore, as so many positive
facts; that the muscles I have called cephalic, 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 influence
of the will, to make them act;—that this will  may be determined
by external as well as internal sensations;—that  when these are
very acute, they may compel the brain to call the  muscles into
action, notwithstanding the express order of self, or, in other words,
in despite of the will,—that  when consciousness does not exist, as
for example in  certain comatose states, the causes of these sensa-
tions, 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 intervention 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 muscles are supplied with  filaments from the  great sympa-
thetic; in consequence of which arrangement they are at the dispo-
sal 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-splanchnic muscular  apparatus, which comprehends the  in-
tercostals, the diaphragm, all the abdominal muscles, the orbicularis
palpebrarum, and, according  to some modern physiologists,  the  di-
lating muscles of the nostrils,—this  apparatus,  I say, -is primarily
subjected to the orders of instinct; yet, as this latter is not conti- 
-28           MUSCULAR APPARATUS OF RELATION,

nually 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
transfer these muscles  to them.  If the will resist, the uneasiness
increases; if it persist in the refusal, the sensation to which I allude,
and which is only a stimulation, overcomes the resistance, and the
cephalo-splanchnic  muscles obey the  instinctive wants.   It is not
merely in reference to respiration, that this phenomenon is observa-
ble; all the viscera of the two great inferior cavities have equal claims
on these muscles. Thus we see them concur, in spite of the will, to
the wants of vomiting, defecation, ejection of the urine, and expulsion
of the foetus.   Whenever the diaphragm descends, it is absolutely
necessary that the abdominal muscles should relax, and vice versa.
These muscles are even forced to conform themselves to the degree
of fulness or vacuity 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
remaining in contact with the intestines, after the expulsion of the
fa?ces, 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  suffi-
ciently 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
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 part, or when
he divided  the medulla below it   If these experiments  be exact, 
AND ITS DEPENDENCIES.
229
the following is the manner in which we should reason. In destroy-
ing 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  con-
tractions requisite  for inspiration.   In dividing the medulla ob-
longata below this point, he allowed  the sensation of the want of
respiration, which  is transmitted to  the brain by these nerves, to
remain;  but intercepted the communication of this centre of sensa-
tion with the nervous cords, by the aid of which the animal could
determine the contraction of the inspiratory  muscles;  and respira-
tion in like manner  ceased.   Let us now make the application of
this fact to the living state. Whenever 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 transmission 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 sensation has the privilege of forcing volition.  We have
already seen, that in  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 me to be extremely
plausible;  but still 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 
230           MUSCULAR APPARATUS OF RELATION,

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  it
is to establish  an association between  these parts; but the expe-
riment 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-splan&hnic muscles to act in conformity to the wants  of the
viscera.  I am  inclined to believe, that the branches of  the tri-
splanchnic 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 explanations I pro-
pose entering into, when on the subject of the functions of the great
sympathetic. In the mean time we may remark, that it is support- 
AND ITS DEPENDENCIES.                 231
ed by the following reflection;—that  the wants which determine
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 mar-
row, can serve to cause in it an afflux of nervous  influence;  conse-
quently, the object of these  communications can only be, to esta-
blish an association of action independent of  this want; and I be-
lieve, that this association can only be that to which I have already
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 neces-
sary, in order that the muscles should  be  moulded after the form of
the viscera.
   This objection appears to me of very little weight; first, because
the brain and  spinal  marrow have always  primarily existed,  and
have only been destroyed by a  disease, when the organs had ac-
quired  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 cephalo-
splanchnic muscles would  follow the  movements of enlargement
and condensation of their viscera.  These facts appear to me rather
confirmatory of my opinion;  since they prove the  indispensable
necessity  of the  brain  for exciting into action the inspiratory mus-
cles, which,  as we have  said, are  necessarily associated  with the
other viscera, in the same manner as they are with the lungs.
   Some writers speak of acephali which have  executed movements
before their birth.  If the fact be certain, I cannot explain it other-
wise than by saying, that the disease which destroyed their brain,
had not yet produced  its entire  effects, and that it  had spared at

  * This assertion is purely gratuitous,  and rests upon the presumed necessity of
the prior formation of the encepnalo-spinal  axis.  But following the inductions of
Serres, and Gall, and Spurzheim, we shall be more inclined to regard the nerves
and viscera as of independent growth and development,  and the chief purpose of
the spinal marrow and base of the brain to be for a centre of union and combination
of nervous power.—Trans. 
a 32
MUSCULAR  APPARATUS OF RELATION,
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  muscles
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 are
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.
  A very 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.   This
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-
tion 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 tissues,
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

  * We cannot conclude from this experiment, that the nerves of motion are dif-
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 nervous
fluids is hypothetical. 
AND ITS  DEPENDENCIES.
233
them under contribution, it must act upon  them through  the me-
dium 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.

   I 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 them; but in order that they should do so, it is necessary
that the visceral irritation should reach that degree which approaches
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 select
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 such
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 congestion,
would cause those muscles, the aid of which was obstinately 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 obstacles which an improper
use of the intellectual faculties opposes to  the gratification of her
wants; it is thus also that mania  from  religious causes,  or from
thwarted love, from excess  of  study or from  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
                               30 
-5J't           MUSCULAR APPARATUS OF RELATION,

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  lose the  power of
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 of
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 locomotive
apparatus, 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-
motion 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, and produce a chill and fever; in a word, in-
flame and suppurate as after the most violent attacks of rheumatism.
   The articular surfaces are liable to similar accidents,  whenever
they are exposed to a too long continued friction. We occasionally
see violent attacks  of arthritis, which arise  exclusively  from  too
violent exercise.   I have had occasion to remark in  these cases that
cold is not the only cause of the mobility of articular inflammations; 
AND ITS  DEPENDENCIES.                 235
for those that depended on over exertion, 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 violent
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 expe-
rience when sleeping, makes them instinctively draw out and ex-
pose a leg or an  arm to the air; and it is upon this part  that the
inflammation 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 to  suffer 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 supplementary
action is developed in the viscera, where it produces serious inflam-
mations.
   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 epi-
gastrium a painful gnawing, accompanied with a sensation of cold,
^nd the muscles begin to lose part of their energy:  under these cir- 
236          MUSCULAR APPARATUS OF RELATION,

cumstances, if it be in a person who takes a long walk, locomotion
becomes 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 insen-
sibly silent, in proportion as the stomach is emptied  and the mus-
cles 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 muscu-
lar movement and of the want of nutrition.   But let him reach a
place  where he can take nourishment and enjoy rest,  he will be
seen to resume with gaiety his journey,—give  himself up once
more  to the pleasures  of conversation, and  again  enjoy a degree
of strength which he considered as lost: so true is it that nature only
permits us to apply our powers to the  exercise of thought, and
to that  of the other functions of relation, when  the instinctive
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
a brief rest and a light  repast are now 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
nature.  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, is  greatly heated, and even  intensely inflamed; the  painful
sensation in the epigastrium, which seemed to require nourishment,
becomes aggravated by their  presence,  and  especially  if they
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 
AND ITS DEPENDENCIES.
237
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
towards 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 universality, that leads to
the belief of contagion.  Having often been witness to such epide-
mics, I think it will be in my power to treat of the 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, alcohol, cam-
phor, bark, &c.   The mortality then becomes  excessive and dread-
ful ; 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 disasters.  Not,
however, that infection is impossible, whenever we accumulate in
too confined places the victims of these deplorable  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 epidemics, 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
last expedition to Spain, that I was enabled to  make these observa-

  * These remarks  are peculiarly applicable to that numerous class of invalids
called dyspeptics, who often deprive themselves of all the benefits of travelling
and change of scene by unlimited indulgence of their appetite for food, and who
falsely suppose that the languor of fatigue requires for its removal free repletion.
The rules of diet to which they had adhered at home are forgotten abroad,  and
they too often return with increased phlogosis of the stomach and febrile excite-
ment superadded to  their former nervousness and irritability.—Trans. 
«'s           MUSCULAR APPARATUS OF RELATION,

lions; 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 in-
cendiary treatment, a fatal consequence of the Brunonian principles
of our schools, did  the rest.  It is not from mere conjecture, that I
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 they cured this
disease 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
adynamic 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 application 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:
but they are still  very serious.  Examine  those hard labourers. 
AND ITS  DEPENDENCIES.                 239
those workmen of the lowest  classes of society, whose renovation
is no ways  proportioned  to  the  waste of their strength; they at
last become withered,  and have their  limbs stiff and tumid, then
their movements slow and painful.  Their skin is 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 dia-
phragm has  been known to be torn in violent efforts.  The abdo-
minal muscles are fatigued, and even extremely  painful, in walking.
The intercostals, compelled, in conjunction with the preceding, to
keep the chest immovable, 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 con-
siderable than that of the muscles of the limbs,  of the sacro-lumba-
lis, 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:
and if overlooked  by the  percipient centre, and persistingly ex- 
240
A SUMMARY OP
cited, it is changed into an inflammation or into a neurosis, in the
same way as that which follows excessive action in the most impor-
tant viscera of the economy.
                        CHAPTER XII.

         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, to put them  in relation with external bodies; secondly, to  es-
tablish 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 internal 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 or  nerves, esta-
blishing a communication  between  the  surfaces and the  central
nervous matter.
  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 cranial  cavity through which they penetrate, are  re-
garded 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 ob-
longata.  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 sen-
tient I.
  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 OF RELATION.
241
 tra-cephalic nerves, the cerebral centre, produce  a feeling of our
 wants; but it is a confused one.
   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 ur-
 gent.
   VI.  The recognition of external bodies, proper for the  gratifica-
 tion of the wants,  supposes  that the stimulation  produced  by the
 former, 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 sup-
 poses also, that the same stimulation has been reflected to the intra-
 cephalic nervous apparatus,  which have  likewise responded to the
 cerebral centre, in  order to unite the intellectual operations with
 the instinctive movements.   The proofs of these facts  are very
 numerous.
   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
 soporose state,  natural or pathological,  puts a stop to perception;
 but does not  prevent the stimulations  of the sensitive  surfaces,
 whatever they may  be, from reaching the brain.   Hence, percep-
 tion 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-
eular  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-
minate object, and disclose the thoughts of the individual  and the
intention of self; in a word,  the will: these  constitute acts.  The
movements which are merely the effect of the cerebral stimulation,
without perception, are irregular, sometimes convulsive,  and  reveal
neither thought nor will.
                              °>1 
242
A SUMMARY OF
   X. Sometimes, in spite of the waking state and of the  presence
of consciousness, the brain receives stimulations that make it exe-
cute movements of which the individual is conscious, but which
the will cannot prevent.  Hence stimulation and perception may
take place at the same time, and in  an independent manner. These
cases are always unnatural, and consequently pathological.
   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 requisite for
the gratification of the want,  without the intervention of the intel-
lectual faculties; because the  influence of the visceral nerves pre-
dominates over that of the nervous  apparatus destined for  the intel-
lectual operations.   Yet  the extreme development of these last ap-
paratus in our species, and the  habit of exercising them, which is
acquired in adult age, give us the faculty of calling for the interven-
tion of the will in these acts,  so as  to modify some of them, retard
others, and prevent a great number; hence, instinct never acts with
liberty, that is to say, does not carry away the will despotically, in
the adult and civilized man.   This  resistance is attributed to what
is called the self, which always supposes the exercise of judgment.
But in  early infancy and  during sleep, instinct 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 does not so full)' 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 unnatu-
ral movements, and various  sensations, which  are  sympathies of
relation, 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  apparatus;  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 OF RELATION.             243

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, arts, &c.; they serve for the
gratification of the wants of thought and of observation, which are
characteristic of man.   Hence the  self is exercised upon wants of
every kind; in other words, on the instinctive and intellectual ones;
giving rise to the 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,
hemorrhage, 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 redou-
ble its irritation; it becomes a cause of health or of disease, accord-
ing to its intensity and to its repetition.   Even the diseases of the
viscera which depend upon it, consist of congestions, inflammations,
hemorrhages, and neuroses.  The  second action occasions move-
ments of locomotion.
   XVII. The fibrin of the muscles is always in a state of contractili-
ty during life, and even for some  time after death; it communicates
with the brain by means of the  nerves, and  with  the  circulating
centre by means of vessels.   When forced suddenly to an increase
of contractility by the innervation of the brain, it becomes  con-
densed ;  its fibres are contracted;  this  is what is called contraction;
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 a waking 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.
   XX. The muscles are all under the immediate dependence of the
brain; but they must be divided into cephalic, which, in the natu- 
244      A SUMMARY OF THE FUNCTIONS OF  RELATION.

ral 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 also 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 have
undergone some modification.
  XXII.  Muscular action  becomes a cause of disease by its influ-
ence on the circulation;—by the rupture and acute or  chronic in-
flammation of the fibrin of the muscles, and of the other tissues of
the locomotive apparatus;—by irritation transmitted to  the  sto-
mach ;—by exhaustion of the nervous power; and by producing a
general languor, which favours the action of causes calculated t«
derange the equilibrium, and especially of cold.
END OF PART 1 
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
individual; 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 between the
different apparatus of the same economy; 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 che-
mistry.
  The functions circumscribed in 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 dif-
ferent from the blood, and others in the solidification of this mobile
matter, or in nutrition.  Still, however, as many internal apparatus
exhibit the union of these different vital operations, and as it would 
 24S            ORGANIC FUNCTIONS IN GENERAL.

 be inconvenient to separate the histories of them, I shall not adopt
 rigorously any new classification.  When I come to treat of an ap-
 paratus 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 appreciable 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 abbreviated outline:

    1. The Nerves of the Organic Functions.
    2. The Function of Respiration.
    3. The Function of Digestion, or  primary Assimilation,  with
 evacuation of its superfluity.
   4. The Absorption of Nutritive Materials.
    r>. 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
physiological life of the parents. By this course we singularly facili-
tate our study, 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, be-
cause it was impossible for me to separate the  phenomena of re-
production, so as to refer  them  to the different functions that com-
pose the history of the physiological life. 
(  249  )
                        CHAPTER II.

    ON 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 reddish
bulgings of tolerable firmness,  in which we find gelatin, and a little
fibrin.  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 numerous 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 em-
braces 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;  (A)
                              32 
250                    NERVES OF THE
visceral cords, to the tissue  of the eye, forming the ciliary pro-
cesses, 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 penetrate 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 (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 muscles
of the os hyoides, tongue,  larynx,  pharynx, and  to the phrenic
nerves; (e) visceral cords to the trachea, oesophagus, thyroid gland,
and lungs; (/) 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 fur-
nishes the anterior and posterior coronary plexuses, which embrace
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; (h) visceral cords to the pul-
monary 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  splanchnic
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. 
ORGANIC FUNCTIONS.
251
to the other muscles of  the  loins, and to those which form the pa-
rietes of the abdomen;  (/) 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,  vesicule  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 termi-
nated 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 notice 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 cceliac
trunk, over 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,
mixed with ganglions, embraces the aorta, the cceliac 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, others to unite themselves to  the phrenic nerves; thus we
find  here  the three usual destinations  of the great sympathetic.
2.  The cceliac plexus, or inferior prolongation of the solar; it sup- 
252
NERVES OF 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 cceliac, and from the semilunar ganglion,
and in part from the smaller splanchnic  nerve already spoken of;
it follows the  arteries, and furnishes filaments  directly to the kid-
neys.   6. The spermatic plexus, furnished  by the two preceding
ones;  it follows  the arteries:  we are unable to say whether fila-
ments are given off from it, which penetrate  directly into the testi-
cles 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 sympa-
thetic.  It may also be  observed,  that  nowhere is this nerve so
considerable as in the abdominal viscera,  which coincides perfectly
with  the part that was assigned to the digestive organs, when  ex-
amining their relations with the brain, and also with  the intellectual
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 sympa-
thetic.
  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 communicated
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 
ORGANIC FUNCTIONS.                  253
into  the tissues in which these nerves are distributed.   There
is then  reciprocity of stimulation between the encephalic and gan-
glionic nerves; that is to say, they serve as exciters of each other.
  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 latter does not force the will, but merely
solicits it, and the percipient centre may resist, and refuse to exe-
cute the acts which it demands: such is the case with the skin, the
subjacent 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, bronchie, 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 supplied
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 re-
quire; 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 en-
dowed 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, sensibility,  on which
the intellectual  faculties are founded,  would belong to the cerebral
nerves;  and the forced  movements, which are all in the domain of
instinct, would  depend on the influence of the great sympathetic.
  So far the distinction seems very clear, but now come the diffi-
culties.
  Sometimes excessive pains, even of the external parts to which
the great sympathetic does not  extend, such as of the skin and the 
254
NERVES OF 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 sympathetic,
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 per-
ceived by a sensation which is  referred to the epigastrium,  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 preser-
vation,  that the stimulation of the external tissues succeeds  in tri-
umphing 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 epithet
dull or obtuse;  whilst, on the other hand, the small intestines, by
the effect of stimulation in chronic phlegmasie of  these parts, ulti-
mately 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, admitted
that the great sympathetic is insensible; but many celebrated phy-
siologists, among whom is professor Lobstein, grant that it has sen-
sibility.  Their reflections have suggested  to  me others, which I
shall now submit to my readers, with 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:
•ranted; 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
thence follow that a chronic irritation was incapable of making it
feel any; no vivisection can demonstrate the contrary; for, in case
the animal  were suffered to live after these experiments, the phleg- 
ORGANIC FUNCTIONS.
255
masiae 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
consequence,  for example, of wounds of the abdomen, operations
for hernia, &c. yet peritonitis, gastritis, and traumatic phlegmasie,
would be productive of painful sensations, capable of masking those
others, always more obtuse, which might depend on the great sym-
pathetic.
  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 phlegmasie, 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 apparatus, 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 sen-
sitive, 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 phlegmasie of the small intestines,
which unquestionably present us  with the irritations  most circum-
scribed within 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 espe-
cially 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.
  I  wish we  could determine whether the pains in peritonitis,
which are so frightful,  have not their principal cause in inflamma- 
256
NERVES OF THE
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 from  the eighth  pair, whilst the small intes-
tines, and also the  liver, which do  not  give  rise to any sensations
during mental emotions, are almost entirely under the dominion of
the great sympathetic.   We may remark, also, that the bladder,  the
genital  organs,  the anus,  the  throat, the bronchie, to which  we
refer  a  crowd of sensations in the affective movements, are more
rich in cerebral nerves than in cords from  the  great  sympathetic.
As to the heart, so abundantly furnished with these latter, nobody
is ignorant of the great obtuseness  of its sensibility, and of inflam-
mation being required to raise it to the grade capable of giving 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 sensations 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.
   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 
ORGANIC FUNCTIONS.
257
co-operative 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-splanch-
nic; 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 account 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 volition, which we
observe in the heart and other splanchnic muscles.  In fact, if we
explain the alternate obedience of  the  cephalo-splanchnic  muscles
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 re-
mark 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 developments,
indispensable to an  explanation of  various  shades, observed 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 obedient
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  papille; it performs no sen-
sitive function; it has a nearer relationship with the order of serous
tissues, which are not required to give rise to a play of sympathies
in a natural state.  Whence comes then the stimulation which pro-
duces the contraction of the heart? It was at one  time attributed to
cerebral  innervation; but  if it depended exclusively on this, it
would be in the perceptive series, and volition might accelerate the
systole, prolong and prevent it by retaining the organ in immobility:
now this is what  does not happen.  The stimulus by intellectual
                              33 
 25?                    NERVES OF  THE

 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 move-
 ments.  It is in spite of the will that the brain, in its excess of in-
 nervation, excites the heart; nor even then does it disturb  it exclu-
 sively, 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 towards it a stimulation,  this per-
 sists 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,
 however,  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 galvanizing
 it: but as it participates with other muscles  in this irritability, we
 do not desire to draw from this any particular deductions;  we will
 only remark, that  the heart is the most irritable of all the muscles.
  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 stimulations
cannot be  regulated by the will, we are led to the position that they 
ORGANIC FUNCTIONS.
259
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 stimulation for
this purpose, without waiting for it to undergo extraordinary exal-
tations 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 communicated to its mass, and with-
out 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 which 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 sti-
mulations of their mucous surfaces.  It is equally true, that when
the brain is compressed, and  the soporose state exists, the stimula-
tions of the mucous  surfaces  bring into action, with  much more
difficulty,  the muscuLr planes that are adherent to them.
   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 meets on
the part of the  sphincters, and cephalic muscles which strengthen
them, a resistance beyond the power of  its  muscular coat to over-
come, this organ calls to its aid, by means  of  the  cerebral nerves, 
260
NERVES OF THE
the respiratory muscles, especially the abdominal  ones,  and the
diaphragm, and their efforts being associated with  its own, it sue
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 can-
not 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 expectora-
tion for the tracheo-bronchial mucous membrane;  the excitation of
movements necessary to generation,.for the sexual  organs; hence,
in fine, the augmentation of the secretion of mucus under the influ-
ences of the passions, for all the membranes of relation. I am aware
that  such connexions  may  be  attributed  to the  cerebral  nerves,
which are distributed to the above membranes; but I cannot believe
that the ganglionic cords are foreign to these phenomena, since we
find the same relations  in the mucous membranes of the small in-
testines, 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 can-
not but attribute it to the great sympathetic.
   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
mucous 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
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 interrupted,
whose  normal  or standard sensibility is necessarily obtuse, whose 
ORGANIC FUNCTIONS.
261
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
icords 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
given off, terminated in,  that is to say, are blended with, the arte-
rial  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 splanchnic 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-visce-
ral tissues, by cerebral nerves, we are  authorised in believing that
the  arteries of the visceral domain participate in the mode of sen-
sibility of the viscera, and are associated with them sympathetically,
in the same way that the arteries of the cerebral system participate
in the  sensibility and sympathies of the  tissues to which they are
destined.  Still, however, the difference is very great; for the arte-
ries of the external parts  only receive very small nervous  filaments,
wdiilst 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 loco-
motive  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 
262
NERVES OP THE
the viscera, they may abound in the tunics of their arteries without
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 phenomena,
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?  I
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 of
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-
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
are 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 
ORGANIC FUNCTIONS.
263
 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 in-
 fluence 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 vas-
 cular?
   The great sympathetic  nerve continues  through  the ganglions.
 Do these small reddish parenchyme 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 pur-
 pose of being afterwards reflected from one viscus to another inde-
 pendently 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 obscu-
 rity 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.
   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  tissur:- 
264
NERVES OF THE
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
of 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 func-
tion 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 regulates
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.
As 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
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  that  can enjoy a complete repose;
and during this state they, together with the other tissues that sur-
round 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 
ORGANIC FUNCTIONS.
265
 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 perma-
 nent 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
 erections, such as exaltation of muscular  movement, or a local ex-
 aggeration 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  movements necessary for the restoration of the deranged equi-
 librium.  More frequently  these local irritations of  the tissues
 placed in the domain of the great sympathetic, are not accompa-
 nied 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
 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
                             34 
266
NERVES OF THi.
cause a liking or hatred for external objects, and even the same ones
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 sid 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
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 incurable.
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 primitively
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 obtain
the movements necessary for the gratification of their  wants; 3.  to
render the muscular movements of the viscera  independent of the
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 inte-
grity 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 
ORGANIC FUNCTIONS.
267
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
performance 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
he objected, that the want of sleep is not felt; such as in arachnites,
insanities, violent fits of passion, &c.   It is because the great sym-
pathetic has then lost  its  influence. But why has it lost it, if not
because the encephalon has abstracted from it the degree  of action
which it ought  to have?   Here the natural order is manifestly in-
verted; but on reflection we shall find, that this state of exasperated
watching  would be a habitual one, if there did not exist some
very potent power to prevent it.  What could, without that, deter-
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 
268                    NERVES OF  THE

which are deprived of reason are still under the dominion of sleep-
I think, then, that in place of 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 my opi-
nion, can only be confided to the nervous apparatus, that is to say,
the great sympathetic, which, in other circumstances, is manifestly
intrusted with regulating the action of the viscera.
   I have reasserted,  that the immobility necessary for sleep was
tne 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 on the
part of the brain an increase of innervation of the muscles.  Not-
withstanding this observation,  I  still  continue in  the  belief, that
the assimilating power  is  not augmented in sleep,  because expe-
rience 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 to aid the vital chemistry;  but I would reply
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 substance  in the animal economy.
Be tViis as it may, I examine facts with the  intention of throwing
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 
ORGANIC FUNCTIONS.                  269
Lhough 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 locomo-
tive 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  sob-diaphragmatic region,  in which  are found the most volu-
minous 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 en-
tire 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 mus-
cular parietes of the hollow viscera; 3.  the vascular cords give power
to the arteries, and invite more or less blood into their ramifications,
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 augmentation of the
secretion of bile, and of saliva,  in gastritis and inflammation 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 of what has been
advanced, 1. establishes  the  independence of  the  internal  move-
ments as regards  the will; 2. forces the  brain to lend its action to
the viscera; 3. to receive from  these latter the excess of irritation
which  torments  them; and 4.  to suspend  the exhaustion of vital
powers, so soon as it is converted to the detriment of the individual.
   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 
270
RESPIRATION.
whenever they establish sympathies between the arteries and the
tissues, the brain is apprized of it by pain. Finally, when irritation
is raised in these parts, to the extent of forcing the will, it is on ac-
count of its being  very painful;  and then, as it is reflected by the
brain into the viscera, we must needs believe that the great sympa-
thetic lends its influence  to obtain this result
                        CHAPTER III.

                        OF RESPIRATION.

   This is one of the principal functions of the living body; its ob-
ject 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
trachee, 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
called gills.  It is situated at the basis of the cranium, and is cover-
ed 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  batrachia, the lungs of which  are
internal, are likewise cold-blooded; this comes from their respira-
tory surface, though internal, having but little extent, being limited
10 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  more-
over, traversed by  the entire mass of the blood.   It was then  ne-
 cessary that it should be folded on itself, as we find  in the membrane 
RESPIRATION.
271
 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
 left 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 pene-
 trate 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 bronchie, 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 bronchie.
 Each of  these  passes into one of  the two thoracic  cavities, and di-
 vides soon  into branches, which are  themselves  subdivided 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, is the frame
 work of the  lungs; let us examine their structure.
   The trachea is formed at its upper part, called larynx, of cartila-
 ginous pieces, moveable on each other by  means of small articular
 surfaces,  and set in motion by a certain number of muscles; its upper
 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, 
272
RESPIRATION,
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  poste-
rior  portion of this canal;  it is this tissue which gives them mobi-
lity; it alone forms the bronchie, 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 continued into the
bronchial vesicles, where it still enjoys elasticity, and even contrac-
tility; but it would not be sufficient to  keep them open, if the air
that  filled them were wanting,  or if the surface of  the lungs could
forsake the parietes of the  thorax.
   The interior of the tracheo-bronchial tree is lined by a membrane
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
fosse, the canal of this name, and the oculo-palpebral surface, passes
into  the trunk to clothe the interior of the parietes of the respiratory
and  digestive organs.
   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
the 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 absorb-
ed 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 terminate
in the left subclavian vein. 
RESPIRATION
273
  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 cra-
nium, furnishes first  to  the larynx of each  side a branch, called
recurrent; it then accompanies the trachea and the bronchie, 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 apparatus
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 areole of which are
moistened by a lymphatic dew or vapour of the greatest tenuity,
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 diaphanous 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 without
openings, which are spread out on one side  over the external sur-
face 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 tissue,
the origin of the  bronchie, and a part of the large vessels of the
thorax. The internal surface of these pleuras  is throughout continu-
ous; and the lymphatic vapour that it exhales facilitates the gliding
of the lungs on the parietes in which they are enclosed.
  Such are the lungs, the principal organ of the  respiratory appa-
ratus.  The remainder of it is composed of bones, viz. the dorsal
vertebre, the ribs, and the sternum; next the intercostal and abdo-
minal muscles and the diaphragm,  the  relations of which we have
studied when designating them under the title of cephalo-splanch-
nic.  Let us next examine the action  of  this  complex apparatus,
which plays so important a part in the preservation  of the life of
the individual.
                              35 
274
RESPIRATION.
 Section II—Action of the Respiratory Apparatus in general.

  Three grand functions are performed  by the  respiratory appara-
tus; aeration of the blood,  pulmonary exhalation, and production of
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 appa-
ratus.  Exhalation  seems to be inseparable from it, and may be
studied in a two-fold point of view; as a means of depuration, and
as a channel for the elimination of the superfluous serosity.   Aera-
tion and  pulmonary exhalation belong to the internal functions.  I
shall here only examine the first, withholding the other to the his-
tory 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 re-
quire to be treated of in connexion with those of the other excre-
tions.

   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
acts 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 ab-
sorbs it in whole or in part; it is it then which must apprize the
centre of perception of the  existence  of the  want, and excite the
necessary movements to gratify it, in a manner similar to that in 
respiration.                      275
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, parturition, &c.  A pecu-
liar pain known by the term  uneasiness,  is the first signal of the
want of air.  This  uneasiness is  not slow in producing a general
irritation of the viscera; and, as the nerves  presiding 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 incontestible: for all  persons who are tormented
by dyspnoea refer their anguish to the epigastrium, as if the numer-
ous 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 means
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 sympathetic,
and these are continuous with others that have connexion with the
spinal  marrow.  It is then impossible to prevent the irritations de-
veloped  in  the  sensitive expansions of the pneumo-gastric from
reaching the brain.
   The principal inspiratory muscles are the intercostals  and serrati,
which  elevate the ribs, and the diaphragm  which, by contracting,
pushes down the  abdominal viscera; hence the expansion  of the
pectoral cavity.  Whilst this is going  on,  the abdominal  muscles
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 produce 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 frictions during  inspiration.  Thus, 
2/6
RESPIRATION.
if the intercostals,  or the lungs of one  side, are painful, instinct
leaves them at rest, and is content to act on the opposite side.   If
both are in a state of suffering, instinct, only calls into play the dia-
phragm.   If this muscle, and the pleura and the peritoneum which
line it,  the stomach, liver, &c. cannot  be moved without  causing
pain, instinct forcibly raises the superior ribs;  finally, if inflamma-
tion has excited the sensibility of all these parts,  as well as of the
abdominal muscles, the dilatation of the  chest is  imperfect,  and
accompanied with the greatest anguish, «both on account of the pain
of the affected parts, and of the incompleteness of the aeration.
   The  expansion  of the thoracic  cavity leads  to the supposition,
that a fluid may penetrate into the bronchie  and bronchial cells;
this fluid  is ordinarily the air.  If the  body were plunged into a
liquid of greater density, such as water, this would be introduced
to the respiratory surfaces, as happens in submersion; but aeration
would not take place.
   The  larynx,  trachea,  bronchie, and  their  vesicles, are then
purely  passive in inspiration; they allow themselves  to be pene-
trated or distended by air,  which  thus enlarges the  parenchyme
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 thoracic
cavity   is  diminished, the  lungs are necessarily condensed;  and
this must be accomplished in a regular and uniform  manner;—we
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 
RESPIRATION.
277
 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
 them 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 in voice and speech, singing, sighs and sobs, laugh-
 ing, coughing, and sneezing. The time to treat of these phenomena
 is when we have before us the regular movements of respiration, 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 result of education.
 Physiologists have at present nearly a complete  knowledge  of the
 mechanism of the production of sounds.   It has been  proved that
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,
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 
278
RESPIRATION.
 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
 Medicates, 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 are either
 inspirations or expirations, more or less profound, quick or slow,
 regular or interrupted, always depending on the sensations that may
 be experienced in the different viscera, and which more or less in-
 fluence 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
 bronchie 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
 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  paren-
 chyma;  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 hurried and very deep inspiration,  accompanied  by a peculiar
 noise.  This is what we observe in hooping cough, a kind of bron-
 chitis accompanied by  a very lively  irritation, that solicits multi-
plied fits of coughing, without giving the patient an opportunity of 
RESPIRATION.
279
exercising  inspiration, which only  takes place at last 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 fosse.  In order to its ceas-
ing, 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 contract, the viscera which
they raise up press the diaphragm into the chest, and the air is ac-
cumulated in the bronchie and trachea: but in place of issuing out
by the mouth as in coughing, it escapes by the nasal fosse; 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 vio-
lent 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 cough-
ing 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 sneez-
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 pain-
ful agitation or anguish; and, in the opinion of the vulgar, he has not
strength  enough to expectorate.  Extreme emaciation also  is op-
posed to the action  of coughing  and sneezing, because the mass of
the abdominal 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 
280
RESPIRATION.
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 neces-
sity of expectorating 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 mori-
bund drink, as they have no longer the power of performing deglu-
tition 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 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 deprived combines with the dark blood returned  by the
vena cava; and this loss of  oxygen takes place without any disen-
gagement of caloric capable of injuring the integrity of the  tissues.
The  carbonic acid which the air gained after its  coming out from
the vesicles, 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 vermilion co-
lour which it had  lost in the aortic circulation;  this is, indeed, a true
depuration.  It remains for us to know to what extent the inspired
air, after its entrance, contributes to this,—a  point upon which che-
mists are not agreed: some will have it that the carbonic  acid  is
formed in the act  of respiration; others, that the  oxygen is  absorb-
ed by the pulmonary veins, and only joined to the  carbon in the
course  of  the  circulation; 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 
RESPIRATION.
281
ume 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.*

  * Taking the experiments of Coutanceau and Nysten on themselves, in com-
mon with those of Dr. W. F. Edwards on animals, we are irresistibly led to the con-
clusion, that the carbonic acid given out in respiration, is the product of a true
secretion or exhalation from the lining or mucous surface of the lungs.  Dr. Ed-
wards found that  this gas was exhaled by the mammifera, reptiles, fishes, and
the mollusca—individuals of all of which classes were made to breathe hydrogen
gas alone for a length of time.  This now generally received fact is in accordance
with all that we know of sound physiology, and  will, we hope,  serve to arrest
the idle speculations of chemists on this subject.  Though there is a connexion
between the processes of the absorption of oxygen, and the exhalation of car-
bonic acid, it is not of the nature of proximate cause and direct immediate effect;
but that which exists between the necessary vivifying influence of oxygen on the
system at large, and of course on all the secretions, including as in the case before
us, the aeriform one from the terminations of the bronchial arteries. Those who
would explain the formation of the fixed air by the union of the oxygen of  the
inhaled air in the lungs with the carbon of the blood in the pulmonary artery—
making the process in fact a decarbonization of the dark or black blood, at  the
terminations  of this  last mentioned vessel,  strangely forget that no inconsi-
derable quantity of this same gas is formed on the skin, under precisely opposite
conditions of the circulation, viz. the conversion  of florid arterial into dark venous
blood.  If the carbonic acid were the direct product of the oxygen inhaled, and
the carbon in the blood of the pulmonary artery, its formation ought to be sus-
pended if the atmospheric air be withheld, and the animal left to exhaust that
already in the lungs by a few respiratory movements.  On the contraiy, we learn
on the authority of Spallanzani and Dr. Edwards, that the quantity of carbonic
acid exhaled by animals breathing hydroden gas alone, is equal to that given  out
when they inhale atmospheric air.
  The proportion between the oxygen which disappears and the carbonic acid
produced, varies very much, according to the species, age, and individual pecu-
liarity of the animal.
  The proportion of azote in the expired and inspired air,  varies, as we are  in-
formed by Dr. Edwards, with the season. In summer, the expired air contains an
excess of azote over the inspired. In winter the reverse was the case: there seem-
ed to be an evident absorption of the gas.  But still farther, he shows that both
its exhalation and absorption are constantly going on, and that the predominance
of one of these functions over the other, accounts for the differences just mentioned.
Azote is given out when the animal breathes oxygen and hydrogen gases alone,
  The four fundamental points in the function of respiration are—
  1. The absorption of oxygen gas which disappears.
  2. The exhalation of carbonic acid by expiration.
  3. The absorption of azote.
  4. The exhalation of azote.
  The absorbed oxygen may in part contribute to the formation of carbonic acid
in the blood: but since, in many instances animals have breathed  hydrogen gas
                                  36 
2S2
RESPIRATION.
  As to the vaporised serosity which escapes with the expired airj
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 vermilion
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 are 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 or 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
the condensations and junctions of divers molecules in a liquid state,

alone for a length of time, and given out carbonic acid freely by pulmonary ex-
halation, we must look to other sources of this acid.  Of these, the digestive ca-
nal may be indicated.  The experiments and observations of Jurine, Chevreul,
Magendie,  and others, prove that carbonic acid exists  throughout the  entire
extent of the alimentary canal.  It is  formed during  digestion and to a certain
amount absorbed. Dr. Desportes has related cases in which symptoms of asphyxia
were induced by this cause.
  Some of our readers will discover that these remarks are nearly a transcript
from a review of Edwards' De I'Influence des Jgens Physiques sur la Vie, in the
North American Medical and Surgical Journal, Vol. V. p. 395-6.   We should
hardly have thought this acknowledgement necessary, were all aware of the right
which we have to the use of that review, on the ground of a writer being entitled
to borrow from himself.—Tjia.vs. 
RESPIRATION.
283
take place in a constant and uninterrupted manner, in physiological
phenomena: it is not then astonishing, that caloric should be conti-
nually disengaged by the exercise of the functions; and most rea-
sonably 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  ones
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
decapited animals as 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 
264
fcKSPlRATlGiV.
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 inherent 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 calo-
ric 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

   * From the numerous and diversified experiments  of Dr. Edwards we learn,
in confii-mation of the opinion advanced in the text, that the energy of respiration
corresponds with that of  calorification—both these functions being greater in
warm than in cold-blooded animals, in the adult than in  the young, and in win-
ter than in summer.  Birds, for example, uniformly consumed oxygen with more
rapidity in winter than in summer.  Hybernating animals if roused from their state
of torpor by mechanical irritation, so that the respiratory apparatus is brought into
action, undergo a very considerable elevation of temperature.—Trans. 
RESPIRATION.
285
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 experi-
encing 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 of
man must be supplied with  warm and oxygenated blood, for the
enjoyment of  energy requisite  to the  exercise of his intellectual
functions. 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 phlegmasie 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 similar
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 phlegmasie 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 is
susceptible. 
      286                 MORBID RESPIRATION.


      Section VII.—In what manner the Mechanism of Respiration
                    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 frequentpassageofthe air in too  dense
      a 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 removal
      than these diseases in their incipient state; but too frequently  atten-
      tion is not paid, they are allowed to make progress, and then be-
      come the cause of fatal disorganizations; hence laryngeal phthises,
      which are  converted into pulmonary.
        Speaking  and singing also fatigue the larynx and the velum palati,
      and thus become frequently causes of angina, when there is an in-
      flammatory 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 foun-
      dation for  pulmonary congestions and hemorrhages.  These  modi-
      fications of the respiratory process act likewise on  the heart, irritate,
      and may consecutively phlogose and dilate it.  The convulsions of
      laughing and of sobbing, may become excessive and habitual, and
      be converted into diseases;  they drive the blood  towards the head,
      which may hence suffer  from  congestions,  phlegmasie, 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,
r      by which  the tickling that provokes these convulsive  expirations is
      still more increased: hence we cannot too frequently counsel pa-
      tients affected  with pulmonary catarrh to restrain the  inclination to 
MORBID respiration.
287
cough, and only to yield to it when they feel distinctly the neces-
sity of expelling the mucus accumulated in the bronchial cavities,
and that the expectoration will be easy.  The congestive and phlo-
gosing 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 inflammation or the least mucus
to be expectorated. We see only at first short fits of coughing with-
out excretions, corresponding to the epochs  in which the stomach
is stimulated by ingesta,  and removed at will by taking some de-
mulcent.  But if this precaution  be neglected, the cough,  by dint
of being repeated, produces an inflammatory fluxion in the bronchial
vesicles; chronic  pneumonia comes on, and soon predominates over
the gastritis.  It  is now more than 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  fosse into the lungs.   Sneezing is  not  less irritating to  the
nasal  fosse;  the more it is yielded to, the more is the feeling which
provokes  it exasperated, and the greater  the  fulness  of the fosse;
cerebral congestion 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
fosse, 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 extre-
mities, 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 dan-
gerous malady. Every practitioner knows that it may be also ren-
dered convulsive, and kept up by  the mere force of imagination, so
soon as the patients think of it, or if those who are present recal it
to their minds.   I have had  under my care  a person, who, after 
JSS
MORBID respiration.
having coughed in an extraordinary manner, was freed from this
inconvenience by strictly attending to himself, agreeable to my ex-
press 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 re-
plied to me by coughing, though  he had not done  so during the
whole day previous.   This inclination gained such an ascendency,
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.

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 hurtful
particles or of irritating vapours,  which will give origin to inflam-
mation in  the air cells and  cavities.  Mineral  vapours,  chlorine,
ammonia, acids in a state of expansion, such as the sulphurous irri-
tating powders,  as  those arising  in the  pulverization of tobacco,
euphorbium, squills, &c. frequently produce coryzas and pulmonary
catarrhs.  I have seen pericarditis evidently produced by the pow-
der, on a man who worked in a manufactory of tobacco.   Different
smokes act also on the mucous membrane of  the bronchie; and
finally,  the mildest odours, such  as those of flowers, are at  times
sufficient to occasion coryzas and bronchitis.  I  have seen the ema-
nations 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 injurious
only by the want of oxygen; such  are azote and  its protoxide, pure
hydrogen, oxide  of carbon, and  carbonic acid without mixture. 
MORBID RESPIRATION.
289
 There only results from them an asphyxia without inflammation;
 but there are many others, which, by their poisonous nature, strike
 directly at the nervous system, and  thus produce real poisoning.
 Of this  number are,  sulphuretted, phosphuretted, and  arseniated
 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 endowed with activity so great,
 as to be capable of producing instant death,—only explained 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 so-
 lution.   When they do not produce this effect, 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 decarbonization of the blood is inter-
 rupted;  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 muscular  contractility  seems
 abolished.   Then all is thrown into a fatal  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 account, the repose of
 asphyxia is only interrupted  by the internal movements of  putrid
 decomposition, which soon furnish the certainty of death.
   Are the aerial influences that cause these phenomena purely seda-
 tive?  We are allowed to doubt it; for, whenever  the agents of
 which I am now treating act  on the body in smaller doses, the phe-
 nomena of life are  exalted  and doubled in  the tissues which they
.have modified, and some of the numerous shades of inflammation
 are manifested.*

   * We cannot, I think, otherwise explain the  etiology of malignant pustules,
 carbuncles, and even of typhus by infection, of which gastro-enteritis exhibits the
 essential characters, notwithstanding all that to this day lias been said to the con-
 trary. 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
                               37 
290
MORBID RESPIRATION.
  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
gives rise  to fever.   Hence,  the pure and  cold air  of  elevated
places, which we know to be abundantly charged  with this princi-
ple,  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 phlegmasie.   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 almost
as vermilion  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 en-
rich 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  bronchie 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 pneumonia, circum-
scribed 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 vermilion blood  by phlebotomy.   On this  account 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 pneumonias of limited
extent, which leave intact the greater portion of the bronchial tree,

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 to this important
point of pathology. 
ACTION  OF THE  RESPIRATORY  MUSCLES.         291
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 etiology 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.
                       CHAPTER IV.

APPENDIX--ON THE FUNCTIONS OF THE CEREBRUM AND CEREBEL-
  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 Gen&rules de Midicine, 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 locomotive muscles:  the  animal is as it were stupid; but if
forced, it walks, and evidently wants but volition to put its muscles
inaction.   But if the cerebellum  be wounded, convulsions super-
vene  in the  voluntary muscles of the opposite side; and if it  be
disorganized, or one of its lobes removed, that  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, ceas- 
lx)2
ACTION  OP THE
 ing 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, its seems  to me that its persistence must depend  on the great
 sympathetic.   I would view the question in this manner.
   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
 governed 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,  &c, 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 less complex kind; such are respiration and the convulsive move-
 ments 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 perception exists,
 and  that it can  communicate with the muscles which  are to be call-
 ed into  action:  but this last is an essential  condition;  for if the me-
 dulla oblongata were separated from the spinal marrow by a section,
 there would no longer be any possible  muscular  movements of a
 general  kind, but only partial convulsions, produced  by the stimu-
lation of each point of the cerebro-spinal apparatus,  on which end
the muscular nerves, either above or below the section, or by  the 
RESPIRATORY MUSCLES.
293
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 exter-
nal  senses, because these  latter cannot operate  on it without the
concurrence 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
whatever  of  the concurrence of the cerebral hemispheres,  the seat
of intelligence.   But from the instant when the instrument which
disorganized the hemispheres, penetrates  to the summit of the me-
dulla oblongata, respiration and life  cease, because the centre of
perception 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  expira-
tion of a certain time have penetrated to this same centre of percep-
tion 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 con-
trived it, that a lively stimulation should  be transmitted to the cen-
tre  of perception, and act on it in an instinctive manner; but if, be-
fore any of  the lobes  of the cerebellum were interested, they had
taken care to destroy  its communications with the medulla oblon-
gata, by dividing the  pedunculi which pass to  the pons varolii, I
am  persuaded that the cerebellar lobe might have been pricked and
slashed without convulsion ensuing;  what proves this, is  the fact,
that, when they entirely removed  one of these  lobes,  paralysis of
the  voluntary muscles of the opposite side took place.
  But whence comes  it, that, during these two experiments, respi-
ration still continued.  Had not, then, the internal pulmonary sense
any need of the cerebellum, to obtain the co-operation of the mus-
cles dilating the chest, though they are in connexion  with volition,
and, as such, seem to  owe their principle of action to the cerebel-
lum? I think this new difficulty may be  thus resolved.
  The dilating muscles of the chest, or the cephalo-splanchnic ones, 
294                     ACTION OF  THE
are called into action by the centre of volition; but this centre makes
them act under two different influences; at one time in obedience 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 perception 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.
  If it be demanded how I can know that the centre of perception,
situated at the head of the medulla oblongata, is charged with  such
a 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 commu-
nication 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 confirma-
tory of those of Legallois; or rather, that they are the same in re-
ference to respiration, since they prove what he had proved; 1. that
the destruction of the cerebrum and  cerebellum does not prevent
respiration, 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 which
can contract to produce respiration, without the abovementioned
parts of the encephalon,  cannot move without these latter for the
processes 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- 
RESPIRATORY MUSCLES.
295
tellectual  faculties cannot  produce voice and speech  without the
instruments of instinct,  and that these  latter may suffice for the
instinct of respiration without the concurrence of the encephalic
cerebral 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
instruments 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 deve-
lopment 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  only suspend, and of those,  finally,  over which it
exerts no  kind of control.   I shall content  myself, then, with re-
ferring to the  first part of this work, still observing, that sufficient
reasons for these differences are constantly found in the organiza-
tion of animals.
  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 move-
ments still persist, even after the destruction of the cerebrum and
cerebellum.  The great sympathetic does  not reach  the  medulla
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 respi-
ration; in the other, on the nerves of the muscles which the centre
of perception  causes to contract for the performance of this function.
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 inadmissible, because
the section of the  medulla oblongata,  and even that of the  spinal
marrow, equally suspend respiration.  In fact, if this  communica-
tion had for its object the obtaining of contraction for the respira-
tory 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  movements are called fe: 
296
ACTION OP THE
by the respiratory sense  at the upper portion of the medulla  ob-
longata.
  It is then very certain, and well attested, that the communications
of the great sympathetic with the eighth pair, and the muscles which
perform respiration,  are  destined to transmit to the centre of per-
ception the desire to breathe, and to make the viscera participate in
the innervation that the centre throws info the muscles, at the mo-
ment in which it acts for the gratification of the desire.
  From  this association  it  happens, 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
appeal  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 vivi-
sectors show that the destruction of the cerebellum produces a para-
lysis of these muscles, whilst it does not  occasion that of the re-
spiratory 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 rendering
them susceptible of obedience, notwithstanding the  absolute defi-
ciency 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. 
RESPIRATORY MUSCLES.
297
  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 to act,
at the same time, as intermedial between the wants of vital chemis-
try 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 vague and  unsa-
tisfactory ; 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 effects  of the venereal orgasm is  to determine a
strong innervation on the locomotive muscular apparatus, and thus
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 are
commonly most powerful in the generative act, the development of
the occipital  protuberances should generally correspond to the
excess of energy in the virile powers.
  It must be  an erroneous opinion, that the cerebellum is  destined
to preside over the movements of the heart, and 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 re-
turns 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, MM.  Foville, and Pinel  Grand-
Champ, have just published an essay on the special  seat of the dif-
ferent  functions of the  nervous system.  The inferences from the
pathological observations which they have collected, and the  expe-
riments 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, preside
over the movements of the legj 3. that the optic bed  and the
medullary fibres to which it corresponds, that is to say, those of
the posterior lobe, keep under their dependence the movements of
the arm; 4. that complete hemiplegia follows an injury simul-
                               38 
298
-  ACTION OF  THE
taneously  and equally affecting  the parts presiding over  the
movements of the arm and of the  leg; and that partial hemiple-
gia, 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 re-
gulator 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.*
   MM. 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 me-
dullary fibres  descend from the restiform eminences which come

   * Dr. Gall has, we think with great reason,  objected to the experiments of
Flourens and other vivisectors on the cerebellum, and  encephalon generally,
that in their horizontal slices and sections, parts possessing very different func-
tions, must be interested or destroyed at the same time. Remembering that one
set of  the intra-cephalic nervous fibres,  radiate  from the medulla  oblongata
on to the surface, and that another series converge to the corpus callosum and pons
varolii, we can readily understand how ablation of a portion of the periphery
shall affect the very centre of the encephalon, and of course, that the consequent
phenomena give a very imperfect measure of the offices or functions of the por-
tion removed.  Our skepticism, founded on  a priori or anatomical observation,
in regard to the value of such experiments, is but too well justified in the con-
flicting results of the different vivisectors. Flourens is contradicted by Magen-
die, and Foville and Pinel Grand-Champ are in their turn opposed by later expe-
riments of Bouillaud, who made use of cauterisation to  destroy the  cerebellar
lobes.   This latter is, however, in  accordance with Flourens, in regarding the
cerebellum as the regulator of the associated movements which compose the acts
of station and locomotion,—a power which is, he thinks,  essentially distinct from
that which governs the simple movements of the trunk of the body and the mem-
bers,  while  there exists between  these forces  the most intimate connexion.
According  to Serres the  median lobe of the cerebellum  is the exciter of the
generative  organs.   Its  hemispheres are  exciters of  motion in the limbs, more
especially the lower limbs.  The cerebellum is, he thinks,  the exciter of
jumping.  The tubercular quadrigemina are, on the same authority, exciters of
associated voluntary motion, or equilibration; and, moreover, exciters of the sense
of sight, in the three inferior classes of animals. For a good summary of the present
opinions and actual knowledge of this and other parts of the nervous system, We
refer such of our readers as can conveniently obtain a perusal of it, to an inaugural
thesis,  " On the  Structure, Functions, and Diseases of the Nervous System," by
John R. W. Dunbar, M. D.  Published by J. Dobson, Philadelphia, 1828.— Trans. 
RESPIRATORY MUSCLES.                 299
from the cerebellum, and the anterior from the pyramidal and oli-
vary bodies, which, in  passing behind the pons varolii, are continu-
ous with the white fibres of the optic beds, and the corpora striata, j
  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
rather 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 adherent
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 promi-
nence externally?   Have these same white fibres of the periphery,
which on  this  supposition would be destined to the intellectual
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
beds of  the optic nerves and the medulla.oblongata?   What is the
office of that observed in the cerebellum and spinal marrow?  Are
there in those places mental or instinctive faculties, and,  if not, has
the gray substance any other appreciable function2  What is the 
300
ACTION  OP 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
between  the cerebrum or cerebellum, and the different parts 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  pe-
duncles 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 nervous
fibres in the central vasculo-nervous matter, that is to say, in  the
gray substance of the medulla oblongata; and thence  the volitions
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 corpora striata  and thalami  of the optic nerves, from  which
must emanate the movements for the voluntary muscles; some, in
fine, would enter into the gray  substance of the medulla  oblongata
only,  in which would  spring the volition to make the inspiratory 
RESPIRATORY MUSCLES.                  301
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 vis-
cera,  abuts,—stimulations which are, as  I  have shown, the deter-
mining causes of the movements attributed to instinct.
   But agreeable to this view of the subject, it would be indispensa-
ble for  this said portion of the gray matter equally to receive voli-
tions 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 medulla
oblongata.  In this manner one might explain  how it is the centre
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 sti-
mulation 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 an-
cients, who jthought that the  cerebellum  presided  over the move-
ments of the principal viscera, and that of Dr. Gall, who places the
seat of concupiscence in this organ; since the venereal appetite forms
an essential part of the phenomena of instinct.  We also explain,
how the will can arrest the effects of venereal desires, and those of
pain and many other instinctive impulsions, owing to the gray mat-
ter of the centre of perception being influenced  by that which pre-
sides  over the intellectual operations.  Finally, 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 receives from the great sympa-
thetic, and which it transmits to the central point that now engages
our attention.
   As it is impossible to believe that stimulations produced on any
sensitive surface whatever, should be directed by a peculiar affinity,
at one time, towards a certain portion of gray matter, and again to-
wards 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 the entire extent 
•02                     ACTION OF THE
of the encephalic apparatus, and even the sensitive 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 returning 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 deter-
mine volitions in the sense required by the intellectual or instinc-
tive 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 towards the
brain, and vice versa; such are the conditions which to me seem
indispensable, for the exercise of  the functions  of the nervous sys-
tem; 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 to
corroborate this idea, the  reasons for which will be more fully de-
veloped 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
phlegmasie 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, the  peritoneum, the arachnoid, in a person who is
well? Does there exist more atrocious pains than those which are
caused by inflammation of  these  membranes?  How are we  to be-
iieve that the nerves that preside  over the functions  of these tissues,
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 
RESPIRATORY MUSCLES.                  303
 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 cephalalgias 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 cerebel-
lum?  The  cerebrum is on  the same footing with many other tis-
sues: suddenly injured, it evidences no pain; but give it time to be
inflamed,  and you will see that it has likewise its sensibility.  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 alleged that the
brain has  been seen inflamed and suppurated in consequence 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 subjects of an opposite
nature it  is obtuse in  the  parenchyme of the viscera; in all it is
exquisite on the  sensitive surfaces.  It is  developed in the com-
mencement  of phlegmasie, but it is deadened often by the  persist-
ance of irritation; and this is  one of the causes which have so  long
rendered inflammatory  diseases misunderstood.
  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-
ritation  vividly into the nervous apparatus; that is to  say, from its
being a very active promoter of sympathies, and pre-eminently the
exciter of the important movements: this is what we learn from the
experiments  of MM.  Foville and  Pinel  Grand-Champ.  It  is a
 great deal, I concede with the liveliest pleasure; but we must not 
304
Action  op the respiratory muscles.
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 movement:
but both assertions are equally incorrect.  The cause  of  sensibility
is every where diffused, since contractility resides in all the tissues;
but there are some of them, the function of which consists in  col-
lecting 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 he attentive, there is sensibility; if it be absent, that is to say,
if the centre of perception be not susceptible of acting, there is only
a transmission of stimulations.   Sensibility can then have no other
seat but the central point of the brain, where the stimulations termi-
nate, nor any other condition than the possession of consciousness.
The self perceives with more  or less readiness  pain in different
organs, according to the state of their nerves;  in the healthy con-
dition, it refers it to  the internal and  external senses, because they
are normal or  standard centres for  the  reflection of stimulations,
which the animal  must necessarily receive, and because the vasculo-
nervous matter is there found in a fitting state for this  reflection;
but if inflammation has prevailed some  time in a tissue until then
insensible, it will create a new vasculo-nervous matter, a true acci-
dental  sense, to which the stimulations will  tend, and in which
pain will  sometimes be more  acutely  felt than in  the ordinary
senses.  A puncture of the cerebrum will not, we are told, cause
either  pain or  convulsions, whilst that  of the cerebellum largely
produces such an effect.   I do  not doubt it, since it  has been ob-
served: but expose the cerebrum and spinal marrow of an animal
affected with a violent arachnitis; 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 of sensibility, independent of  the centre
of perception and the existence of consciousness, seems  to me  chi-
merical.   I  may  be deceived,  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 
DIGESTIVE  apparatus.
305
                        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
and insalivation, 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;
and the inferior portion, which is narrowed, is continuous with the
oesophagus.   The pharynx is formed of muscular bands, lined inter-
nally by a mucous membrane having papille communicating  with
the cerebral nerves, and in which to a certain extent is  continued
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-
                             39 
306
digestive apparatus.
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 ilucts, 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 valvulas conniventes.  The muscular plane is
formed of fibrin, 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-
cular is closely united to  the mucous  membrane, by an areolar tis-
sue, which never contains fat.
  The serous membrane, which is external, is the only one of a
homogeneous  structure.  We find  in  it  gelatin  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 
digestive  apparatus.                 307
that forms two lamine, between which the canal is placed.   It is
strongly adherent to this latter through the greatest part of it, that
is to say, at the anterior and posterior surfaces of the stomach, and
at the anterior face only of the intestines;  but in some parts it re-
cedes, and then its only connexion is by means of a cellular tissue,
in which may be deposited some fat.  This arrangement is observa-
ble at the two curvatures of the stomach, and at the internal curva-
ture only of the small intestines.  The object of this is to facilitate
the dilatation of  the  digestive canal, by permitting it to glide be-
tween the two lamine 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 pneumogastric, is of the encephalic domain; the other is derived
from the great sympathetic, a description of which  has been already
given.  Each region of the digestive apparatus now requires a par-
ticular examination.
  The stomach, which forms the most important portion, is placed
in the epigastric region, above the  other  two, and beneath the
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 eke out the  chapter by  a detailed description of
this organ, but content myself  with designating what is important
to be known, in order to have a just idea of its functions.  I 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 
;tu3
DIGESTIVE  APPARATUS.
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 from this, that the substances which it contains 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  also 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
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 not found in the intes-
tines.  It remains for us to know  whether the portion of mucous
membrane, belonging to the stomach,  contains secretorj'  organs,
the office  of which is to furnish a fluid fit to produce the assimila-
tion 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 
DIGESTIVE APPARATUS.
309
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 lamantin 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 differ-
ent 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.   I
believe there are  but two recognizable portions; the duodenum will
form the first; all the remainder of the small intestines on to the
ileo-ccecal 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-

  * The fact, if established, of there beiug in certain animals a superadded glan-
dular apparatus, for the secretion of what is called gastric juice, would in our
minds, be a strong argument against the admission of such a juice, in animals in
which like man, there are no glands to be seen. When in addition to this we bear in
mind the circumstance of the liver surrounding the stomach of some of the  smal-
ler and inferior  animals, and emptying its secretion into this cavity by several
ducts, we may be allowed to be  skeptical on the subject of agastric juice, which,
if it had originally any specific or peculiar properties, must have them materially
affected, if not entirely altered by the admixture with bile.  The  want of same-
ness of properties as regards taste and chemical composition, and its varying so
much in these particulars, not only  in different animals, but in the same animal
at different times, are familiar objections to our believing in a peculiar fluid se-
creted by the stomach, and possessed of specific powers,  like  the secretions,
properly so called, from glandular bodies.—Trans. 
310
DIGESTIVE  APPARATUS.
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 is
moveable, and much more narrow in its diameter than all the other
regions of the alimentary canal.   In this portion the mucous mem-
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 lamine of the corresponding portion of the mesentery. The very
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-
tent possesses, perhaps, an assimilating property. These  characters,
to us, seem sufficient to distinguish  the  small intestine from the
others.   After  having described a number of  convolutions, placed
one above another, it terminates at the ileo-ccecal valve, a fresh nar-
rowing, which  offers great interest to the physiological  physician,
as we shall see when giving an account of the physiological 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  caecum, a kind  of enlargement or sac,
whence begins  the colon.   The mucous membrane  that forms the
ccecal valve, is strengthened by a cellular tissue, numerous vessels,
and a greater number of mucous follicles than are 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
will be turned to a useful account in the pathology of intestinal
phlegmasie.
   The  colon constitutes the major part  of the large intestine.   It 
DIGESTIVE  APPARATUS.                  311
begins in the right iliac region, at the pouch called  caecum, 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
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 of 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 adherent 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 inferior surfaces, having
the same relation to it as to this  last  mentioned viscus.   Vessels
and nerves  placed in the cellular tissue of the  omentum, are com-
mon to the  stomach and transverse portion or arch of the colon.  It
is important to bear in mind  this  arrangement, for the just appre-
ciation 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. 
312
DIGESTIVE  APPARATUS.
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 communicates
with the brain by the small cords that connect the great sympa-
thetic with that  organ.   This is what experience proves; as the
kind of pain  called  colic,  has almost always its seat 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 feces  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.

  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 appro-
priated to  vital chemistry in the fluids;  this process is deteriorated,
and  hence the source of the  want.   It is  then that  the  portion
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
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. 
HUNGER,—THIRST.
313
 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
 a peculiar visceral sensation.  Now, when the stomach is inflamed,
 it is not the feeling of hunger which is felt, but others, which occa-
 sion 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 nerve the
 famelic 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 cerebral
 centre; but this latter speedily reflects it into the nerves of its do-
 main, 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 pre-eminently 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  slower
respiration, coldness of the entire body, and especially of the skin,
diminution of all the secretions, a sensation of emptiness and light-
ness in the body, proceeding from the circumstance of absorption
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 powerful
                              40 
314
HUNGER,--THIRST.
stimulus to those very organs which it had previously thrown into
a state of languor; sadness is  changed into anger, and the cerebral
centre,  tormented by the constantly increasing stimulation of the
great sympathetic, repels every idea alien to the want, and reserves
all the powers of the economy to  execute  the acts necessary for
alimentation.   As muscular action is its principal  instrument, the
muscles receive an abundant innervation; agility and force are dis-
played  in the highest degree, especially in the carnivorous animals,
of which often  much  exertion  is required to procure their  nourish-
ment ; 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 ship-
wreck,  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 mem-
brane which is the seat of  the feeling,  is injected with blood, and
deprived of serosity;  it becomes burning and inflamed. The desire
for fluids is exhibited with renewed 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  per-
son; but it is  more  especially the  latter,  which seems to us that
which inspires the most ardent desires, and most excites to anger.
   Hunger  and  thirst  may be suspended by sleep; for so soon as  con-
sciousness  disappears, sensibility is no longer manifested, though
the irritations which  give  origin to it still  persist.   This fact  in
conjunction with a thousand others, proves that sensibility is by no 
                         HUNGER,—THIRST.                      315

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
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 thjs  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 sensibiUty all the movements that re-
 sult from the stimulation of organized matter, you ought equally to attribute 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 conferred on the contrac-
 tion of muscles separated from the living body, and on the movements of the ex-
 cretory  ducts in exciting their fluids.  Sensibility not being appreciable, except
 by  contractihty, 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 contact of a stimulus, has felt;
 every fibre is then sensible.-  it would afterwards remain 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 of 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-
  Mial   For the first we require but a piece of organized matter; for the second, 
316
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 I.  It  moreover follows, that
he who can sleep in spite of the wants by which he is agitated,  suf-
fers less  than him who is deprived  of this advantage.  This  fact
confirms 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 u.«
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 pathological
part of the digestive function.

we want an animal full of life, having a cerebral centre, and being in a waking-
state.  If you place sensibility in  the nerves, why not say that this property still
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 sensibi-
lity in an arm or in a leg, which you irritate, why will you admit its existence 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 organ-
ized matter, and reserve that of sensibility for the phenomena of consciousness;
the property entirely intellectual; will become the attribute and the proof of
mind,  and we shall no longer hear the ridiculous question proposed: Are plants
sensible ?

  * If a man tell yon, / suffer in the limb rvhich I no longer have, it is because he experiences irritation in
the extremities of the divided nerve, which are a part of his body; but this depends on a fact foreign
to the question now under discussion, and which I shall treat of in another place. 
DEGLUTITION.                     317
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-
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
alimentary bolus, which is carried into the pharynx in the manner
already indicated when treating of the sense of taste.  The mucous
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 the 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 
318
DEGLUTITION.
the will, and the bolus can no longer be  arrested in its progress to
the stomach.
   If, however, its presence was inconvenient; if it was not suffi-
ciently moistened by mucus; if it was stopped by asperities, as in
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
vomiting, and we shall then see the respiratory muscles, which 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.   By this  mechanism, then,
the will  is 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 the 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 ex-
cited ; for, as this movement resists volition, it will expel the ali-
ment, 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 aliment, but only obliged them to
suspend their action, and to open the cavity of the mouth in order
to facilitate vomiting. These  muscles have then obeyed the visceral
sensations, which draw after them  the will, but were not at all sub-
servient to the  impression made on the-sense of taste: this impres-
sion 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 pro-
duced by the sensation of taste  independent of the will, are the se-
cretion 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 anticipation 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 latter
process belongs to vital chemistry;  but  while this power acts on
them, it  manifests phenomena  of  relation, the study of which  is 
FIRST ASSIMILATION.
31*
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
in 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.
   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 
320
FIRST ASSIMILATION.
likewise directed into it, and this without the necessity of any ef-
fort 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 re-
lations by which this afflux is determined are, as we know, perform-
ed 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
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 gastric ca-
vity, 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 least 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 
FIRST ASSIMILATION,                  321
 lets it pass the first,  than because it is entirely absorbed by the
 mucous membrane.  It would be, however, hazardous to d ny, 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.
 the pylorus, to which they had  been many times presented, allows
 them 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
 state 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 commanded
 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 distin-
 guish 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.   Dr.  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 alter-
ation ;  whilst the second appeared only at the expiration of three
or four hours,  under the appearance of chymous matter already
                              41 
322                  FIRST ASSIMILATION.
perfectly elaborated.  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 derive 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.
  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-coecal 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 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 
FIRST ASSIMILATION.
323
empty, which has been referred to the more rapid  absorption in
the ileon.   For myself, I hold it incontestible,  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 ccecum, I should be induced to  believe that assimila-
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 coscum,
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 assimilator, 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
retained, and arriving sooner at the  large intestines, than many
others, and  sometimes these matters take a retrograde direction in
the intestinal cavity; but as these differences are  especially notable
in the pathological state, we shall reserve them for the last section
©f this chapter.
   The excrementitial matters contained in the cavity of the large 
324
FIRST ASSIMILATION.
intestine, are there submitted to a very slow progression.  This or-
gan is one of deposit, and must consequently be much less movea-
ble than the superior region, which is but a place  of transit.  The
cells of the colon aid in the retention of its contents.  Here the
organic relations  are infinitely more  limited; the appeal made to
the grand secretors is null in the normal state; that exercised  on
the mucous follicles is very limited, and reduced to the secretion of
a sufficiency of mucus to avoid dryness  and constriction,—pheno-
mena which are as yet but too common.  It is clear, that if this rela-
tion had 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 sto-
mach, 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 ordi-
nary mode of vitality of the mucous membrane of  this intestine,
and  of the muscular  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
parietes. 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 as
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 a
word, there takes place  an agreeable innervation, that  solicits  the 
FIRST ASSIMILATION.
325
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-
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 be-
comes more accelerated and full.   The brain, stimulated by a more
considerable 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 reduced,
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 stimu-
lation is diffused by means of the encephalon through all the regions
of the body.   Were it, in fact, limited  to the muscular coat, and the
secretors auxiliary to digestion, the intellect and the entire muscu-
lar apparatus  would be strangers to it; we  should  not  experience
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 becomes
by cerebral innervation.  Observe also, that the other internal
senses, and especially the pulmonary,  acquiring more  activity 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 luns^s at this  time
is another very powerful  cause of the augmentation of action in the
respiratory muscles; and this arises from  the respiratory surface, 
326
1'IRST ASSIMILATION.
diminished by the sudden engorgement of the parenchyma, receiv-
ing a smaller volume of air than before, which obliges it to solicit
more frequent inspirations.   It is thus, that we find manifested 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  intellect refers to
the stomach during  the chemical  operation  of  digestion, because
each of them developes sympathies somewhat different.
   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 cardiac
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
moment, 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  spi-
rituous liquors; the mucous tissue in which it resides, has become
hot, and even burning, and to the desire  for stimulating has  suc-
ceeded  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 ingestion of watery drinks, were we not arrested by the  sen-
sation  of fulness which depends on  the general  distention of the
viscus.  This sensation joined to that which results from refrigera-
tion, soon restores to the cardia the property of being agreeably 
FIRST ASSIMILATION.
327
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
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 chemis-
try 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  incompar-
ably more pronounced if the food have been mixed with  a certain
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 
328
FIRST ASSIMILATION.
hypochondrium, 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-
teresting observation,  that the breathing,  which during  the  first
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 distract-
ed then by any disagreeable sensation; and this is what is so impor-
tant 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. 
DEFECATION.                      329
 This fact seems to prove that digestion is continued in the small in-
 testines.

 Section IV.—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 region
 of the trunk.  Thus, during the first period, when the stomach was
 full  and the lungs  engorged with  blood,  the  intercostal muscles
 acted with much energy in raising the ribs; the diaphragm  and the
 upper fibres of the  abdominal muscles allow themselves to be dis-
 tended 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 epigastrium to
 subside, has spread itself in a sinuous stream in the small intestines,
 we see the pectoral muscles diminished in size, the diaphragm de-
 pressed,  the upper sections  of the sterno-pubien  muscles and the
 upper fibres of the  transverse and oblique 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 evidently this
 same cephalo-splanchnic motor apparatus obedient to the modifica-
 tion of the large intestine alone.
   At first the accumulation of faeces in the cavity of this organ pro-
 vokes 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 surface;
 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 in-
sufficiency of this effort causes a certain degree of pain, which pro-
                              42 
3.30
IJEFECAT10N.
duces an appeal to the brain,  and thenceforward the will is forced
to yield to the muscles  above mentioned,  an impulsion which in-
stinct alone could not communicate to them.   But all this does not
yet suffice; we require  an attitude for faecal discharge, a point of
support for the inspiratory muscles, to keep the chest immoveable,
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 ad-
mirable union of synergetic efforts that defecation 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 viscera.
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 facul-
ties.  It is worthy of remark, that sensibility, so far from being
blunted, becomes more delicate in proportion as we advance in life;
at 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 diges-
tion.   This last remark, however, having been made by all physio-
logists, I dp not deem it necessary to dwell on  it any longer. 
ABNORMAL ASSIMILATION.                331
Section V.—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 apparatus,  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
singular organ;  its destiny is to be always irritated, and therapeu-
tists 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 super-animalizes, 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

  * 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 radicle* 
332                 ABNORMAL ASSIMILATION.
me 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 absorp-
tion, and is super-animalized; that the urine and faeces undergo the
same alteration; but why should not there be a similar change in the
stomach?   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

convey this stimulation into the splanchnic nervous apparatus, since the stomach
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 exists: now it is this condition  of things which makes
the state of sensibility, that constitutes consciousness.   What then becomes of
sensibiUty 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.
333
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
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 pancreatic
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 phlegmasiae, 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 observa-
 tion 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 Medicates.]   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
 are adapted to its vitality will offend it much less than  those which 
334                ABNORMAL ASSIMILATION.
are repugnant to it.  Let us next examine into  whatever is appre-
ciable in the lesions which it suffers from both of these sets of agents.
  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
universal  disturber, and a source of organic disorder both in the
viscus  itself and in those which  sympathise with it.  Alible sub-
stances 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 hun-
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,  expe-
rience, 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 participat-
ing in  it.  It will not then excite surprise  to hear us say,  that these
organs must be the first by their diseases to participate in the dis-
orders of nutrition.  We shall thus acquire evidence, that, if it be an 
ABNORMAL ASSIMILATION.                335
over-irritation, which the stomach undergoes in consequence of its
having been forced for too long a time to digest the healthiest ali-
ments 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 morbid
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 substances
that have reached its cavity.
   Two phenomena, we have  said, necessarily  take place during
digestion; the assimilation of alible matters, and a notice transmitted
to the centre of perception as to the manner in which this assimila-
tion is accomplished.  The first is in the province of vital chemis-
try, which calls to its aid contractility, in order to attract the fluids,
and excite the necessary movements of the splanchnic  muscles.   I?
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  movements 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 contrac-
 tion, 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 
336               ABNORMAL ASSIMILATION.

in the head, are among the accompanying symptoms; and  in fine,
the instinct is modified in a very disagreeable manner for the cen-
tre 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 encephalic
functions than in the other viscera.  Thus, to heat and rapid circu-
lation are joined bursts of gaiety and afterwards of fury, delirium,
excessive and even convulsive strength in the muscular apparatus,—
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 sensation
of contraction and strength, there is that of weight, relaxation, and
fulness of the stomach.   This  viscus is sometimes  in so powerless a
condition that there is not the least  gas expelled  from the mouth;
the strength is then destroyed, and the pulse scarcely perceptible;
speech and even thought become impossible; convulsions  supervene,
and we find persons sink in this state, with the stomach full of ali-
ments, 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  disagreeably
affected by the ingesta and its not reacting on them for the purpose
of assimilation.   The kind of excitation which it experienced only
acted on the centre of perception,  so  as  to cause convulsions, and
the violence of these latter exhausted life.   In  fact, death cannot
result in such cases without convulsions;  so true is it, that this vis-
cus is so constituted that it can never remain any length of time
without being excited;  let  it  be in a manner adverse to, or conge-
nial with, the well-being of the animal  economy, it can never re-
main inactive.
   This  kind of death  is, however, extremely rarej  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 fermen- 
ABNORMAL ASSIMILATION.
337
tation or putrefaction, the gases more or less opposed to vitality
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, whatever  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 mechan-
ism 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 obey 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 oesopha-
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
                            43 
33S
ABNORMAL ASSIMILATION.
likewise a deglutition of  air, which renders the stomach still more
compressed by the enlargement of its cavity.   Finally, the  antipe-
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
fossae is in a state of congestion, caused by 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 are 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  cutane-
ous surface by the  obstacle which it  encounters  in traversing the
chest,—we may have some idea of the prodigious vascular irritation
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 evencasesin which the irritation
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 lung?. 
ABNORMAL ASSIMILATION.
339
condensed, retain the blood which comes from the  head, and  pre-
vent the emptying of the vena cava; the blood of the encephalon
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 faeces and urine escape in vomit-
ing.
   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
absolutely impossible to produce this discharge. The reason is this: 
340
ABNORMAL ASSIMILATION.
the volume of the organs contained in the abdomen being too in-
considerable to exert a pressure under the  arch  of the diaphragm,
the abdominal 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 con-
tinues to be excited in an antiperistaltic direction, the person is ex-
hausted in vain efforts;  it is as impossible for him to vomit,  as for
the consumptive, 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 
ABNORMAL ASSIMILATION.
341
alone?   Let any one attempt to produce defecation when the ex-
pulsive  movement is not developed in the muscular  coat of the
colon and rectum, and he will  never  accomplish it   There is no
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 has
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 w7ere 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 
342
ABNORMAL ASSIMILATION.
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
wTas  always full; and  dissection  after death  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
consideration.
  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 wrhich 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 
ABNORMAL ASSIMILATION.
343
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
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
M.  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
peristaltic  movement  which conducted them  towards  the large
intestine.   Now, it seems to  me, that the choice of matters to be
vomited can only depend on a similar  mechanism.   We can con-
ceive,  at present, how the mucosities  produced by a slight gastri-
tis, 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, with-
out aliments 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 phlegmasiae  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 
544                ABNORMAL ASSIMILATION.

the pylorus, and other partial phlegmasiae 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
of antimony and potass, 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
sense continues to be depraved, and profoundly perverted, in those
who have  been treated by this  method.   Digestion is often de-
stroyed for many  years in most of them;  they retain a chronic
gastritis, with a convulsive disposition  of the stomach and small in-
testines; they become hypochondriac, and neuropathic; and if, unhap-
pily, 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 
ABNORMAL ASSIMILATION.
345
 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,
 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 astonish-
 ed, when he sees  to what an extent the stomach may  resist this
 cause of irritation in robust persons.  We sometimes see jugglers,
 as they are called, polyphagi, who,  for  a series of years, swallow.
 with  impunity, flints, knives, and other like substances; they, howt
 ever, all end  by  sinking under inflammation of the stomach and in-
 testines.  We can conceive that beings thus privileged  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 de-
licate 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,
revive 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  mauners  and happiness of society;  but we must set
                              44 
346
ABNORMAL ASSIMILATION.
out from the point whence we deviated, and explain the bad effects
of indigestible substances, which hitherto we have merely hinted at
   The stomach, as we have seen, displays, for the digestion of ali-
ments, an action proportionate to the difficulty of their assimilation;
but for this purpose there must exist a certain affinity between them
and it;  otherwise, that  is in  the cases in which they are indigesti-
ble, 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 exci-
tation occurs; in the second this  membrane does not act for  the pro-
cess of  assimilation, but rather causes muscular movements of ex-
pulsion, 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 vegeta-
ble 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, corrosive sublimate,
and purgative salts, is then still more pernicious, and  we see,  in
fact, that those who have been addicted  to such things become 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 de-
purating power, always occupied in the expulsion of mineral mole-
cules, 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 mo-
ment in the viscera and the tissues of the  locomotive apparatus;
engorgements arise in the lymphatic  system, in  the principal se-
cretors, 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; 
                    ABNORMAL ASSIMILATION.                347

 they renew the phlogosis, which, from being latent, becomes acute,
 and hastens destruction. Will you limit yourself to the employment
 of nutritive substances of the most benign character, such as gela-
 tin, 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
 on the same line with 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 gaity; 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, oph-
 thalmias, and acute rheumatisms, come on with violence under the
 influence of heat and cold, or of the passions—make rapid progress,
 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  phlegmasiae.  This  success
encourages them; they are persuaded, that they owe their life solely 
348
ABNORMAL ASSIMILATION.
to the energy derived from  their succulent food, and fermented
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 haematosis 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 
ABNORMAL ASSIMILATION.
349
 in the most energetic state, when the freshness of the complexion,
 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 turgescence,  en-
 gorgement 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 equilibrium, or the
 irritation is exasperated; and  in this case it sometimes passes into
 the acute state, and these persons have for the first time a pretended
 essential (idiopathic) fever; or at times it remains  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 dissipated, and they are in pre-
 cisely the same  state as those of whom  we have already  spoken
 The only difference consists in their arriving  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 ir-
 ritation 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 
350
ABNORMAL ASSIMILATION.
small intestine, affecting the head, produced in it  cephalalgia ; the
brain being stimulated, rendered the muscles painful,—and all these
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 render-
ed 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 inflam-
mation, 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
of 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
eold 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- 
ABNORMAL ASSIMILATION.
351
 nics, bitters, anti-gouty, detergent, purgative, and deobstruent me-
 dicines, 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, 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 apparatus, 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 apparatus; 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 a:■«  owing  the principal symptoms in 
352
ABNORMAL ASSIMILATION.
 typhus, whenever gaseous poisons, arising from the decomposition
 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 the 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 diarrhceal movements, and completes  the assimilation  of
chymous matters which had already passed through  the stomach. 
ABNORMAL  ASSIMILATION.
353
 This is one of those phenomena which have led me to believe, that
 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  how 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, by arresting
 the advance of their contents, give rise to the most dangerous in-
                              45 
354
OF THE ABSORPTION OF
flammations. The bladder and genital organs participate to a certain
extent in the irritation.
  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 Fallo-
pian tubes, and are 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 anastomose, and intersect
each other repeatedly, without undergoing any change of diameter,
like the veins; they go  to  the mesenteric, mesocolic, and gastro- 
NUTRITIVE SUBSTANCES.
355
 epiploic ganglions, and finally reach the orifice of the thoracic duct,
 to be subdivided and anastomosed anew.
   The thoracic duct, which is the termination not only of the lym-
 phatics of the abdomen, but likewise of those of the pelvic extremi-
 ties, and of the leftside of the head and neck, begins by five or six
 large trunks, after which it presents an enlargement called reservoir
 of Pecquet, or cisterna 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 subclavian 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 seve-
 ral 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 said
 to the contrary, for we find  in  it gelatin; 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  anastomosed without  end,  and united
 into a mass  by means of cellular tissue, thus  forming  an  organ,
 which receives many blood-vessels and trisplanchnic nerves, and is
 enveloped by a tolerably dense cellular membrane.  Their  volume
 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 vitality. 
35ti
OF THE ABSORPTION OF
Section II.—Of the Functions qf 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 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 not adapted  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 ex-
treme 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 acton, 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: 
NUTRITIVE SUBSTANCES,
357
 because they are then  no longer presented molecule by molecule,
 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 always preside over the motion of the ab-
 sorbed fluids, when they have reached the tissue  of the lacteal gan-
 glions?   Proof derived from the  aid of our senses here again fails
 us.  It is in vain to tell  us that the glands under consideration are
 collections of vessels folded or rolled on each other, when no pre-
 paration 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 capil-
 lary 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 probable, upon this ac-
 count, 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 mo-
 mentary extravasation; that is to say,  of what use is the lacteal gan-
 glions?   I am reduced to inductions in  order to reply to this ques^
 tion; but, as I am of opinion that they  will be  better 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
subclavian 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 destination. 
'*5a                 OF THE absorption of
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
inflammation  must  be opposed  to  nutrition, especially when
concretions  and  obstructions are  formed in the thoracic  duct, or
when it is compressed 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 ali-
ments, 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 follow-
ing 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.                 359
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 ihe 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 ganglions 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.   I have like-
wise met with general chronic phlegmasiae 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 diseases, it is not dependent on the obstruction of 
360
CIRCULATION OF THE BLOOD.
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 OF  THE BLOOD.

  So soon as the chyle has been  poured into  the subclavian 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 parenchymal 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 parenchymae of the organs,  and in the  veins,  inas-
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 fibrin eminently contractile;
it is hollowed out into four cavities, two  of which receive 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 of 
DESCRIPTION  OF THE  HEART.               361
 the sixth and seventh left ribs, and between the two laminae 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 preceding one, 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  internal 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
                             46 
362              CIRCULATION OF THE BLOOD.

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
Venae cavae; 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  cavae and pulmonary artery;
from the left  with the pulmonary veins and the aorta, and is reflect-
ed 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 de-
rived from the cardiac plexus, which  is formed principally, as we
have seen, by cords of the great sympathetic, but where also termi-
nate 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 in-
ferior vena cava, that which has circulated in all parts  of the body. 
FUNCTIONS OF THE HEART.
363
except the lungs. Now, when on the subject of respiration, we have
seen that the blood loses its vermilion  colour in contributing to the
exercise of the different functions of the  organs;  it is then with
black blood that these right cavities  are in contact.  The left  au-
ricle 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 were 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  op-
posing an  insurmountable  barrier until the moment  when a new 
364
CIRCULATION 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.—Foetal 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 deviation, 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. 
OF THE ARTERIES.
365
  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,
trachea,  lungs,  (bronchial arteries,) and the superior extremities.
Afterwards the  aorta,  descending  always upon the left side of the
body of the vertebrae, traverses the thoracic cavity,  where it is con-
fined to supplying  branches  to the -skeleton and the parts which
cover it; next it perforates the diaphragm, descends upon the ante-
rior part of the  body of the lumbar vertebrae, is then called abdo-
minal aorta,  and  furnishes  arteries to all the viscera of the abdo-
men 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 removed 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. 
366               CIRCULATION OF THE BLOOtf.


            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
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 fibrin,  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,  which some  anatomists have gone so far as to divide into
two laminae,  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 pro-
per coat, which it would be very erroneous to compare to any por-
tions 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 gelatin arranged in
areolar laminae, we do not think  proper to  dwell  on it here.   Con-
tractility is extremely obscure in the internal coat; but extensibility
is very remarkable, since it can form hernia, in certain aneurisms,

  * So far from the proper  coat being formed of fibrin, chemists are not agreed as
to the presence of any of this organic element in the arteries. Berzelius assures
us that it cannot be found in them.—Trans. 
VITAL  PROPERTIES OF THE ARTERIES.           367
through the rents of the proper  coat.  It  is particularly with the
properties of this last  that it is important for us to occupy our-
selves.
  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.
In our opinion, this property considered in the arteries,  is altogether
vital.  In fact, it belongs to the particular composition of the fibrin
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
in 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 inorganic 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 com-
pared 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 person
should do exactly the contrary, and consider, for example, the elas-
ticity of water, and that of gas, as properties borrowed from living
bodies.   It  is thus,  in my opinion,  of colours,  forms,  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, exactly in
the degree  necessary for a due  performance  of the  functions 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  latter, 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. 
368               CIRCULATION OF THE BLOOD.

  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 proba-
ble that the pain might be perceived in the tissue of the arteries;
but it is necessary for this, that other sensations  should  not pre-
dominate  to absorb the attention of the percipient centre.   Now,
that is scarcely possible; for the 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
belonging to it.  This reaction cannot fail to communicate a new
impulse 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  observed 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 
FUNCTIONS OF THE ARTERIES.
369
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
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.  We 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 fibrin, it is true, but of fibrin 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 which they undergo in their size, when  the  organ  in
which they are situated enjoys an unusual degree of vital action, or
is the seat of inflammation, are independent of the impulse of the
heart; but this is only observed  in  the  branches,  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
internal sensitive surfaces, (mucous membranes,)  and  the secreting
or erectile organs can communicate to those vessels which 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,
                               47 
370
CIRCULATION OF THE BLOOD.
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, notwithstand-
ing the assertion of Stahl, who taught that the blood was regulated
less by physical than organic laws, and the experiments  of Pierre
Antoine Fabre, which  proved that the blood in the  capillary sys-
tem 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.  Besides,
the coats of the arteries, becoming more flexible in  proportion as
they decrease in size, cannot drive back the  blood by a shock as
forcible as that impressed upon it by the larger arteries, which cannot
fail to weaken the impulse of the heart  Finally, the blood, reach-
ing 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 man-
ner, 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 
FUNCTIONS OF THE CAPILLARIES.
371
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
adjoining parts, and even retrogrades, if it is necessary, rather than
accumulate in excess  before the obstruction that is opposed to it
   All these observations relative to the diversion of  the blood are
very correct; physiology  and pathology  continually furnish con-
firmation of them.   The experiments of Fabre, repeated by  Dr.
Sarlandiere, 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 were congested there,
w#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 differ-
ences are observed; we see great irregularities in the quantity of
blood that is found  in different parts of the skin, and in  those of 
372              CIRCULATION OF THE BLOOD.
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
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 disor-
ganized by the previous inflammation, contains none.   But we Kan
only observe this in subjects exhausted and rendered almost exani-
mate  by the duration of the disease  or  by  haemorrhages; for the
plethoric have always sufficient blood, to allow all the parts adjoin-
ing 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
perceive them in the small vessels, as in those that  approximate
nearest  to the capillary system; but he observes, that at this degree
of diminution 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 lo-
cate 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 energetic 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 
FUNCTIONS OF THE CAPILLARIES.               373
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.   I
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
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

  * The elasticity or peculiar property of the arteries by which they are promptly
restored to their original diameter, after the distending power of the blood pro-
jected from the heart is withdrawn, is of a very different nature from that evinced
in the muscular tissue;  and cannot depend  on fibrin.  The proper coat of the
arteries is similar in its  composition and general powers to the yellow ligaments
of the vertebra,  and the posterior cervical ligaments of quadrupeds, and that by
which  the shells of the bivalves  open, when the" muscles which had kept them
closed  are relaxed.  In all these examples, the property of contractility, which is
paramount in muscle,  and dependent on fibrin, is scarcely, if  at all evidenced.
How then  can we with any propriety admit  structures  so opposite in their pro-
perties to be composed of the same elements;  or regard that as merely a differ-
ence in degree which exists in kind.
  The  proportion of the yellow elastic fibrous tissue, or that constituting the pro-
per coat of the arteries is diminished in the smaller vessels,—and in the capillaries
is almost entirely wanting.  It is in these latter that the chief vital phenomena of
the circulation are evinced, and in which contractility is said most to prevail. We
are, however, still more at a loss than in the case  of the great arterial  vessels, to
ascertain on what special tissue or structure their properties depend.  Though
compared  to muscular  it is not identical with, or similar to this latter tissue either
in composition or function.  The  contractility of the capillaries is that common to
cellular tissue,  of which they chiefly consist, with the greatly increased suscepti-
bility derived from the  profusion of nervous twigs  so interlaced as almost to form
a coat to the vessels. This arrangement is very evident in all the visceral branches
of the aorta,  and on very good authority we  may say with Lancisi in his letter to
Morgagni, that, from the ganglia of the great sympathetic, twigs are given off so
numerous  as to surround  the  arteries and be continued with them, even in the
limbs, on to their termination in the veins. No doubt but there is free interweav-
ing of the  twigs of the sympathetic with the ramifications of the cerebro-spinal
nerves, along  the vessels, and especially towards their extremities, which will
serve to explain the much  greater sensibility in these latter than  in the larger
trunks, where the sympathetic alone forms the source of nervous supply.—Tbans. 
374              CIRCULATION OF THE BLOOD.

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, composition, and decomposition,
must take place;  and there  also  is  verified, as respects living
bodies, the axiom  of the chemists: Corpora non agunt, nisi sint
soluta aut fluida. It is by the successive diminution of the filiform
structure that nature accomplishes this purpose, and  we may con-
ceive the last can no longer be organized coats, themselves contain-
ing other  vessels.  A glance  at the different orders of animals 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 a
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
off 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 func-
tions than that of  assimilation, or rather when nutrition requires
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 apparatus to
direct the action of this vessel; but there is here no evidence 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.
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 they
arise from the great vessel of deposit, pour out their fluid into this
living matter, which may be compared to that of the  polypus, and 
FUNCTIONS OF THE CAPILLARIES.
375
which forms, I repeat it, the greater part of  the  bulk of the ani-
mal.
  In the mollusca a heart is found with only one ventricle; but the
vessels which arise from it are by no means numerous; so that
gelatin or albumen not vascular, forms still the greater part of the
animal, and alone secretes the calcareous phosphate; for eertainly,
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 assured
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 exposed
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 with-
out 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 ven-
tricle, 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
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 gelatin, albumen, and fibrin, the basis 
376
CIRCULATION OF THE BLOOD.
of all our tissues? and are they not formed equally in the mollusca
and in fishes? Fibrin perhaps is wanting in the polypi; but mucus
and gelatin are found in them; and we know that fibrin is  nothing
but a degree of improvement of these two forms, which belongs to
animals more elevated in the zoological scale.  With respect to the
different forms of animal matter afforded by the secretory organs,
such as milk, bile, saliva, &c. they proceed from the  three primi-
tive ones; and, if these do  not need vessels for their existence in the
animals of the lower classes, wherefore do we make this  aid indis-
pensable 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 cer-
tain size contain others in  their walls; that  even these latter, when
they are sufficiently large, contain others of a third class, is compre-
hensible; but that there is  no  limit to this multiplication is  a thing
that cannot be admitted.   I believe even  that it does not extend
very far, and that, in many organs, the vessels terminate abruptly,
depositing their  fluids between the molecules of the primitive tissue,
whether it be  gelatinous, albuminous, or of  fibrin.   This  appears
to me to take place  in the  white pulp of the brain, and in the ten-
dons, ligaments, bones, and  even  muscles.   With regard  to  the
lungs, liver, spleen, and digestive canal, they are undoubtedly much
better supplied with vessels;  but these latter themselves, becoming
capillary, are no more than gelatinous cylinders, not vascular.  The
cellular tissues, and  the fibrous membranes which serve to  contain
the vascular fasciculi, in the spleen, for example, and in the  erectile
tissues, are in a similar situation.   It  is the same with the  mucous
membranes, kinds of parenchymas, in which the vessels disappear
very abruptly.  As  for the serous, areolar, and adipose tissues, in-
flammation proves to us that  they are very vascular; but this same
remark always holds good, that their vessels, whether  sanguineous
or lymphatic, are cylinders  of  simple  gelatin.   The  lymphatic
glands appear possessed of very little  vascularity, as we  may infer
from the manner in  which inflammation is carried on;  we know
with what facility their vitality is  extinguished, which should in-
duce us to consider them as formed in general, like the tendons, by
a mass of gelatin 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- 
FUNCTIONS OF THE CAPILLARIES.
377
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 intrusted 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 theft 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  intrusted  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 che-
mistry.*  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 which it re-
quires, 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 of
nervous matter, all pathological phenomena are developed:  I think
that the vessels and nerves, properly so called, are affected only se-
condarily, 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-
culation; and, in fact, have  all  been  comprised  in  the  history of

  * The author might have still farther strengthened his position by a reference
to vegetable physiology.  In plants there is no circulation properly so called—
the movements of the  fluids are mainly molecular.  There is nervous action
without continuous nervous cords, and secretion and new growths without dis-
tmct vascularity.—Trans.
                               48 
378               CIRCULATION  OF THE BLOOD.

what is called the capillary circulation.  This distinction is, how-
ever 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 numer-
ous, it may be drawn from all sides by the stimulations which are
developed 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 demon-
strated it.   This is what I call the great route or direct  course of
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 receive
a great quantity of it, to supply  the  contractions that may be re-
quired, 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, ligaments
and bones; tissues which, forming a great part of the  mass of the
individual, co-operate, but in a passive manner,  to  the exercise of
functions.  They have a vis  inertia, which  depends on their com-
position, and this latter is the effect of nutrition.   As it is  for nutri-
tion that the blood is conveyed  to them, they receive but a small
quantity of it, and almost all that^reaches them is extravasated in
the animal matter of which they  are formed.  I should even be in- 
FUNCTIONS OF THE CAPILLARIES.
379
duced to believe, that the whole of this fluid there undergoes extra-
vasation, 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 in them;  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 in-
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
believe that it does; but they have behind  them numerous capilla-
ries, 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 fibrin,  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,  extravasated into
 their fibrin, assists their contraction, and  will be diverted  from
the direct route much more when the muscles are in activity than 
 3S0               CIRCULATION OF THE BLOOD.

 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 which they
 transmit to the brain, and to the heart, by means of the nerves, im-
 parts 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  prodigiously dimi-
 nished.
   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
t 
FUNCTIONS OF THE CAPILLARIES.
381
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 produced  by
mucous inflammation.
  If we cast a glance  over the skin, we shall observe in it differ-
ences 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 influ-
ence 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, disco-
loured, pale, or overspread with livid spots; in a word, it will exert
no derivation from the capillaries which place  the blood at  the  dis-
posal 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; they are still greater,
if we compare these tissues  with those in an opposite temperament, 
382
CIRCULATION OF THE BLOOD.
 which have no sympathies, and where we have said that the capil-
 lary system was not enough developed.
   For example, in vain would  any cause, whatever  it might be,
 accelerate the course of the  blood;  the  tendons, aponeuroses, and
 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 parenchymae 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 re-
 ceive 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
 so 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, commu-
 nicated to their membranes, and  cause  them to lose in  an  instant
 their transparency?  This could  only happen whenever  inflamma-
 tion 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; per-
 haps 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 te-
nuity 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  mo-
lecules 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 which 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 exudations,  and gives  to the  animal
 matter a new disposition, by rolling it in small cylinders, and by 
FUNCTIONS OF THE CAPILLARIES.
383
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 should pass between their molecules with-
out being 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 in fact; and if it possesses them, they ought to
be traversed by the fluids when these latter have arrived at the ter-
mination 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, 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 lat-
ter 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 sufficiently
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
agitated, disturbs the regularity of the course  of the  blood  in its 
:>M
CIRCULATION OF  THJE  BLOOD.
 capillaries.   The irritation  of this matter, transmitted  to  the  en-
 cephalon by its  conductors, the  nerves, 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 which
 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  circulating blood, while accelerating greatly its pro-
 gress 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; hence the latter is always less
considerable in these tissues than in the others. 
         PHENOMENA OF THE CAPILLARY CIRCULATION.     385

  When the course of the blood is greatly  accelerated, that part of
it which  is directed to the inert tissues  is diverted and drawn
towards  the capillaries of parts naturally  more  active;  and as it
exists in all parts which expend little of the fluids, so there is always
found within the reach of these latter, capillary net-works of deri-
vation which prevent the blood from remaining in the vicinity  of
the inert tissues.   It is thus that this fluid proceeding 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 ca-
pillaries of the cellular tissue, and marrow; that which is directed
towards the tendons, aponeuroses, and ligaments, by  the muscles;
that which proceeds towards the white pulp of the brain, by the ca-
pillaries of the cineritious portion; and  that which would be too
abundant for this last, by the sanguineous 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 which I havejust 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 advanced 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 qf 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
the abdomen, and which terminates in the first.  It appears to me
                              49 
386
CIRCULATION OF THE BLOOD.
that it is more  natural to divide the venous apparatus into  three
trees, 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 portae, 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: ]. The external,  which is cellular, and compact, and
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 fibrin: it  is  in fact gelatinous; is gelatin in a particular condition,
adapted to the  functions  of this  class of vessels.  In the cerebral
sinuses which  perform the offices of veins,  the dura mater supplies
the  place of  the  two coats of which  we have just  spoken.   3.
The third,  or internal  coat, is called internal  membrane; it is
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  laminae very diffi-
cult to separate, in  which are frequently distinguished white fibres
crossing each other; they do  not exist in the pulmonary veins,  in
the vena cava  superior, in the  inferior as far as the iliac veins, the 
STRUCTURE OF THE VEINS.
387
  internal jugular, the sinuses of the brain, and the vena portae. 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 with 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 relations of
  these vessels are very trifling.
    The venous trees of the lungs and digestive viscera have  but
  One arrangement,  which reigns throughout  their entire  tissue;
  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
 cellular  tissue; there are  many valves found in it, and its extensi-
 bility 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 portae, the diameter of which is less than that of the two veins
 by which it is formed.
  The vena portae, 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-
ledochus and hepatic ducts.  Arriving at the concave surface of the 
388
CIRCULATION OF THE BLOOD.
 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 portae. These two
 branches accompany the hepatic artery in all its divisions; they ra-
 mify in the tissue of the liver, always enveloped by a prolongation
 of the fibrous membrane of this viscus, which is known under the
 name of the capsule of Glisson.  The vena portae may then be re-
 presented as a tree having a very short trunk, and  branches which
 end in  the two capillary systems, located, the one in the  digestive
 organs, and the other in the liver.  This is the only example 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 im-
 planted in one or other of the auricles.

 Section XII.—Of the Functions  of the different Venous Appa-
               ratus, or qf the Venous Circulation.

   It is  from the general capillary system that the last subdivisions
 of the venqus 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 to-
 wards 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
 tcrgo in the absorbing mouths.  There is in this case no impulse of
the heart to determine the chyle and the lymph into these mouth*-. 
FUNCTIONS OF THE VEINS.
3S9
whatever they may be;  it is requisite then that they should be en-
dowed with a pumping and an absorbing power, and that a contrac-
tile 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 order
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 may, 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 expe-
riments  that  doctor  Sarlandiere made  upon the circulation,  we
observed  these  movements to be independent of the heart, since,
after  having removed this organ, we saw the contraction  and re-
laxation of that vein continue during many minutes in the cut ex-
tremity, 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 gelatin alone, as we  have as-
certained to be the case in the frog.  Now,  I believe that these con-
tractions are common in the  whole extent of the venous  coats, al-
though  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
muiun-r, by acting as a  vis a tergo, and because, moreover, irrita- 
390
CIRCULATION OF THE BLOOD.
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 pro-
vided with valves very near to each other.
  The most powerful vis a tergo is produced on them by muscular
action; and when this latter becomes feeble,  the blood always
undergoes  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 spleen.  This  fluid passes  immediately  into  the  radicles of
the vena  portae; and  as it  is little  removed from the heart,  it
doubtless  still preserves much of the impulse  which it received
from that organ.  We must  nevertheless necessarily 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 portae, instead of arriving directly  in the vena cava,  is
poured into the liver, and traverses anew a capillary apparatus, be- 
FUNCTIONS OF THE VEINS.               391
fore reaching the heart.  This singular arrangement has caused the
belief that the blood of the vena portae was destined  to afford 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 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 performance
of the functions.  And, indeed, if tke 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 continuance
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 stagnated
in a simple vein, the vessels  would  be liable  to enormous  dilata-
tions;  the blood would coagulate there; the vein  which should con-
tain it would lose its elasticity, perhaps even  be  ruptured.   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, 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.
   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 
392
CIRCULATION OF  THE  BLOOD.
adult, the same phenomenon occurs, with this difference only, that
the vena portae 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 cavities 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 absorp-
tion, 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 situated
in the liver.
  Let  us inquire now  into the office  of these two reservoirs or
diverticula,  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 last
becomes 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 portae, in the spleen and  liver, the numerous capillaries of
which serve, without any inconvenience, as a place  of deposit, un-
til  the  heart  shall  be able to  give it a  passage, and re-establish
the equilibrium.  If it  were otherwise, and  that the secreting ves-
sels of the  abdomen  were as easily opened  as  those of  the skin 
PHENOMENA  OF THE CIRCULATION.
S93
 and lungs, it is evident that all violent exercises would produce
 haemorrhagies by  the mouth and 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 Circula-
                              tion.

   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
system, and the interstices of  fixed animal matter, in every direc-
tion, and even go through the small vessels in a very short time in en-
tirely opposite directions.  In the round of the circulation, the blood

  * What has been just said on the functions of the liver and  of the spleen, is but
the summary of what I pubhshed in the 8th volume of the Memoires de la Society
MSdicale d'Emulation.  I have sought only to simplify and  perfect this theory,
which for the last nine years I have advanced in my course  of physiology. An
essay inserted in the Journal General de Medecine, appeared to me to render this
short note  necessary.
                              50 
394             CIRCULATION OF  TriE 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 con-
taining vessels, of the particles which are constantly sent forwards
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  dilation; 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, which may be-
                   come causes of Disease.

  These alterations must be examined in the heart, in the arteries,
in the capillary system, and in the veins.

        Section XIV.—Of the Alterations qf 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. 
MORBID STATES OF THE CIRCULATION.          395
   The heart receives its share  of the stimulations acting on  the
 snimal economy, by  means of the nerves, which it possesses in
 eommon with all the other organs.  We find it accelerating its con-
 tractions, under the influence of the intellectual operations and  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
 receives 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-marked
 effects in  the more mobile tissues, the  first which are destined to be
 in action  in the various relations.  Now these tissues  are  the vis-
 cera, 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 effected 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, which,
 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,
 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 
396              CIRCULATION OF THE BLOOD.
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 re-
spiratory 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 occasion
a great increase of its movements,  as happens in  all phlegmasiae 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 acceleration 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, &c. in which we observe, during several  hours, a full pulse,
burning skin, sparkling eyes, and  red face ? Has not the appetite
likewise disappeared,  and is  not thirst associated with 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 disordered
circulation under which he suffers.   The heart  is not at this time 
MORBID STATES OF THE  HEART.
397
the only part irritated; the other viscera, and especially the sto-
mach, 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 appro-
priates to itself the irritation, which it first experienced only sym-
pathetically; 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 the
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
readiness than other parts, inflammation  to this viscus, after having
at first irritated it by sympathy;  hence we often  see it becoming
diseased 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 im-
plicitly 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,
 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- 
398
CIRCULATION OF  THE  BLOOD.
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 sys-
tem.   Let us now suppose a great number of these muscles acting
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 are obliged to make the  chest the point of support for all the lo-
comotive 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
permanently irritated. Tickling carried to excess, always produces
precisely analogous effects, inasmuch as the kind  of pain resulting,
and the efforts of resistance made, render the chest immoveable, and
determine the spasm of the heart. 
MORBID STATES OF THE HEART.
399
  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 ne-
cessarily participate.
  I do not at present speak of  its being under  the  influence of ex-
treme heat, because this effect is referrible 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
of suffocation and syncope.   This  oppression is redoubled on the
slightest motion; and the contraction of the inspiratory muscles, re-
strained as they are in their efforts  by  the pain in  the heart, neces-
sarily adds to the oppression. The digestive organs likewise suffer, 
400
CIRCULATION OF  THE BLOOD.
 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 pa-
 tient is exposed not only to the oppression caused by defective oxy-
 genation, but also to other accidents which likewise occur in  aneu-
 rism, 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,
 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 
MORBID STATES OF THE HEART.
401
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  fre-
quently 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, and 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.
  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 exposes them to
profuse nasal haemorrhages,  cerebral  congestions, epilepsy, and

  * 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, attended by haemoptysis and pneumonia,
and sometimes chronic phlegmasiae of the parenchymatous structure of the lungs,
running into phthisis pulmonalis.
                               51 
403
CIRCULATION OF THE BLOOD.
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 other per-
sons,  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-
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 
DISEASES OF THE ARTERIES.
403
 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-
 tation, 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
 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 
104
CIRCULATION OF THE BLOOD.
 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 am-
 pullae 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-
 pullae, 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, no  doubt, 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,
 remain stagnant in them, and produce together with ampullae the
 varicose enlargement  of which we spoke.   In this manner are the
 viscera gorged and inundated with blood  and serosity, and finally so
 disorganized as to  become unfit for the  performance of their func-
 tions.   Sufficient attention  has  not been  paid to observe the extent
 to which inflammation of the very vascular organs may penetrate in
 the  arterial and  venous vessels; if we were assured that  it always
 extended some distance, we would  cease to be surprised at finding
 it sometimes 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
 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 maybe 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- 
DISEASES  OF THE ARTERIES.
405
  I do not know whether inflammation of the arteries, at first ge-
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 the softening which they un-
dergo, renders them susceptible of dilatation produced by an impe-
tus of blood, and the efforts  of the adjoining muscles.   If these
derangements 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 general
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
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

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 constitutes the
essence of angiotenic fever.  Arteritis is then but a complication of the gas-
tro-enterites constituting this latter fever, a complication by which it becomes
much more alarming, is opposed to a favourable termination, and aids in giving it
a fatal character.  On the other hand, we find, that angiotenic fever really termi-
nates in a putrid fever, unaccompanied by arteritis.  There is no reason 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. 
406
CIRCULATION OF  THE  BLOOD.
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
subclavian  and carotid  arteries, and of  the  arteria innominata,
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 sud-
denly in a syncope.  I deposited the morbid parts in the  anatomical
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 uncommon
occurrence, for it seems  to me that all violent  inflammations  com-
municate  more or  less  irritation to the  vascular system.  Why
should we  be surprised at it, since they act so  powerfully on the
heart?  Cannot the irritation under which it then suffers  by sympa-
thy, 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-
ratus, under the  names  of herpes, scrophulas, syphilis, rheuma-
tism, and gout, have not sometimes a tendency 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 vis-
cera, which are also all subject to inflammation.

    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, the

  * Dr. Fallot, physician  at Namur, has communicated to me a case of chronic
inflammation  of the aorta, in  which this vessel was thickened, tuberculous, and
even ulcerated in several places.  This fact is given in the Annates de la Mtdecim
Physiohgique, tome 4, page 325. 
DISORDERS  OF THE  CAIILLARIES.
407
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 inflammation; they
always  originate either in irritation or an obstacle to 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 in-
flammation, 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
exposed.  We see it take place, without any preliminary inflamma-
tion,  in the brain and lungs, owing to moral affections, for we know
that they irritate prodigiously the viscera, and also after very vio-
lent exercises.   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 ffom the
vessels which carried it, and is extravasated in larger quantity than
usual between  the particles of animal matter, or in the interstices of
what are called primitive fibres, and then  the  functions of the
Viscus  are interrupted.   If this  latter be a  secretory organ,  and
 communicate externally, it may be preserved from disorganization
 by a haemorrhage.  In this way haemoptysis has  frequently dissi-
 pated pulmonary congestions. But if there  be no passage for the
 elimination of blood from an  important organ, as the brain,  haemor-
 rhage,  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 medul-
 lary  tissue.
   The flat and membranous viscera are less exposed  to these kinds
 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 haemorrhage in such cases  takes place by 
408
CIRCULATION OF THE BLOOD.
the 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-perito-
neal 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 influ-
ence of irritation.   There ensues no  disorder of the general circu-
lation, 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 contusing
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  capillary
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 consequence.
I do not believe that  we can admit the  existence of such fevers of
somewhat a mechanical nature.  So long as the congestion,  what-
ever it may  be,  is not followed  by an inflammatory irritation, the
heart is  not made sensible of it, as we know from congestions pro-
duced by a mechanical obstacle to  the  course of the blood, as in
pregnancy, voluminous tumours  of the abdomen,  effusions in  the
chest, &c.  Do we not meet constantly with persons who are so af-
fected by these causes, suffer from dyspnoea  to the extent of suffoca-
tion, without any febrile  movement  supervening?  If, therefore,
fever at times follows irritative congestions, it is because  the same 
DISEASES OF THE VEINS.                 409
irritation which produced them is converted into inflammation; 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 extravasated blood undergo a
putrefactive movement, which  shall perform the office of a stimu-
lant 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 phlegmasiae  or cedematous 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 ampullae 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-
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-
                              52 
410
CIRCULATION OF THE BLOOD.
 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 vari-
 cose, and the flux was attributed to the rupture of the dilated veins.
 Notwithstanding the writings of Stahl, this opinion was long  pre-
 valent  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  wTas 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 heard 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. Such is unquestionably the  case, 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
 phlegmasiae of the  abdomen. One  thing is very certain, that I have
 often found the vena cava extremely  voluminous in those subjects
 dead from violent gastro-enteritis, with very great sanguineous en-
 gorgement of the liver; and I  believe that this excessive distention
 might very well be accompanied by a  true  phlogosis.   Could we
■but determine this, and mark the symptoms  which  designate it in 
DISEASES OF THE VEINS.
411
the course of those diseases, we should perhaps obtain some insight
into their prognosis, and some valuable indications to direct us in
the use of local blood-letting, and topical applications.
  The vena portas has been 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, preoc-
cupied 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
haemorrhoids, flatulencies, dyspepsia, and hypochondriasis, were in
their minds nothing else but an extension of the varicose state of the
vena portae. 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 consecutive
phlebitis.  I believe, moreover, that  the  engorgement occasioned
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 parenchymas 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 phleg-
masia.
   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 inflammatory irri-
tation  of the substance of the lungs, or some  obstacle opposed to
 their disgorgement.
   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 
412
CIRCULATION OF THE BLOOD.
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 of
the organ is the secondary effect of an inflammation of the digestive
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
 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 always
 acting, the vital erection  becomes permanent,  and  thenceforward 
INFLAMMATION.
413
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 fibrin
furnished with its colouring matter.*
   The vital erection  once converted into inflammation, the phe-
nomena of organic chemistry are perverted;  the organ is at first
hypertrophied, and, if the  irritation persist, it changes its nature,
either by the production of pus, or by being in some other way de-
teriorated.
   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,
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 of
 the other  viscera; but in other cases, the vital erections of the lungs

   * 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 phlegmasiae 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 s,tate lasts not only in secretory organs, but in a muscle or an erer til.
 tissue, some degree of inflammation is the invariable result. 
414
CIRCULATION OF THE BLOOD.
or gastric passages having been urged too  far by unusual stimula-
tion, the excess of blood, which ought to have  been evacuated by
the 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 acci-
dental irritation has arisen.
   Such is the state of things in irritative congestions, which, when
formed, 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.
  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 
INFLAMMATION.
415
 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
 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 pro-
 poses 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 haemorrhagy 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 learh 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 sub-
jects, they are always the effect of some peculiar irritative agent. 
416
                       CHAPTER  VIII.

                     OF  THE DEPURATIONS.

   We must first remind the reader of the uses of the very compound
 fluid, to which the sanguineous vascular apparatus serves as a reser-
 voir; since besides the part which we have seen it perform in inner-
 vation, muscular action, and all the vital erections, the blood serves
 also to furnish the materials of secretion and nourishment for all the
 organs.
   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 suitabty 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 faecal matter.
 The second separation is seen after intestinal absorption in the de-
 purating organs, which hasten to eliminate  a superfluous serum,
 the retention of which would distend the blood-vessels, and oppress
 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.
   The organs charged with this process are, next to the digestive 
QF CUTANEOUS DEPURATION.
417
canal which concurs in it to a limited extent, the skin, 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 im-
portance as to its bearing on our studies.  Thus, if the fluids elimi-
nated be not endowed with a peculiar power by which they are di-
rected to such and such  emunctories, it is very certain that their
separation, from 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 normal
type, to enable us to have an idea of its aberrations, which become
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,
and carbonic acid, without mentioning certain aromatics,  such as
                             53 
4KS
OP  THE DEPURATION*.
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 collect-
ed and condensed  in a small  space, we are soon assured that it unites
all the elements of sweat.
   The skin  contains likewise excretory  canals coining 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*

  * Dr. Anselmino, in a memoir recently written on the chemical nature of the
sweat, gives the following results:
  One hundred parts of healthy human sweat, evaporated to dryness, were found
to consist of—
    Matter, insoluble  in alcohol, (principally calcareous salts,)     -    2 parts.
    Peculiar animal matter of saliva, with sulphates,                  21
    Substance soluble in weak alcohol, (ozmazome, and the muriates
      of soda and lime,)     ........48
    Substance soluble in rectified  alcohol, (ozmazome, alkaline ace-
      tates, and free acetic acid,)  .....--29

                                                              100
  The sweat of persons labouring under scarlet fever, tetters and syphilis, was not
sensibly different; but it was found that the product of the insensible perspiration
in puerperal women abounded in acetic acid, from which the author explains the
sour odour exhaled by such persons.  Dr. Anselmino was unable to find the lactic
acid,  announced several years ago by Berzelius as the acid of perspiration, and
thinks its existence in it very doubtful.   On the other hand, he agrees with The-
nai'd  in finding the acetic acid united with a  peculiar animal matter, which he
supposes to be the substance designated by Berzelius as the lactic acid.
  The volatile part of the sweat was found to be identical with the insensible per-
spiration.
  The depurating function of the skin  by the discharge of certain gaseous pro-
ducts, is now placed beyond  doubt.  Of these,  carbonic acid and azote  are con-
stantly eliminated,  in the proportion, says Abernethy, of two parts of the former
to one of the latter. Dr. Collard de Martigny, in his late memoir on the  subject,
informs us, that a full  diet of animal food increases the relative amount of the
azote, while a diet of  white meats or vegetables causes the carbonic acid to pre-
dominate.
  The similarity in function of the skin and lungs thus deduced analogically, is
proved by the direct experiments of  Dr. Edwards, in the work  already cited.
He even shows that animals  of the batrachia tribe will  live longer deprived  of 
OF  CUTANEOUS DEPURATION.                419
    The vital action of the skin is in direct proportion to the quantity
 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
 fapts which seemed to constitute so many exceptions to it  Thus
 in certain fevers the product of gastro-enterites, the skin, although
 of a burning heat,  and  penetrated  by blood, is  dry and even arid,
 notwithstanding 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 confirma-
 tory 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.

 their lungs than of their skin; and that in  the elevated temperature of summer
 they not only are obliged to come up frequently to the surface to  breathe, but
 also to go on land in order to turn to the greatest account their cutaneous respira-
 tion, which is more active than in the small quantity of air contained in the water.
 During a hot summer, if frogs cannot leave the water, they die.  The same series
 of phenomena is found to take place in fishes similarly circumstanced.
  The objection urged by Dr. Collard  against there being a cutaneous respiration
 from the circumstance of the skin  exhaling  carbonic acid independently of the
 contact of oxygen, is invalidated by the occurrence of precisely the same exhala-
 tion from the lungs, even when oxygen is withheld from them.  We are authorized,
 from our existing knowledge on this subject, in regarding the two functions, cutane-
 ous and pulmonary, as identical, in  as far as concerns the elimination of carbonic
acid and azote, and we may add the absorption of oxygen and azote,  if due reli-
ance can be placed on the experiments of Abernethy.  We must not forget the
very important fact already noticed, p.  281, tliatthe elimination of carbonic acid
from the lungs and skin takes place under  two entirely opposite states of the
general circulation; viz. of the conversion of dark into red blood, in the lungs,
 and of red into dark, in the skin.  Of course the formation of the carbonic acid in
both cases can only depend on a common system of vessels, and a secretion per-
formed under similar circumstances.  Now  these conditions are fulfilled by the
 bronchial arteries for the lungs, and the cutaneous  ones for the skin, all coming
from the aorta; and from  their exhalent  terminations is  derived the  carbonic
 ind.—Tp4vr 
4^0                  OF THE DEPURATIONS.
  If the skin be covered with sweat, in inflammations of the sail-
stance of the lungs, it is because these phlegmasiae exert an influence
over the cutaneous apparatus as irritating as that produced on this
latter by the mucous surface of the digestive canal; or rather, it ia
on account of pneumonia  accelerating the circulation, and sending,
like muscular exercise, much blood into the tissue of the skin, with-
out imparting to it the same acute irritation as  in  gastro-enteritis,
The correctness of this explanation is shown in the circumstance of
that form of gastro-enteritis of itself not painful, or prevented 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 occasionally
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  irritation in
this membrane, by which it is rendered susceptible of  exhaling a
serous fluid without being solicited thereto by the superabundance
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 constriction  ant1
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 surround- 
OF RENAL DEPURATION.
421
cd 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 surmount-
ed 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
penetrates internally so  as to embrace the other or second by pil-
lars or kinds of  arches;  its tissue is granulated, and it contains in-
numerable sanguineous  vessels: to it is attributed  the office  of se-
creting the urine.   The second, which presents small cones of un-
equal size, and of a red  colour, darker  without than within, is com-
posed of an assemblage  of small capillary tubes, adhering to the cor-
tical 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 papillae; they are penetrated by the
orifices of the tubuli uriniferae of the tubular portion, which are
nothing more than the excretors of the urine, and which, when sub-
jected to pressure, allow it to escape.
  These papillae 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 pa-
pillae, and by the other  are continued into the pelvis.   This last is
a reservoir which occupies the centre of the gland, and corresponds,
on the side of its free portion, to the concavity of the kidney: it re-
ceives 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, consequent-
ly, 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 ernulgent; their veins correspond to the
arteries, and their lymphatics are quite numerous. 
422
OF THE DEPURATIONS.
      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
acid and forming salts.  The materials found in the urine are urea,
a gelatinous animal matter, muriate of  soda and of ammonia, phos-
phate of soda and of ammonia, either separate or combined in triple
salts, phosphates of lime and of magnesia, phosphoric, uric, and ben-
zoic acids.  At times we discover in the urine the sulphates of soda
and of lime, the oxalate of lime,  the urate of ammonia, silex, &c.
   Urine is, then, a very compound fluid; and physiologists usually
consider its discharge as the  means of eliminating the superabundant
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 phosphate of lime, which gives so-
lidity to the osseous sj^stem, 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: the diminu-
tion of the serosity, which is the basis of their secretion, renders it
more concentrated whenever the  sweating is profuse; whereas, in
the case in which cutaneous  depuration is suspended, 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  principle, that the kidneys al-
ways discharged  very nearly  the same quantity  of  substances
other than  the serosity,  which alone  is susceptible 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- 
OF RENAL  DEPURATION.                 423
tulation?  This problem is not 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,
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 urimiry 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

  * This is the common language of pathologists, but it does not, we conceive,
fairly express the question.   To speak of the  blood being driven from the surface
to the internal organs, by cold, is not to relate what actually occurs.  Tn indivi- 
424
OF  THE DEPURATIONS.
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 not take place in a decided manner;  the
blood is in rapid motion, for then it is always, as we 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  sudorifics, when  taken  in warm

duals exposed to cold air, or immersed in cold water, there is a diminution and even
suspension of the functions and vital phenomena of the skin:—it is pale, shrunk,
and ceases to exhale either sensible or insensible perspiration:—its sensibility is
deadened, and the capillary circulation impeded and restricted by the diminished
diameter  or a collapse of the vessels.   What evidence, we would ask, can be ad-
duced of this enfeebled action of the cutaneous system being followed or accom-
panied by determination of blood to the interior, and  congestions  in  the  larger
viscera?  Is it in the cold air and minor exhalation from the lungs—absence of
thirst and heat in the abdominal viscera—torpor of the brain, evinced in enfeebled
intellectual efforts and  indisposition and inability to thought? The entire se-
ries of phenomena in all the cavities are similar to those on the surface:—there is
diminished action throughout:—minor exhalation, secretion, and sensibihty of
all the membranes and glands.  Infactthere is an utter incompatibility between the
symptoms and effects in the brain, lungs, and abdomen,  exposed to great cold,
and in those evinced in these same viscera when suffering under the undue de-
termination, constituting vertigo and apoplectic tendency in the brain,  pneumo-
nia in the lungs, and gastro-hepatic diseases, or cholera,  and yellow and bilious
fevers in the fiver, spleen, and intestinal canal.   Cold applied to a sensitive sur-
face of any extent, cutaneous, pulmonary, or gastric, by means, respectively, of
the cold bath, cold air,  or cold drinks, acts sympathetically on the whole nervous
system, and of course upon the entire  capillary  tissue, and wherever found su-
perficial or deep seated, this tissue is shrunk and collapsed,  and the larger  ves-
sels are also in a measure enfeebled—there is then diminished propulsive power
in the whole circulating system, and a  tendency to stasis of the blood in  all its ra-
mifications, in whatever part found: but no driving  of this fluid from  the skin
to the viscera.  This view of the operation of cold,  will be found in  harmony
with the greater number of its morbid  phenomena, and certainly guide us to a
more consistent, rational, and satisfactory employment of it as a therapeutical
agent.—Thans. 
OF RENAL DEPURATION.
425
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 in cases
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 phlegmasiae 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
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-
                              54 
426
OF THE DEPURATIONS.
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-cutaneoug 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 irritation
of the secretory vessels, which furnish urine in extraordinary abun-
dance.
   The moral affections exert a powerful agency on the  eliminating
function  of the kidneys:  in  fright, Ihe 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 di-
minished.
  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 alway:-
accompanied by a mucus which comes from the follicles of the pel-
vis and bladder: occasionally this  humour  predominates, as in the
cases  in  which the surfaces over which the  urine passes arc seized
with inflammatory irritation. 
OF THE EXCRETION OF URINE.
427
           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, analogous 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
pelvis, and the  inferior portion  of the muscles of the abdominal
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
of 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,
and others are detached from the sacral nerves, which, as we have
seen, are derived from the brain. 
428
OF THE DEPURATIONS.
            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. This 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 dis-
tended, 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 depend
on the direct influence exercised by the will over the muscular coat
of the bladder,  or simply produced by the exercise  of volition 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-splanch-
nic 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 in one of  the
two following ways: 1. By  contracting the sphincter of the blad-
der; 2. By refusing to allow the cephalo-splanchnic  muscles to aid
in the effort made  by the muscular coat of the bladder to bring about 
OF PULMONARY DEPURATION.
429
the ejection:  but, in return, he enjoys the power of seconding this
effort, by inducing  a contraction of the diaphragm and the abdomi-
nal muscles stronger than that produced by mere instinct in persons
whose intellectual faculties are  suspended, and in whom, conse-
quently, 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 bronchiae, 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,
expiration  gives issue to  a great quantity of water that escapes with
the air, in the form of vapour, and 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
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
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 
130
OF THE DEPURATIONS.
 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 phlegmasiae of the different organs do not act by a peculiar
 sympathy on the exhalent orifices of the  bronchial  vesicles.  We
 shall 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 move-
 ments, 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
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 bronchia? in giving some consistence to  the vapour issuing 
OF MORBID DEPURATIONS.
431
 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. The eva-
 cuation of a certain quantity of fluids.  It is therefore from the de-
 rangement 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 irruption 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
 phlegmasiae.  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 useof sudorifics: this discharge throws the patient into extreme
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 
432
OF THE DEPURATIONS.
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 supplementary
irritation, and we shall then see the attacks of ophthalmias, coryzas,
gingivites, aphthae, amygdalites, pharyngites,  and laryngites also
called croup. In the female, the  same aberration may produce ute-
rine catarrhs, or suppress the excretion  of the menstrual blood, and
become the cause of metritis, or  of inflammation of the principal or-
gans of the abdomen,  chest, or head, and other parts on which the
haemorrhagic 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,  aponeurotic, 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-
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 cedema, deforming the part.   Such is the ele- 
OF MORBID DEPURATIONS.
433
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  temperature, &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 conveniently seen in the post
mortem examinations made in cold and temperate climates; where-
as those who sink under disease in hot  climates, exhibit the  cellu-
lar and parenchymatous tissues  dried and wasted; and  more fre-
quently 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
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
                             5S 
434                  OF THE DEPURATIONS.
inflammation.  It is in this way that cold produces bilious and bloody
vomiting, mucous diarrhoeas, salivations, very abundant leucorrhceal
fluxes, ascites, and even general dropsy taking an extremely rapid
extension.*
   If we pass to diseases in which wre 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

  * These secondary effects of cold, and others mentioned by the author, in the
preceding page, are susceptible of ready explanation, without  admitting an af-
flux of blood to the affected parts from the skin.  All the  internal surfaces  and
secretory vessels of the glands, promptly sympathize with the  cutaneous enve-
lope, when it is exposed to cold.  The action of all parts is diminished synchro-
nously;—and all, as in the case of the skin, react, undergo a glow and additional
injection of their capillary tissue. The appearance of the skin after the body has
passed from a  cold to a warm medium, is a good measure of that of all the other
parts.  But these are not capable of enduring the alternate chill and glow to
which, by constant habit, the skin is reconciled:—they suffer from congestions,
increased secretions, and, at times, haemorrhage, during the period of reaction.
 The suffusion  and increased sensibility of the extremities, after preceding torpor
from cold, is  too apt to be  represented internally by pleuritic  stitches, rheu-
matic pains, catarrh, bronchitis, haemoptysis, diarrhoea, dysentery, &c.   In all
these cases  the morbid  state is simultaneous with, or directly consequent on,
the state of reaction, glow and increased excitement, and is never associated with,
or caused by, the  primary sedative operation of cold.  The internal  organs  do
not suffer during the paleness and shrinking of the skin, however long and severe
they may be, but during the period of reaction and heat.  The effects  of cold
cannot then, compatibly with the rules of logical induction, be referred to  the
veflux of blood from the skin to  the viscera.  We have shown in a former note,
p. 424, that no such reflux takes place; but even if it did, it  would not be a
cause adequate to the production of the subsequent phenomena.—Tbans 
OF MORBID DEPURATIONS.              435
a small proportion of salts, but it has suspended in  it sugar in a
particular state.   I do not know whether this cetiology 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 their stomachs,
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
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 
136                 OF THE DEPURATIONS.
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 vesiculae
seminales,  and the rectum and vagina, expose it moreover to parti-
cipate in the irritation of those parts.
   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.  We 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 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 irritations,
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 w ith 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  prevent the
 gout, herpes, and other affections of the external parts of the body, 
OF MORBID DEPURATIONS.
437
from being  transmitted to the bladder,  ought to  turn to account
what we have just elucidated, and husband an organ, without 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, for 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 phlegmasiae; 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.
   The intellect  exercises, in  certain cases,  a marked sway over the
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  others;
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 de-
posit over that secreting the  urine: dilatation of the ureters  and in-
flammation of the kidneys are the consequence.
   The existence of a mucous membrane furnished with an internal
tense in the duct of the ureters, affords an  adequate explanation oi 
43S
OF THE DEPURATIONS.
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 colicky 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-
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 oedematous state  of the lungs.   Are we not justified in
suspecting that the retention of pulmonary  serosity  contributes,
sympathetically, to the general dropsy consecutive to that of the
parenchyma, in the cases of continual dyspnoea produced by certain
catarrhs, and the influence of a chronic irritation of the digestive
passages? Ought we not, in consequence, to  infer the indication for
diuretics to  supply the want of pulmonary exhalation?  This is my 
OF MORBID DEPURATIONS.
439
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-
phia,  putrid meat,  certain poisons,  it first gives rise to irritation of
the gastric  passages;  all the  sympathies linking these with the
other viscera are awakened,—such as the pain and oppression of
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 a febrile 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  re-
peatedly 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, 
440                 ©y THE  DEPURATIONS.
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
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 sur-
face in such a manner as to excite sweat, as in the case of muscular
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 condi-
tion, as to enable them  simultaneously to give issue to the  matters
troublesome to the animal economy; the great sympathetic, the re-
gulator  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
gastric viscera, which is productive of a double  effect: 1. That of 
OF MORBIB DEPURATIONS.
441
contracting 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, by which the strength is
finally exhausted.
   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 bronchiae,  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 agastro-cerebral
congestion, will  finally terminate in an evacuating process of the
eliminators, and  frequently of the  secreting  organs which fill the
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 cer-
tain organ, and in a certain degree, it  must terminate  in a certain
corresponding manner; and, in the case  before us,  this termination
is the definitive transmission of irritation to the secretory organs,
whether there be a peccant matter  or not in the body.   In the nor-
mal state, this irritation serves to eliminate the  products  of diges-
tion, 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 attended 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 inflammation.
  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 always
                               56 
442
OF THE  DEPURATIONS.
 been confounded with those of a  sporadic, putrid, and adynamic
 character.
   I shall say nothing of the corrosive  poisons introduced into the
 stomach  or injected  into  the  veins,  for the  rapid disorganization
 produced by them does not allow of the system's putting forth its
 conservative 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 phlegmasiae, 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
 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, or what
 is called a state of cacochymia.  So soon as we have  succeeded  in
 quieting the irritation of the  part opposed to assimilation, this last is
 accomplished with regularity, and all  the depraved juices are elimi-
 nated 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

  * The whole of this paragraph ought to be a subject of daily meditation to the
 physician, who desires reason to guide, and success to result from his  practice.
 He will be led to ask himself whether it be necessary and proper to produce by
his emetico-cathartic, or diffusible stimulant and tonic  medicines, a perturbation
of the whole system, similar to that resulting from poisons and the worst causes
of disease. Will he find his excuse in the discharge of peccant matters, by vomit-
ing and purging, when he himself created the irritation which provoked to their
 fonnation}  Or can he promise his patient that the quiet and ease which follows a
 true crisis shall result from this treatment? He  will hardly find in stimuli and to-
nics a means of allaying the compound perturbation of disease and prior medica-
 tion. He may by these means increase and even cause exaggerated sensations in
 various organs, followed by morbid sympathies; but he does not remove or quiet
 the primary  irritation,  which  finally becomes  more diffused and complicated
 in its nature.—Trans. 
OF THE SECRETIONS.
443
proceed  from an abnormal or morbid  irritation of  the  viscera,
which deranges the action of the  eliminators; and that the danger
resulting is due less to  the  retention of substances  to be  elimi-
nated, than to the consequence 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 stu-
dying 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 pre-
pare us for that of the secreting organs.
                       CHAPTER  IX.

                      OF THE  SECRETIONS.
                               •
   The secretions consist in the formation of certain humours, which
are to concur to the performance  of many functions.  The organs
charged  with  this task 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-
ing a complex gland.   All glandular structures, whether  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 
444
OF THE SECRETIONS.
oily secretions,  which concur both  to  sensitive and 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 analogous to the mucous.
  Passing afterwards to the digestive  function, we shall there find
the secretions destined to  assimilation, and which we shall study,
commencing with the sense which prepares for this very important
function.  Such is the order that we propose following in this  chap-
ter, 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, in form 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 they 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  of
organs charged  with effecting its secretion; but it remains to be as-
certained, whether the portions of animal matter which produce the
humour in question must necessarily be disposed  in  rounded cor-
puscules, 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 ac-
cording to the particular region of the  body.  The fluid called  ceru-
men, which is secreted by the external  meatus auditorius, is regarded
by  M. Vauquelin asa compound of albumen, thick oil, and colour-
ing matter. 
OF THE MUCOUS AND LACHRYMAL GLANDS.        445
             Section II.—Of the Mucous Glands.

  The mucous glands, called also follicles or cryptas 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 particu-
lar  humour is found in a tissue, we are forced to conclude that this
latter is organized in such a manner as to be able to produce it; and
when in place of one humour we meet with many, we must acknow-
ledge 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 calculated 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 imprest particular characters 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 between 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 by a
mucous membrane, which bears the same relation to them that it
does elsewhere to tissues of a similar nature. Generally, in all points
where  the hollow organs which contain mucous membranes are con-
tracted, the follicles are much more numerous.
  The mucus is analogous to  vegetable mucilage,  and  contains in
addition azote.

Section III.—Q/* the Lachrymal Gland and  its Dependencies,

  The lachrymal gland secretes the tears, which  are  carried by
the alternate movements of the depression and elevation of the su- 
<46
OF THK SECRETIONS.
 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 interior
 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 hu-
 man  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 puntta
 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, and approaching and coming
 together, or isolated, they open into the lachrymal sac.
  The lachrymal sac is a small membranous,  oblong  pouch,  situ-
ated at the great angle of the eye; its internal wall is formed by the
lachrymal gutter, hollowed out of the  ascending apophysis of the
superior maxillary and lachrymal bones, and  the external by an
aponeurosis; the inferior presents an opening of communication with
the nasal canal.  This latter,  situated  behind  the ascending  apo-
physis of the superior maxillary bone, descends backwards and in-
wards, and opens into the inferior meatus of the nasal  fossa, below
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 
OF THE GLANDS FOR DIGESTION.
447
 great 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 destined
 to secrete 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 the zygomatic 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 com-
 pact cellular tissue, each  of which gives origin to a small excretory
 eanal, which unites to  the  neighbouring ones  to form  a  larger
 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 qf Steno.  This duct leaves the  gland to pass over the mas-
 seter muscle, which  it traverses transversely,  and opens in  the
 mouth, on a level with the second superior molar tooth; its interior
 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 body of the inferior maxillary bone, in the
 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 Warthon,
which opens on the sides of the  frenum 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 from before  backwards, in a direction 
443
OF TH*E SECRETIONS.
parallel to that of the opposite side.   Its organization is like that of
the former 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 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;
3d, 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 portae,
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  are furnished  by the  pneumo-gastric, or
eighth pair, the phrenic, and 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- 
OF THE FUNCTIONS OF THE SECRETING ORGANS.      449
 veloped by a cellular membrane,  called the capsule of Glisson,
 which is but the continuation of that immediately covering the ex-
 terior 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 communis
 choledochus,  and opens into the duodenum with that which comes
 from the pancreas. The bile does not get into the gall-bladder until
 after the union of the two canals, that is to say, by ascending against
 its own  weight.  The ductus communis choledochus does not pene-
 trate the duodenum before its having passed for some time between
 its mucous and muscular coats.  The peritoneum covers the liver
 at all parts, except at the excavation of the gall-bladder, the two in-
 ferior 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 into
 the duodenum separately,  or united to the  ductus choledochus.
 The nerves, that  are distinguishable, are  branches of the great
 sympathetic.

  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 sepa-
rated therefrom by vessels for the purpose, which proceed from th^
                              57 
450
OF THE SECRETIONS.
arteries, and which are called collateral or secerning.  The glands
were considered as congeries, formed by the capillary arteries 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
cat,  the beaver, the black liquor of the cuttle-fish,  and the poisons
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 ani-
mals, though I might  be justified in doing so.
  Since we do  not find in the blood the principles constituting  the
essential  character of the humours furnished  by the glands, it is
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 
        OF  THE  FUNCTIONS  OF THE  SECRETING ORGANS.     451

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-
existence of the humour, which attracts the molecules that resemble
it, at the time of  their passing over their orifices. These hypotheses
have fallen into the discredit they merited, and simple secretion is
no longer admitted:  the word alone remains in the science, 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 transformation of fluids, that the
word secretion represents to  the physiologists 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 already
said, when speaking of the capillary circulation, that we cannot be-
lieve 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. Now, I think  that it is in that extravasation
and filtration of blood, particle by particle, through the glandular
parenchymae, that these separations and transformations  of circu-
lating  matter take place, by which a portion of it is made to appear
with attributes  that it did  not before possess.
  To this it may perhaps  be  replied, that this assertion is hypothe-
tical.   I regard it as an inference much better  founded than that
which  had been proposed,  since it rests upon an incontestible fact,
the absolute necessity of the extravasation  of fluids at the extremi-
ties of  the blood-vessels. Indeed, this necessity is demonstrated by
the nutrition of all the tissues;  for it is not possible to suppose se-
creting vessels,  on account of the fixation of albumen, gelatin, fibrin,
and the salts, in the different tissues which they form.   But if ex-
travasation 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 transformation of the
fluids should take place in a portion of mobile matter, isolated from 
45^
OF THE SECRETIONS.
the general circulating current, in the interior of the secreting ves-
sels?"
  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 which
I have laid down, because the changes of form in the mobile matter,
and the chemical compositions of the living body, must be accom-
plished 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 repose is
necessary to the play of chemical affinities:  now, that repose, or at
least that  retardation of progress, is more considerable in the extra-
vasated 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 ves-
sels.  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  des-
tined.
  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.

Section VI.—Of the Action and Useof 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 which 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- 
        FUNCTIONS OF THE SEBACEOUS AND MUCOUS GLANDS.    453

 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.  Notwithstahding 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 VII.—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 discharg-
 ed only when superabundant,  but is always mixed to a certain ex-
 tent with  the faeces and urine.  It also comes  off with the blood in
 the haemorrhagies 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
 after the evaporation of these waters, during the application of heat;
 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 epide-
 mics, and of medical topography, 
454
OF THE SECRETIONS.
           Section VIII.—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
to be  the irritation of the mucous  surfaces of the  pharynx, nasal
fossae,  and  eyes; it is  it which causes the afflux of blood  into
those tissues; which engorges them,  as the augmentation of their
secretory  action proves; and  which produces  the same  effect
upon the lachrymal glands,  and determines their  super-secretion.
Whenever this takes place, the absorbent action of the puncta lachry- 
FUNCTION OF THE SAL1VART  GLANDS.          455
malia is increased, and the tears flow in  abundance into the nasal
fossae; hence the frequent necessity of blowing the nose when one
cries; but that does not prevent the increase of the mucus by an in-
fluence peculiar to the pituitary membrane.   It is an opinion gene-
rally 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 opi-
nion was sustained by one of my pupils,  in a memoir ex professo,
but he had no idea of the progression of irritation  along  mucous
surfaces.  I think it very useful in the explanation of many physi-
ological and pathological phenomena, and hope that it may be  ap-
proved of by physiologists.

  Section IX.—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 which
they furnish  descends insensibly along  the  oesophagus into  the
stomach.  But, whenever mastication is exercised, or  the interior of
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 which 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 the influ-
ence usually attributed to it; for when the lining membrane of the
mouth is  irritated, without mastication being exercised, the saliva
does not cease to flow in great quantity.   This may readily be  ob-
served in smokers,  and all those who have an inflammation in  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
the super-secretion 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, whence it is con-
veyed into the salivary glands, and made to pervade  the interior of 
456
OF THE SECRETIONS.
 their excretory canals.  This mechanism then appears to me analo-
 gous to that of the flow of tears by a moral cause.
   In  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 that the muscles of  the  inferior
 maxilla 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 pa-
 latum molle.  It is from these  parts,  according  to my view,  that
 the irritation is propagated to the salivary glands; and if it be true,
 which we cannot doubt, that hydrophobia may be produced by vio-
 lent anger, and communicated by the  bite of the infuriated indivi-
 dual,  we must believe that the saliva is  then  converted into ve-
 nomous 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 gratified,
 has sometimes been productive of spontaneous hydrophobia, suscep-
 tible 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.
   The saliva has all the qualities necessary to serve for the solution
 of aliments; it is alkaline and soapy, which renders  it miscible with 
              bECRETING  FUNCTION OF THE LIVER.          457

 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 certain index
 of this is the unpleasant impression  it makes upon the taste.

     Section X.—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  by 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  this vesicle, the bile remains and undergoes a concen-
 tration attributed to the absorption of a part of the serum, albumen,
 and  mucus that it  contains.  This concentrative absorption is analo-
 gous to that observed in all the reservoirs which receive the pro-
 duct of secretion.  The cystic bile is then stronger 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 greatly augments the for-
 mation 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 portion 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 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,
                              58 
45S
OF THE SECRETIONS.
penetrates into the liver and gall-bladder, and produces 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
m^st then flow in a great quantity into the  parenchyma,  in order
that the  bile  which is  evacuated  be replaced  by a  fresh portion;
whence it results that the more the  digestive canal  is stimulated,
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, &e. 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  constrict the vascular
system, by producing  a permanent  contraction, arrest to a certain
degree this secretion, diminishing at the same  time  that  of the
mucus, and retard 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 mo-
ment when the chyme traverses that intestine, that the cystic 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 this 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
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. 
MORBID CUTANEOUS SECRETIONS.             459
Section XI.—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 red-
dish 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 all 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 phlegmasiae 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,
cannot be considered as dependent on that cause.   The cutaneous
scabby affections  have, from the most remote antiquity, been attri-
buted 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 consecutive to  the
phlegmasiae of the sexual  organs,  and  there already 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 
460
OF THE SECRETIONS.
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 de-
purators 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 aphthae, 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-
chiae, 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 ulcera
 tion is chronic.  Such is the origin of schirrus, which, like the
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 intensit)r, becomes
 chronic, and is finally reduced to a sub-inflammation of varying ex- 
                  MORBID MUCOUS SECRETIONS.              461

 icnt   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 conse-
 cutively to the irritation of another mucous membrane.   It is thus
 that the mucous lining of the lungs or mouth, is affected by the ir-
 ritation of that of the stomach; the covering of the glans penis by that
 of the bladder or vesiculae 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
 many authors to admit, for the production of  this last, the absorp-
 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 we admit
it in certain cases and not in others, since they are precisely analo- 
462                  OF  THE SECRETIONS.
gous?  For example, when aphthae in the mouth is produced as an
effect of gastritis, is it attributed to a virus?  When that disease oc-
casions irritation in the  bronchiae,  which  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 idea
of attributing it to a virits circulating in the blood-vessels. In those
persons who have an affection of the liver, the skin often becomes
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 be
forced to admit one for the repetition of the irritation of the sexual
organs in the mouth, and different  regions of the skin.
  But, as others allege, how many suppositions equally gratuitous will
not the admission of such a virus exact!  It  must be asserted that
X 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
ef the blood, and other circulating humours.
  It may perhaps be objected, that it sometimes attacks the mucous
membranes of the bronchiae and digestive organs.  I would answer,
in always taking  part with the disbelievers in 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 these
organs by the antivenereal medicines, when syphilis is followed by
internal 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 to  the inter-
nal mucous membranes?
  The strongest objection perhaps is  that drawn from the consecn- 
MORBID MUCOUS SECRETIONS.
463
live 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 the irri-
tations of the  genital organs act strongly upon the locomotive ap-
paratus?
   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  always  cure;
2d, that other stimulants  as well as it,  produce  cures;  3d, that
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, by 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 adversaries
©f a venereal virus. Hence it would result, that if a virus is insisted
on in the syphilitic affections  produced  by 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-
fected.  Such is the species of contagion that I 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 con-
stitutes the principle dearest to the partisans of a syphilitic  virus.
Nevertheless, this kind of contagion, if admitted, will never prevent 
464
OF THE SECRETIONS.
the phlegmasiae  termed  syphilitic, from being likewise produced
without inoculations, and by the simple effect of frictions too  often
repeated upon the sexual organs; which would go to prove, that ir-
ritation, 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 irritating poison, 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
capable of producing the same affection in those who would be sub-
mitted 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
absorbed, and develop 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
circulate in the humours without being perceived. The miasmata of
the plague, yellow fever, all  typhous  fevers, variola and measles,
can no more be detected by the chemist than that of hydrophobia, and
yet no one hesitates to admit them.  They are manifested by their
effects, 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 its particular specific re-
medy?
  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.  I  might  perhaps  admit  that this  product absorbed, would
be susceptible of carrying the  irritation to other parts; but it is not
the 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 enable us to throw greater light 
        MORBID LACHRYMAL AND SALIVARY SECRETIONS.     465

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 phlegma-
siae 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 phlegmasiae of the orbit of the eye,
not excepting cataract, are apt to make their attack.   The conjunc-
tiva 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.   We 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 in-
strument.   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
indicated.   The same effects result from smoke, and all the causes
which exercise a special irritation over the  ocular apparatus, and
particularly 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
observed 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 acci-
dental 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-enteritis which  have not
                             59 
466                  OF THE SECRETIONS.
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 men-
tioned 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 some-
times  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 phlegmasiae 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 phlegmasiae or sub-inflammations.
   The secretion of the liver, when regarded as the cause of disease
merits a particular attention.  We are aware of the importance at-
tached to  it by physicians, in this respect, during the reign of the
 humoral theories;  and it is known that ontologists, in all  their va-
riations of language, are far from  having  made any change in the
 fundamental ideas of their predecessors.  We are indeed no longer 
MORBID HEPATIC SECRETION.
467
told of cacocholia or corruption of the bile, but we have gastric de-
rangement, 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 me-
dicines that evacuate the bilious humour.  Although  bile be  not
so powerful a cause  of diseases as has been  believed, it must how-
ever be admitted that it can give rise  to some.   We shall discover
them while examining into the manner in which the biliary  secre-
tion 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 examina-
tions;  but the symptoms dependent on it are not sufficiently  distin-
guished  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  yellowish
tinge of the skin, and the bilious odour, to guide us in the diagnosis;
and even these symptoms are very fallacious.
  It is not thus in cases where the inflammation is developed in the
large intestines; when the bile is poured  out on them, it is 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 
465
OF THE SECRETIONS.
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,  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  tnem 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 thepresenceof bile, in the diseases which interest the
liver and its excretory apparatus. When the secretion of the liver is ex-
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-
perabundant:  and the ordinary  result of such  a  morbid condition
is the absorption of the superfluity of the secretion,  and the yel-
low 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- 
MORBID HEPATIC SECRETION.              469
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 the duodenum;  and since experience has taught us
that in removing  these phlegmasiae 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 from the influence of what is properly
called bile.   I constantly find  that whatever be the intensity of  the
phenomena attributed to bile,  and 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 irritant in the interior of the digestive canal.  The
indications furnished by  the bile as a foreign body necessitating  the
use of evacuants,  are,  however, not always illusory; but 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 cognizance of pathology.
   It has been thought  that when the secretors are in extraordi-
nary action, there is a number  of organic movements directed  to-
wards their tissues, and that they thus become the point to which 
470
OF THE SECRETIONS.
the efforts of the vital powers are 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 it
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, in order to cure bilious diseases.   But, except  these
cases  where it is itself in a state of phlegmasia, this practice would
have no effect.   It  is, therefore, to the secretors themselves, and
generally to the neighbouring mucous surfaces, that we  should  ad-
dress  the means  calculated to moderate  the  secretions; and  these
means ought generally 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 phlegmonous.   The
fluid of the pancreas is susceptible,  like  all the  other products of
the secretors  of being  decomposed, and of  forming concretions,
which arise in its parenchyma or obliterate its canals; but upon this
point  semeiology is not  less obscure than in those of the diminution
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  appearance, it will
be,  for a long time,  difficult to raise the veil by which the real  affec-
tions of the pancreas are obscured. 
MORBID PANCREATIC SECRETION.
471
  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.  Such 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
which 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 secreted
in their respective cavities,  art sometimes succeeds in  dissipating
this  engorgement, by exciting suddenly, and in a more energetic
manner, the secretory  action; but this method, too often repeated,
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 in-
flammation or sub-inflammation, and produce neuroses, by reacting
upon the nervous apparatus, the sole conductor of stimulations de-
veloped in any point whatever of the living animal economy. 
472
                       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 functions,
to pass out, after being  moulded in 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 chemis-
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 is not sufficient to  distinguish  them; it confounds them 
               OF  THE  INTERNAL EXHALATIONS.            473

with the exercise of contractility, with sensibility, and with all the
prodigies of  the  intellect, which  are, as well as that chemistry,
phenomena 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 pheno-
mena 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 tis-
sues, 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 suita-
ble ?  Indeed  I cannot  conceive why this opposition to the perfect-
ing 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 impossible
to dispense with it, in our efforts to establish a classification of phy-
siological 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  life from
matter,  it consists in a play of molecular affinities, making part of
the phenomena which distinguish living bodies.  All these petty
cavils do but little honour  to these gentlemen, for they only an-
nounce their superficial views, and a  want of attention in reading
new works,  even though they should  not proceed from less excusa-
ble motives.  The term vital chemistry is not of my own invention,
 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 be-
 tween  the organic phenomena,  which  the  celebrated  Bichat  has
 considered in such a summary manner that they are still involved
                               60 
474
OF THE INTERNAL EXHALATIONS.
in much obscurity.  When the futility of these distinctions shall be
demonstrated, I will abandon the term vital chemistry; until then,
I will continue to employ it, and I now proceed to use it for eluci-
dating the phenomena of what is designated under the head of in-
ternal exhalations.

Section I.—Of the Tissues charged with the Internal Exhala-
                            tions.

   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 insinuate
themselves between the fasciculi of the  muscle itself, immediately
envelop certain viscera, as the heart, surround the vessels, to which
they furnish a sheath, and with them are insinuated into the different
parenchymal, 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 general,
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 caloric, this sub-
stance does not exist; whilst the  lymphatic vapour, which is essen-
tially  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.
   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 
OF THE INTERNAL EXHALATIONS.
475
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, been
compared by  him to  sacs without apertures, the internal surface
corresponding to itself, and the external being adherent to the sur-
rounding parts, by means of cellular filaments.  On the same line
with  those membranes appertaining to the great viscera, such as
the brain, lungs, heart, and the abdominal cavity, are classed
the synovial and tendinous capsules, whose free surfaces are like-
wise in relation with themselves; and the  external which corres-
pond  to cartilages, ligaments, 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 in their degree of
concentration,  the  serosity 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 fila-
ments by which the peritoneum 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 the pleuras, which have no fat behind them except at the medi-
astinum, and  in the serous membrane  of  the pericardium,  which
only presents some at the surface of the heart, but  does not offer
any between it and the pericardiac sac, &c.  The arachnoid is the
only serous membrane the  external surface  of  which never gene-
rates adipose matter.   Fat is never admitted into 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 membranes called lateral ligaments, &c; but there are
 met with certain free spaces between these latter, as we see in the
 popliteal  regions, which are filled with a  tolerably large quantity
 of fatty cellular tissue.
   Such are the principal tissues on which  the  internal  exhalations
 are performed; we must place  on the next line some  membranes 
476            OF THE INTERNAL EXHALATIONS

which their resemblance, as respects exhalations, has led to be ap-
proximated to the preceding ones: such in the first place are those
that secrete the humours of the eye, and the membrane furnishing
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 w>th the cellular laminae 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
deposited 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 exuded 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 areolae 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
latter 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 effects of a much more considerable  pres- 
OF THE INTERNAL EXHALATIONS.            477
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
which depend those of the  interposed humours.   Hence, the ex-
planation 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
intrusted  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-
nomena 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
from  each other.   To this, in fact, is reduced the part  of contrac-
tility; but whilst it gives motion to or  retains the fluids, chemica! 
478
OF THE INTERNAL EXHALATIONS.
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 differences of
which elude our view.  Now all this  being applicable to the forma-
tion of the humours of the eye, and that of  the  fluid in which  the
acoustic nerve is 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 of
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
the human body, by opposing in its character of bad conductor the
too rapid evaporation of caloric.  Experience is conclusive on this 
OF THE INTERNAL  EXHALATIONS.             479
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 I 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;1it 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
fulness 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  fractures.  Might it not be for the
 bones what fat is for the soft parts,  a kind of deposit of the super-
 fluity of nutrition, destined to  aid  in their restoration in case of
 need? 
480
OF THE INTERNAL EXHALATIONS.
  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 gelatin,  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 hu-
mours.

  Section III.—In what manner  the  Internal Exhalations
                  become Causes of Disease.

  The internal exhalations are brought about in a 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  parenchimatous 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 are
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-
tity than usual.  It is  in this way that an excess of exhalation takes 
OF DISORDERED INTERNAL  EXHALATIONS.        481
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, parenchymae,
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 analogous 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 accumular
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 exhalations
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  see
after falls, shocks  of the limbs produced by firs-arms, explosions of
gunpowder: to their inflammation do we refer all the phlegmons of
                              61 
482
OF THE INTERNAL EXHALATIONS.
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 excrescences, the growth of fungous
flesh to excess, the generation of pus and the various aspects which
it may present, scirrhi, 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-
purating function  of  the skin.  This, which  gives origin  to  so 
OF DISORDERED INTERNAL EXHALATIONS.         483
 many 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 kidneysj but there are  other  cases  in
 which the inflammation  caused by  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, which 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  schirrous  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, are converted, in the tissues intrusted with their performance,
into an irritation which rouses them from the torpor in which they
had been  accustomed  to live, and places them in  connexion with
the organs which  transmit to them  inflammation and sub-inflam-
mation.
  Suppressed cutaneous transpiration exercises  likewise an irrita-
tive influence over these tissues,  which follows immediately after
sub-inflammation: I now allude to cedemas and dropsies  of the se-
rous membranes, which we at times observe succeeding' the  im- 
484
OF THE INTERNAL EXHALATIONS.
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 oedemas  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 trans-
mission 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.  Depura-
tions of matter are then multiplied after the slightest irritation, as if
the adipose net-work had acquired the irritability of the membranes
of relation.  Inveterate gastro-enteritis seems to be  often the cause
of this.  The puerperal state likewise produces this melancholy
diathesis when mothers refuse to suckle their offspring; 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 lymphatic humours,
which nature had destined for the nourishment of the child.
  Whenever the muscles degenerate and their fibrin 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 pre-
vented motion and  forced  the limb to absolute rest, this  change
is owing to a development of the cellular tissue interposed be-
tween the muscular fasciculi.  We know that this tissue penetrates
between each muscle, then between the fasciculi composing it and
finally between each red fibre, as far  as they can be divided, and 
            OF DISORDERED INTERNAL EXHALATIONS.         4S5

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 laminae, as
well as in those which accompany the sanguineous and lymphatic
vessels; it swells and bathes them in lymph and fat.   It abstracts,
for their  profit, the vital action which ought to be  received  by
the muscular fibres.   This double cause, the superabundant vita-
lity 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 fibrin, 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,
tendons, ligaments, finally, all that is not fibrin, 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 these fatty and albuminous growths to debility, still less to
 a rheumatismal diathesis  of a particular kind, or to a humour. Rheu-
 matism is truly a  disease  of the gelatinous and muscular tissues
 simultaneously;  but this disease, which is only an irritation, by ren-
 dering the contraction of the muscular fibrin painful, condemns it to
 repose, and thenceforward  the entire vital action is diverted from
 this fibrin and fixed on the tissues which  are interposed 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 tendinous attachments, as
 well as around the articulations.
    In  paralysis from irritation of the brain or muscular nerves, we
 meet with  a somewhat  different degeneration; we see the areolar 
4S6
OF THE INTERNAL EXHALATIONS.
tissues injected with a gelatino-albuminous lymph, to such an extent
even that the limb seems  cedematous; 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 areolae, and the diminished power of absorption com-
pels them to remain  there, and hence results the cedematous 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 phlegmasiae 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 irritations 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
them, a certain proof that the irritation developes the nervous mat-
ter, which was lost in  the  medullary tissues,  rouses them from the 
OF DISORDERED INTERNAL EXHALATIONS.        487
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
phlegmasiae, 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 places them,  like these latter, in relation with the centre of
perception, 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
membrane 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 phlegmasiae 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 sys-
tem, 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  distin-
guished by an extraordinary irritability of those tissues, which  act
on the albuminous and oily portion of  our humours, without even
excepting the most dense ones, and which  receive it while they
repel  the red molecules, or which only admit them in a state of de-
composition, 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
irritative diseases, serves  still to distinguish them from  common
phlegmasiae:  this word, as already known, is sub-inflammation;
but as I propose recurring to this topic, I shall not now make any
efforts to  convince practitioners of the necessity of admitting this
expression, or of  finding another which shall give precisely thft
same idea. 
4SS
OF THE INTERNAL EXHALATIONS.
  Polysarchia, 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 explain,
not why it is created, but rather  still more, why all persons who
eat  much and who do not use exercise proportionate  to  their loco-
motive powers, are not thus affected: be this  as  it may, this exu-
berant 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 who are lean and haggard.
The explanation usually given is  in the alleged  relaxation of  the
fibre; but can  such relaxation, regarded as bordering on a patholo-
gical state,  be compatible with the exuberant haematosis which we
always observe 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 vitreous humour and
crystalline  lens. On the other hand, ophthalmias of the conjunctiva
impart to the membranes that exhale the above humours an irrita-
tive impulse, by which they lose their  transparency.  We  meet
moreover with critical phlegmasiae 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
diseases have been treated by the stimulating method, or abandoned
to nature.   The inflammations of  the retina and iris may likewise
affect  the internal exhalations of the eye, so that the membranes
which are intrusted with them receive  irritation  from all the sur-
rounding tissues, and retain it in  a grade proportioned to the im-
petus  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
lesions; but we have not all the wished-for data to the passages by
which they are transmitted to it.   There is no  doubt  but many
cases of deafness, the cause  of  which seems undiscoverable, owe 
OF GENERAL ABSORPTION.
489
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 the 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 areolae
of the laminar tissues; 4. Upon the  oily fluids deposited in the adi-
pose and in the medullary and diploic tissues; 5. Upon the humours
of the eye and of the internal ear;  6. Upon the interior of the ex-
cretory canals;  7. Upon the  cutaneous surface; 8. Finally, absorp-
tion 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 parenchymse;  but this latter forms part  of the pheno-
mena of nutrition, in which  we meet with the composition and de-
composition of the solids.   This last will  therefore be reserved for
the following chapter.
  General lymphatic  absorption  is the  only one,  the agents  of
                              62 
490
OF GENERAL ABSORPTION.
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
directly into the venous radicles.

 Section I.—Summary Description qf the Lymphatic or Ab-
                       sorbent System.

  The organs of absorption are divided into  two classes:  1. Lym-
phatic  vessels;   2. Lymphatic ganglions.   The lymphatic vessels
are tubes intrusted 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 subcutaneous, 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
subclavian and  internal jugular veins.   Two of these trunks are
much  larger than the others:  they 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,
upon the transverse apophysis of the last cervical vertebra, and
opens at the angle formed by the right internal jugular and subcla-
vian veins, after a course of about a third or a fourth of an inch. 
         OF THE INSTRUMENTS OF GENERAL ABSORPTION.    491

   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 the}7 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 lympha-
tic ganglions has been before described, when treating of the diges-
tive 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 articula-
tions, 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 bronchiae and of the lungs
terminate in the ganglions called bronchial, which  are  situated, in
part, about the ramifications of the bronchiae, and  in part in the me-
diastinum.  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 lymphatics,
pass successively into others  more deeply seated,  until they have
reached the central lymphatic trunks which are to deposit them in 
492
OF GENERAL  ABSORPTION.
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 intrusted 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 divided:
no one denies to the lymphatics the office of conveying and  depo-
siting 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 imme-
diately into the venous radicles.  We may express ourselves in the
manner of the ancients, by saying that the veins absorb.  The ex-
periments tending  to prove this fact may be found in the different
works of M. Magendie.*   We had at first thought that it was exe-
cuted by small canals, which, after  having  obtained from the sur-
faces 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,  form-
ing part of the  general system, would be the great  lymphatics; the
second,  without any  communication with this system, would  be
called the  small lymphatics, or the short absorbents. But to sustain
this opinion, we ought to  be assured that absorption is  always per-

  * 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 remainder
of the body, other than by this  single vein and artery; he injected into it a decoc-
tion of nux vomica, and,  in  six minutes afterwards, the effect of the poison was
manifested.  M. Segalas, a pupil of M. Magendie, repeated this experiment, but
he left no  communication between the portion of the intestine with the remainder
of the body, except the chyliferous vessels,—all the arteries and veins being
divided; he injected half a drachm 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 potass,) in the thoracic duct. 
         OF THE INSTRUMENTS OF GENERAL ABSORPTION.      493

formed at its origin, by organized canals; which it is impossible to
affirm, since dissection has not enabled us to distinguish the parti-
cular absorbent mouths. It might indeed happen that the fluids, de-
posited upon the surfaces, were pumped up in virtue of the affinities
of vital chemistry, and at first in a true state of extravasation, intro-
duced molecule  by molecule, between those of the  fixed animal
matter,  and  that,  there  confounded with  the blood  also extrava-
sated, these molecules might be seized upon sometimes by  the ve-
nous radicles, and sometimes by those of the general lymphatic sys-
tem, according as their affinities would direct them  towards one or
other description of vessels.  The greatest obscurity still exists on
this point of physiology which forms part of the  mysteries of the
capillary circulation, a circulation which obeys, as we  have already
seen,  the unexplained laws of the molecular affinities  of vital  che-
mistry.   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  sub-
mitted to absorption,  those which ought to traverse the  great lym-
phatic system before being  admissible into the veins, and  those
which are privileged  to  penetrate immediately into  these vessels
after they have been pumped up by the animal  matter of the sur.-
faces.  The following are some data, which, it seems  to us, might
serve as  a means of leading to this 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 parenchymae, having a proper tissue,  nerves, and sanguineous
vessels, arterial and venous.   The lymph which reaches them can-
not, then, remain in condensed columns, as it was in the vasa  affe-
rentia, but must  be  extravasated there and submitted  to the action
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 kinds: the one will be admitted directly by the
radicles of the veins;  the other will be attracted towards the great
lymphatic apparatus, and will have to traverse it before mixing with
the blood.   Now, our modern physiologists have admitted this di- 
494
OF GENERAL ABSORPTION.
 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; whilst 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 from the serous mem-
 branes, the synovial capsules, the areolae of the laminar tissue, the cells
 of the adipose, medullary, and diploic membranes, those of the hu-
 mours of the eye, the arachnoid,&c. terminate in lymphaticganglions?
 It would be rash to affirm that this is indispensable,  for the gan-
 glions that are met 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 cranium,
 where absorption does not convey any fluid coming from  the ex-
 terior.   It is generally believed that the serosity of the arachnoid
 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, al-
 cohol, &c. whilst others must necessarily be submitted to the  in-
 fluence of the ganglions, aud traverse the whole extent of the lym-
 phatic 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 caual, penetrates directly to the kidneys;
 but  as  there  have  never been found  any particular vessels for
 its conveyance, 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.
  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 
        OF THE INSTRUMENTS OF GENERAL  ABSORPTION.    495

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 sto-
mach 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
out abundantly 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
mucous 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 fol-
low 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 our-
selves with  giving  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
 the kidneys eliminate, in a short time, all this fluid,  without any in-
 creased  frequency of the pulse taking place; yet we must concede
 that the acceleration of the  systole of the heart is favourable  to 
496
OF  GENERAL  ABSORPTION.
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 vessels
must, like the veins, act upon their fluid, by alternations of contrac-
tion and  of relaxation,  although  it may be impossible to perceive
them: perhaps  at some future period that instrument  will be disco-
vered which shall render them perceptible.*

  * The precise mechanism by which absorption is performed, is as yet an unset-
tled question.  Capillary attraction is not an adequate cause of the movement of the
chyle and lymph in their respective vessels, nor is successive  contraction  of the
coats of these latter a satisfactory agency. If we search for illustration in vegeta-
ble physiology, we shall find a process very analogous in the  rise  of the  sap in
plants. Dr. Dutrochet in a late work on the Immediate Agent of the Vital Move-
ment,! would  seem to have proved that the vital impulsion, the vis a tergo, is
communicated to the fluid in the  lymphatic vessels of vegetables by the spongy
terminations of the radicles of the  root.  Another power of a more negative
kind, producing a movement of  afflux or pumping, is in  the  leaves, evapora-
tion from which invites fresh fluid from the parts beneath. It  is this latter power
which causes absorption, when the cut end of  a branch  is  immersed  in  water.
The distention of the vessels by the rise of their peculiar fluids,  is called the tur-
gid state by Dr. Dutrochet, and  is kept up,  according to him, by a  physico-
organic or vital action  termed endosmosis, in virtue  of which the  small hollow
organs are filled with a liquid which  seems to be urged on with force, and accu-
mulated in their cavities.  The spongy terminations of the radicles are exclusive
agents for the absorption of the water by  which they are surrounded in all nutri-
tive soils. They are constantly introducing, by  endosmosis, this fluid into the in-
terior of the cells composing their tissue, which is  thereby rendered turgid, or
filled in excess.   The water thus imbibed by the terminations of the radicles,
propels that portion precedingly introduced, and causes necessarily the rise of
the sap in the vessels communicating  if not continuous with the root.  It is pre-
sumable from  some experiments of Dr. Dutrochet, that  if the cut end of a
plant be immersed in a fluid destructive of its vitality, say diluted sulphuric acid,
this latter will rise in the vessels,  without any action whatever on their part,  and
merely by the  movement of afflux of the leaves, already mentioned,  by which
they draw up the sap interposed between them and the foreign fluid; a movement
which we must not confound with capillary attraction, nor the mere suction or
motion of fluids to fill a vacuum, but which is a vital process dependent on the en-
dosmosis  of the leaves and their evaporating function.
  The author, whom we continue to cite as authority on this occasion, illustrates
the meaning he attaches to the term  of endosmosis by various experiments. The
process rests on a simple law which he has shown to exist, viz.  that if an  ani-
mal or organised membrane be interposed between two fluids of different degrees
of density, the one having this property the least so, passes through the mem-
               t L'Agtnt Immediat du Mouvement Vital, &c. Paris, 1826. 
OF  THE  INSTRUMENTS OF GENERAL ABSORPTION.      497
   The mental  affections  have a notable influence on the phenome-
non of absorption; it is known how far they can increase the action
of the secretory vessels; and we have already remarked that elimi-

brane to the other fluid more dense.  If the motion be from without inwardly it
is  called endosmosis; but  if the  lighter fluid be within the cell, sac, or cavity,
whatever, and the denser one external to it, the former passes out and constitutes
the action called exosmosis. These processes of endosmosis and exosmosis are elec-
trical phenomena and producedby electrical currents. Dr. Dutrochet couldimitate
them by the aid of electricity or galvanism. Thus he took a piece of chicken's coecum,
the kind of membrane on which he had before experimented, to show the passage
of fluids through it in the directions above mentioned, and having tied both ends,
introduced the negative pole into its interior, and placed the positive without, so
that the side of the intestine  was the communication between  the two poles.
The galvanic pile being now put in action, and the portion of the coecum im-
mersed in water, it was found  that the cavity before empty, soon became turgid
by the passage of water through the sides in the direction of the electric current,
that is from the zinc  or most dense to the copper or least dense pole.   The re-
sult may be reversed,  and  exosmosis take place, by placing the positive pole
within the cavity, and the negative  outside, as in the case of the less dense fluid
being in, and the denser out.
   The hollow organs are compared  by Dr. D. to Leyden  jars  with permeable
sides, and as the current of fluid is always towards the negative  pole, there will
be endosmosis when their  interior is in a state of negative electricity,  and ex-
osmosis when it is positively, and the exterior negatively electrified.  But we are led
to believe that the two processes are constantly going on at the same time—the
preponderance of endosmosis causing absorption to be the most energetic, and
of exosmosis making exhalation paramount.
   The sap-vessels of plants, and the absorbents of animals are, we may presume,
in a similar condition, and subject to the same laws. The former receive their fluid
contents from the spongy extremities of the radicles or capillary portion of the roots;
the latter are supplied from the spongy tissue of the membranes and capillary origin
of the lacteals and lymphatics.  The structure of both the radicles  and mem-
branes is vesicular, the vesicles containing a dense fluid.  Through these the
rarer fluid, in the soil, as regards vegetables, and on the membranes, as regards
animals, permeates by endosmosis: it passes from vesicle to vesicle, and by main-
taining these in a state of turgescence in excess acts as an impelling power to
the fluid in the tubes in connexion with these vesicles.   It  might be thought
that the lymphatic  and  lacteal glands would interrupt the  passage of the
lymph and chyle; but the contrary is the case.  They are provided with a capil-
lary tissue, the endosmosis of which  produces  the afflux of fluid contained in
the vasa afferentia, and at the  same time the expulsion of the fluids precedingly
introduced, and hence an impulse d tergo for the vasa efferentia.  These glands are
then in fact organs of afflux for the fluid below, and of impulse for that above—
they constitute motor organs for the fluid contained in  the vessels.  In this re-
spect they resemble the leaves of plants, which, independently of their agency
                                    63 
49S
OF GENERAL ABSORPTION.
nation ought necessarily to augment absorption.  It is the observa-
tion of this last relation which has directed  physicians  to  the pre-
scription 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 on the mucous  lining
of the digestive tube; for whenever it becomes immoderate,  the se-
creting vessels do not act, and the tissues loaded with lymph attract
an additional 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 rapid
than in men; it  may be considered as existing in the highest possi-
ble degree among persons of a rigid and robust habit, whilst in sub-
jects of an  opposite constitution  it is always very feeble.

Section III.—In  what  manner the  Absorbent System becomes
                           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
which sympathise  the most with its ganglions.   Now,  the stimula-
tions which cause the absorbents to act  are those of the membranes
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

in the afflux of the sap in the ascending vessels, are also organs of endosmosis or
vis a tergo for its return in the descending ones  of the vegetable.
  Other causes of endosmosis are mentioned by Dr.  Dutrochet in addition to the
mere difference of density of the  fluids. Their  chemical  composition gives
rise to great  variations in this respect.  He shows, moreover,  that there is elec-
tive absorption, and that solid or fecal matters, for example, in the intestine will, in
place of being absorbed,  cause exosmosis or exhalation.
  The novelty and plausibility of these views must be our apology for the undue
length of this note.  The subject is indeed a most fertile one,  and shall ere long
be placed in detail before the medical reader in another work.—Tkans. 
DISEASES OF THE ABSORBENTS.
499
 surfaces determines them to the performance of absorption, the ac-
 tion of all the lymphatic vessels thence arising, and the ganglions
 in which  they terminate, is necessarily increased: such is the chief
 cause of glandular phlegmasiae; 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 for it to exist, in order that irri-
 tation 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 me-
 sentery; well, it is  the same  case with the  phlogosis of the skin:
 when it exists, the  ganglions to which  the lymphatics of the part
 are  distributed  simultaneously become diseased; hence  buboes of
 the groins in catarrhs of the external genital  mucous membrane, and
 even in inflammation of the toes.   All erysipelatous affections cause
 the adjoining glands to tumefy; inflammations of the mouth,as also
 those of the face and neck, produce the  same effect upon the cer-
 vical ganglions.   Let there arise a phlegmasia 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 inflamma-
 tion?  Let the mucous membrane of the bronchiae  be inflamed, the
 bronchial  ganglions become tumefied; and, if the catarrh continues,
 they experience a real phlegmasia.   It is then a fixed law, that ir-
 ritation may be transmitted from the surfaces of relation to the lym-
 phatics and neighbouring 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 they  are  altered
 in the bodies of those who have died from  such  phlegmasiae, we
 are certain to find a complication of enteritis or of bronchitis; which
 confirms the conjecture hazarded above, that the fluids absorbed by
 the membranes called serous need not necessarily traverse the lym-
 phatic ganglions.
  Although  simple  inflammation, absque materia, of the skin or
any other  membrane of relation, is sufficient to cause a tumefac-
tion  of the ganglions which receive lymphatics from it, we confess
'hat  this influence is much more marked if the phlogosis be caused 
500
OF GENERAL ABSORPTION.
 by liquid  matters, very  acrid and  capable  of rapidly traversing
 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 investi-
 gation should be made  with respect to the ganglions of the medias-
 tinum, for it appears to us that the mucous membrane of the bron-
 chiae must frequently, during the time of a plague, participate in the
 inflammation of that of the stomach  and intestines.  I have dis-
 tinctly said, that in certain epidemics of our climate the gastro-en-
 terites are much more frequently accompanied by ganglionites of the
 mesentery than in others; this difference is perhaps owing to the
presence of some miasmatic poison, the source of which is not wrell
known; perhaps also it is dependent on the moisture of the atmo-
sphere:  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.
In fact a cooling of the  surface suffices, without the co-operation of
any cutaneous inflammation, for a painful and truly phlogistic tume-
faction of the glands of the neck to supervene.  It is  in this way
that those engorgements of the nose, lips, ears, and cervical glands
observed in spring and autumn in young subjects, whose skin is
delicate  and sensible, are most frequently excited.   If the constitu- 
DISEASES OF  THE ABSORBENTS.
501
tion 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  lymphatic 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 en-
deavour  to support this opinion by the best  authenticated and 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 suf-
ficiently  renewed, he is necessarily deprived of light,  and saturated
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 abundant  nutriment;
he cannot derive any benefit  from  it, if these organs  are  not ren-
dered fit for  a  perfect assimilation by air adapted to  the  wants  of
his system.  He will then under  such  circumstances make a bad
use of the nutritive materials, and  his  development will  never  be
complete.  But if we add to  these two causes of  weakness the hu-
midity with  which the air he breathes is  saturated,  we  shall find
that  the  abundant evaporation, which always takes  place  from his
own body, will not be dissolved; his vessels will  then remain sur-
charged  with lymph; he will become chilled, particularly  if the air
is deficient in caloric; he will no longer have sufficient  fibrin, and
colouring matter;  he will not regain regularly his heat when it has
been ahsuacted, and his tissue, moistened and relaxed, will not have
that  readiness to free and energetic inflammation, which is remarked 
502                OF GENERAL ABSORPTION.
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 mannner  in  which they
are developed, and  what relations connect them  with other irri-
tative 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
eommunicate 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 scrofulous en-
gorgements—those  of the lips, cheeks, ears, nose, fingers, and feet;
hence, among the white tissues, the most active and  the most san-
guine become  first irritated;  they  possess action  sufficiently to con-
tract irritation, but not enough to  experience it to that extent which
induces us to £all it sanguineous.  They claim it, therefore, in that
degree which  we call scrofulous.
   This first  impulse being given under the influence of alternations
©f heat and cold, it  is understood  that it ought to be  repeated in 
DISEASES OF  THE  ABSORBENTS.
503
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
tissues, 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 gelatinous 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 evacuation
which  shall unload them, can produce the same result.  Scrofulous
irritation may then commence in the midst of tissues, which in or-
 dinary cases it affects only secondarily:  it is in this manner that
 contusions are observed to immediately develop 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 ques-
 tion  which now  engages us.
   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,
 give rise to the scrofulous inflammation when 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 
a04
OF GENERAL ABSORPTION.
 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 firmness
 of their ligaments  and bones, were the only evidences of it even on
 to adult age.    But this period arriving, an accidental  irritation 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 suppu-
 ration, produce suddenly scrofulous  inflammation, so much the more
 intractable as there does not exist a prospect for their healing, de-
 rived 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 ad-
joining the exterior, of  the ligaments,  periosteum, cartilages,  and
 even of the bones, when they have been so unfortunate as to con-
 tract a syphilitic phlegmasia. The more they are stimulated by real
 or imaginary specifics,  the greater  is  their suffering; the point of
 irritation continually  changes its  situation; and too often their ma-
 ladies terminate only at  the moment when the stimulants  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-
 ease that this dreadful epigenesis  or new series of symptoms is ma-
 nifested. The viscera, being warmer, and plentifully supplied with
 blood, resist it  at first, and contract only irritations purely sangui-
 neous, 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 whit^ 
DISEASES OF THE .ABSORBENTS.
505
tissues are finally roused into action; and  as the scrofulous predis-
position, though less in  the interior than externally, still  persists,
the viscera are infarcted with  lymphatic  engorgements which no
longer admit of any hopes of cure.  The  same defect of nutrition
which produces the scrofulous predisposition, may also become pre-
dominant in the osseous system; then the bones, no longer incrust-
ed with  calcareous  phosphates, remain 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 contract slow phlegmasias,  which
produce engorgements  of the surrounding 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: very  frequently this hypertrophy be-
comes morbid in the pulp, which degenerates, and there  takes place
in the ventricles an irritative exhalation of serosity, producing 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 materials,  which, not
receiving the normal direction, on account of the weakness of assi-
milation, and  the languor of the eliminating power, establish a lym-
phatic plethora very favourable to the development and irritation of
the white tissues.
   The exuberant nutrition of the abdomen is also manifested in the
scrofulous disposition, when there is connected with it a slight en-
teritis, either by the enormous enlargement  of the  liver and the
swelling of  the ganglions of the mesentery, or in  consequence of
the gases wThich the irritation of the  membrane unceasingly fur-
nishes.   The  lungs  have not been observed to participate in this
hypertrophy: on the contrary,  the curve of the softened ribs, and
the sinking in of the sternum, produce a narrowing of the thoracic
cavity, and compression of the lungs and  heart, which  retards the
passage of blood through these organs, forces it to stagnate in the
head and abdomen, and to favour the plethora  and the exuberant
                              64 
506
OF GENERAL ABSORPTION.
nutrition which render those organs liable to inflammation.   But
at a later period, when puberty directs the last effort of growth to-
wards the thoracic viscera, 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 osteo-malaxy, become, at a later period,
the cause of the most fatal visceral inflammations.  Let us now exa-
mine 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 the least irritable;  that in virtue of this disposition, these
tissues contract 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 suppuration which
is peculiar to them.  This progress of things is somewhat analogous
to that of sanguineous inflammation, and yet it should be  distin-
guished from it; the precision of medical language demands  it, and
still the words in use do not attain this object. Shall we employ the
word scrofula ? It is founded upon the resemblance of the Empha-
tic 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 engorge-
ment?  It  does not indicate any  better the physiological modifica-
tion, and besides recalls ideas of obstruction through weakness, or
a supposed coarseness of  the molecules which would be dispropor-
tioned to the caliber of the vessels.  The expression infarction is
no better.  There remains that of lymphatic inflammation; but if
we wish to designate fully this 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 inflam-
mation  is possible in some of them, such as the ganglions, the se-
cretory glands, the cellular tissue, and the serous membranes- but it
does  not always exist  in them, and the tumours adduced  as ex-
amples are the very ones in which  it does not exist.  Shall the 
DISEASES OF THE ABSORBENTS.
507
term chronic be added?   This will  still demand an explanation:
it will be necessary to say that the chronic inflammation of the
white tissues bears no analogy to  that of the sanguineous vessels:
well, it is precisely 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 pro-
duce tubercles, the lardaceous  state, schirrus, encephaloce^e, mela-
nosis,  in a word,  all those degenerations  which may serve as a
foundation to the disorganizing ulceration called cancer.  When the
sanguineous 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  irrita-
tion commence slowly, confining itself to the accumulation of white
fluids, it is a primitive sub-inflammation.   Does the irritation be-
gin by redness and heat, it is inflammation.  Are  fluids  not san-
guineous accumulated at the same time in the part, it. is a mixt in-
flammation, partly inflammatory, partly sub-inflammatory.  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 when-
ever  the sub-inflamed  part suddenly reddens, becomes  inflamed
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 to
the variolous virus, sometimes to the rubeolous, and at other times
to miasmata; yet it will not be less useful to possess terms  which
shall portray each shade  of those  irritations.   Until specifics are
discovered for each of them, of which we are allowed to doubt,  we
shall always find in the language above proposed, the first indica-
tions  to direct us in modifying irritation  by the two classes  of  re-
medies with which we  are acquainted, and the employment of which 
50S
Oi NUTRITION.
is familiar to us, viz. antiphlogistics and revulsives.  For a long pe~
riod of time nosologists placed the variolous at the head of the in-
flammatory diseases: has this classification therefore  prevented the
discovery of vaccination? and is it not to the precision which phy-
siological medicine has attained in the diagnosis of the seats  of the
irritation at the different stages of this disease, that is owing the great
success which renders it at the present day less fatal  than formerly?
Impressed with  this important  truth, that the danger of confluent
small-pox is in a great degree the consequence 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 with-
out injury; and from confluent, as it was, the variola became discreet,
and the patient escaped 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 Midecine Physiolo-
gique.
                       CHAPTER  XII.

                        OF  NUTRITION.

  Tins is pre-eminently the function of the living body; it consti-
tutes 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 dif-
ferent in each of them.
  Nutrition is the same from the first moment of existence to the
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

  * Compte rendu de la Pratique Chirurgicale de I'Hotel-Dieu de Lyons, durin^ six
years, read in a public meeting of the administration of the hospitals of that citv,
the thirtieth of December, 1823, page 45. 
OF NUTRITION.                      509
uodies, 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; at-
traction 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 body; their action is only modified to a certain extent, and
whenever these agents have much energy,  life  is unable to resist
Ihem: organized bodies are susceptible of the same modifications as
inert ones; they are projected, attracted,  burnt,  frozen, in a word
disorganized.
   Chemical laws are  modified in another  manner: they may, it is
true, when very powerful, destroy organized  beings,  as is seen in
the effect of concentrated  caustics; but they serve as a basis for the
formation  of these same  beings,  which  does not happen with the
physical laws.   Scarcely  has nutritive matter been introduced into
the stomach, when the play of molecular affinities to which 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 con-
tact.  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. 
510
OV NUTRITION.
  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 apper-
tain 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 particles 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-
cises of the  instinct and of intellect, presupposing, as we have already
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 all so
many phenomena,  the  ideas of which we derive from the  modifica-
tions 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 enough 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 strain si-
milar to what  we meet with in the work of M. Berard, 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 contractihty."
  But when certain philosophers maintain that sensitive and intellectual pheno-
mena are not  the consequence of organization, I am at a loss to understand them. 
OF  NUTRITION.
511
   The laws of which  we  now treat are referred to  forces or pow-
ers ; this manner of expressing ourselves does not affect the reality of

It is alleged that matter does not give rise to them, but it is still the manner in
ivhich 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 dis-
tinct 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. Berard avers that the sentient power ought to  be  considered abstractedly
from matter, whether governed by known physical and chemical laws, or 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 matter,
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 otherwise
than in its relations with the organs.  These strike our senses; and, whatever ef-
fort we may  make to conceal them, we can never succeed.  To say that the orga-
nization  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 possess this organ: now, if we can only
think because we have a brain, it seems to me very  probable, that thought  takes
place by its instrumentality.   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 speak-
ing 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 and of grossness of thought, are reduced to tins simple pro-
position, repeated to weariness for so many ages: we cannot conceive how the move-
ments 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 astc- 
512
»F NUTRITION.
the phenomena,—the word power being an abstract idea, by which
we mean the unknown cause of the phenomena; we may then make
use of the words, physical power and chemical power.   This  lat-
ter will  be  divisible 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 in-
clude 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  pheno-
mena 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-

nishment 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 long-er
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 me-
taphysics, 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.                     513
                                        4
 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 con-
 tinue; the former is at first predominant, both are then for a while
 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
 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 the 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-

  * These opinions of the author, already explained and illustrated under the heads
of the capillary circulation and the secretions and exhalations, find strong corro-
boration in the views and experiments of Dr. Dutrochet.  The growth of parts is
regarded by this physiologist as the result of endosmosis.  Each vesicle entering
into the composition of an organ, has in its interior a fluid denser than the sap o
a plant, or the blood of an animal, as the case may be; of course this nutritive
fluid is attracted from the vessels, and a part is introduced into the vesicle, in>
creasing thereby its size, and giving it growth.  But. as explained in a former
                               05 
514
OF  NUTRITION.
 plished at the same time, and have  nothing in  common with  con-
 tractility and sensibility; these latter are then but the means of car-
 rying 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.

 note, the inward is not the only current, since electricity, the cause of the phe-
 nomenon, gives rise to two currents in opposite directions, and of unequal force;
 and as that of introduction or endosmosis is stronger, the vesicle or cell is always
 filled in excess and preserves its turgid state. The feeble exosmosis is in degree
 aided by the violent entrance of new fluids which must expel some of the mat-
 ters formerly introduced. There is then a continued renewal of the contents of
 the vesicle, in other words, a continued movement of composition and decompo-
 sition. What is said of one vesicle or cell, applies to all, the union of which con-
 stitutes the organ.  But this exchange of fluids is attended by important altera-
 tions in their chemical composition, on account of its being the effect of electri-
i cal currents: and this circumstance will serve to explain the different nature of the
 matters composing the organs, and those circulating in the vessels.
    Secretion may be regarded as nearly an analogous process.   Each vesicle  se-
 cretes its contained liquid; that is, it only allows molecules  of a particular nature
 to permeate through its sides.
    The sanguiferous system in animals, in  its minuter ramifications, keeps up a
 kind of irrigation of the organs, and carries to the  elementary vesicles the new
 organic materials which it transmits by a kind of filtration, and not, as generally
 supposed, by vascular orifices.  But whilst the vesicles thus receive by endos-
 mosis new molecules from the blood, they expel by exosmosis others, which are
 carried into the general current.  These phenomena, as described by Dr. Dutro-
 chet, are in strict unison, if not identical with those regarded by the author in the
 text as taking place by means of vital or organic chemistry.   In speaking of the
 production of fatty and oily matters, he says, p. 477, "we are then compelled to
 allow that the cells which contain these kinds of humours, fabricate them imme-
 diately at the expense of the fluids in circulation:  and since dissection  cannot
 show us organised ducts in the form of vessels, which may be intrusted with
  bringing about this transformation, we are compelled to refer it to an inexplica-
 ble 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
  phenomena of vital chemistry."  Now  these are  precisely the changes which
  Dr. Dutrochet supposes to take place by means of electricity.  By both writers
  they are believed to occur beyond or out of the circulatory vessels, and to be ac-
  complished by the intervention of the cells or vesicles composing the  organs,
  without the aid of the vital properties of sensibility and contractihty.  Our confi-
  dence in the correctness of these views is not a little strengthened by the differ-
  ent manner in which their distinguished authors were led to form them__the one
  by induction, the other by a series of experimental observations.—Trass. 
OF NUTRITION.
515
  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 calcareous phosphate, as in rickets, or by the presence
of fluids, are  condensed and present less bulk in every sense.  The
same 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 could 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 nutritive
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 depends on 
516
OF NUTRITION.
an animal matter interposed between the fibres, which in a measure
is but attached to and  does  not constitute a part of these  latter?
After all, nothing is more difficult to solve than this question,  be-
cause 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 decomposition 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
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 assi-
milates foreign bodies; between  these movements and the stimu-
lation of the nervoso-vascular expansions of the membranes of re-
lation; between this stimulation and the perception of  a want; be-
tween 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 «s 
OF ABNORMAL NUTRITION.
517
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 recognize 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
inquiring into what agencies render 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 haemorrhage; after
which  comes inflammation, which arises in the most irritable part.
The stomach will, in consequence, be the most frequently attacked:
but this may react upon another organ, the brain for instance;  and
the irritation having become predominant in this part, blood will be
invited to it, and a  host of disorders  thence arise.   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 plethora is
more  lymphatic than sanguineous;  which singularly favours the 
518
OF NUTRITION.
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 consider-
able 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  gives more energy to  composition  than  decomposition,
either because the stomach, being less excitable,  supports  and assi-
milates a greater quantity of  aliments, or because cutaneous elimi-
nation 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
cold, the excess of nutrition is only evinced in the fulness of the fat
and blood:  hence plethora and 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 countries.
  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.  Inflammation, in fact, always begins by increasing  the
vitality and the volume of the tissues attacked by it.  I have  fre-
quently had occasion to open  the bodies of those who had sunk  un-
der the  first  period of a  phlegmonous phlegmasia, and I always
found a considerable increase  of fat in the part affected  and in  its
immediate  vicinity.  It is in this way that a slight attack of gastri-
tis gives rise to collections of fat in  the omentum  and  mesentery,
and produces a remarkable projection of the abdomen, which, joined
to the freshness of complexion, gives an idea of strength  and health. 
OF ABNORMAL NUTRITION.
519
whereas it is often only the prelude to the most dreadful inflamma-
tory diseases.  If the excess of nutrition be directed on the thoracic
cavity, the lungs, overloaded with blood and unable to expand, be-
come diseased; the heart is in a state of hypertrophy, and the dys-
pnoea, 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 exces-
sive volume of the head,  a state often, as I have already said, con-
verted into hydrocephalus; but in more advanced life, this plethora
leads to encephalites, madness, and apoplexy.  The morbid fulness
often  shows itself in the throat, especially  in  youthful  age, and
thereby predisposes  to, and  keeps up  very violent and often ex-
tremely untractable anginas.
  Irritation, when acting more particularly on the nerves, produces
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 produced by  sanguineous inflammation, but which carries
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 render 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. 
520
OF NUTRITION.
  Those red and fungous tissues, so rich in blood-vessels and known
under the names of bloody tumours, fungous haematodes, 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 are 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; it vegetates, and is on its inner sur-
face converted into a kind of tissue analogous to that of the serous
membranes.  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 inflamma-
tion 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 va-
rious ways the organic chemistry.
  The modifications  constituting  a predominance of decomposi-
tion, and consequent diminution of the nutrition in the living body,
are all those which we have seen  capable  of augmenting growth,
and others which  are entirely of an opposite nature.  The first and
most powerful of  these last causes is the defect of nutritive mate-
rials.  This fact  is so evident, that it  would be idle for us to stop
at it; but we cannot forbear speaking of the influence which food of
a bad quality exercises on the decomposition of the solids and fluids.
It is already seen  that we allude to scurvy.
  This affection, characterised by sanguineous extravasations, either
externally, (as  in  haemorrhagies,)  or in the interior of the tissues,
as the skin, and cellular net-work, (as ecchymoses, 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
engorgements  in  the parenchymae eminently venous,  such as the
liver and spleen.   We,  moreover,  meet with a languid absorption,
producing dropsy and inflammations, which promptly go on to sup-
puration, haemorrhagies, and gangrene.
  These phenomena have been attributed by physicians  to the ex-
treme diminution  of vital power.  There is, without doubt, weak- 
OF ABNORMAL NUTRITION.
521
 ness in scurvy; but this asthenia is different from that of other dis-
 eases, for death will follow exhaustion from a host of chronic affec-
 tions, without any sign of scurvy.  I have examined these diseases
 attentively, in order to have an opinion based on something solid;
 and I have always remarked, that the patients who sink under gas-
 trites, 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-
 domen?  I do  not believe it; and I now think, that if we observe so
 much weakness and fragility in the blood-vessels, serous tissues,
 and muscles, it is  because a particular mode of irritation had been
 previously established in the internal membrane of the digestive
 canal, by which assimilation was rendered imperfect,  especially as
 regards the formation of gelatin  and fibrin.   This modification is
 frequently repeated in the membrane covering the gums, which is
 inflamed, ulcerated,  and mortifies; but this inflammation may be
 wanting, 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, 1. an irritation of the internal  membrane of
 the digestive canal; 2. an  imperfect assimilation of the elements,
 especially of fibrin and gelatin, 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

  * Writers long ago  pointed out the analogy between the putrid fever  and
scurvy.
                              66 
522
OP NUTRITION.
that it is often torn in the efforts of contraction; and, finally,  why
the tissues in scorbutic persons are so easily disorganized in phleg-
monous inflammation.
  Then  come excessive evacuations,  either of blood  or secreted
fluids; and we know that,  when 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 ex-
citing the secretory action.   Coition in excess hastens decomposi-
tion, 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.
  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 predo-
minance 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 more espe-
cially 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 un-
der a  burning sky, as we find in the Arabs  of the desert.
  Among the causes hastening  the decomposition of  the organs. 
OF ABNORMAL -NUTRITION.
523
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 which it causes, when carried to the de-
gree that produces  fever.
   Sub-inflammation has but little agency on  general  nutrition, un-
less it be complicated with  inflammation and erethism, or interest
the organs that  preside over assimilation and haematosis.
   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.
   Does there exist any instance of debility of nutrition, or predomi-
nance of decomposition, that can be regarded as foreign to irrita-
tion viewed either as cause or  effect?  My  opinion on the subject
is this.
   The langour  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 cases 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 sedative indi-
cations are simultaneously, presented with those of excitation: 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 excitation,  and
even sometimes the bringing on of evacuations, either immediate or
revulsive, of some fluids, such as blood, or the secretion of an arti-
ficial  phlegmasia.   I  only know  of  senile marasmus which  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 ap-
 prised that this marasmus must not be confounded with  that seen
 in certain old persons, who are far from having attained the natural 
524
OF GENERATION IN GENERAL.
limits of their existence, and who are only thus exhausted by a vis-
ceral inflammation, kept up by the improper use of stimuli.
  I have given in the Annates, vol. v. p. 545, the case of a  caries
Mid softening of the cervical vertebrae, observed in a woman attacked
with cancer of the breast.  I do not believe that we can look on the
decomposition of these  bones as independent of irritation, 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.

  Generation, or reproduction, is performed in man)' ways in the
series of living bodies.   The more complex their organization, the
more difficult is the execution of this function.  It is known to all
that the limbs of a polypus detached from the trunk are converted
into  polypi; and the same is the case with a great number of plants
that are reproduced by grafting;  but in the larger  portion  of ani-
mated 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
this 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 develop, but we are as yet far
from determining with precision what is given by the first.  Until
the new being is organized, we see nothing but  free animal matter.
This  is secreted,  or, more  properly, fashioned  by means of vital 
             OF THE MALE ORGANS OF GENERATION.         525

 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 the female;  2. the causes pro-
 ducing and the circumstances attending their union, whence results
 the mixture, or being placed in relation with each other, of the  re-
 productive animal matters;  3.  the preservation and growth of the
 new  being, in the sexual organs of the mother; 4. its issue, or the
 ejectment of the foetus; 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
 connected 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
 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  envelop  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 pro-
 minence which is traversed obliquely by, or in which are discharg-
ed, the principal trunks of the seminal vessels which pass to the epi-
 didymis.
  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 
526
OF GENERATION IN GENERAL.
free.   The epididymis is a canal formed by the reunion 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 mem-
branes; viz. from within outwardly, the fibrous coat, forming two
small sacs; the tunica vaginalis, a serous membrane,  which is
merely a portion of the peritoneum:  it encloses each testicle, with-
out however containing  it  in  its,cavity; the  erythroid coat, or
cremaster muscle, formed by fibres of the  ilio-abdominal muscle;
and the  dartos—cellulo-filamentous  membranes, which are in ap-
position  at the internal part, and  thus separate the two testicles
from each other: finally the scrotum, or cutaneous envelop, which
is only a prolongation of the skin, presenting on the median line
a prominent surface called  raphe,  and corresponding to  the appo-
sition 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 ner-
vous 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
seminales, 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, 
           OF THE FEMALE  ORGANS OF  GENERATION.        527

which open into the urethra on the lateral parts of the verumon-
tanum.
  III.  Finally, the excretory organs of the semen and their appen-
dages, 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,
1. the prostatic, embraced by  the prostate  gland and nearest  to
the bladder; 2. the membranous, from eight  to ten lines in length,
placed  beneath the symphysis pubis; 3. the spongy, and much the
longest, beginning below by an enlargement  called bulb, and ter-
minated above by another expansion, which has received 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
bodjr, the two posterior roots  of which are attached to the internal
border of the rami of the ischia and pubis, whilst the anterior extre-
mity 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.
  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 volumin-
ous, 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 pubis; 2. the labiae, membranous folds occupying 
528
OF GENERATION IN GENERAL.
 the lateral and upper parts of the  vulva; 3. the nymphas, 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 labiae;
 5. the meatus urinarius, or external orifice of the urethra, which
 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, communi-
 cating with the first by its neck, and with the latter by two  canals
 which go out, one 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 which  they only adhere by  one of  the  fringes
 which terminate their external extremity called fimbriae.
   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
 however 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 we
 see an erectile spongy tissue like  that of the urethra.   As  to the
 ovaries, they are  enveloped in  a  cellulo-filamentous  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- 
OF THE FUNCTIONS OF THE ORGANS OF GENERATION.   529
thetic and spinal cords; they are also supplied with arteries, veins,
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 mammae 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 mammae receive ar-
teries, 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  the struc-
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 the stimulations of the genital organs
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
them.  This phenomenon is in some measure an excess of precau-
tion on the part of nature, tending to give 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  vesiculae seminales.  The
stimulation  exercised on the sensitive surface, or on the  mucous
                              67 
530              ©F GENERATION in GENERAL.

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 vesiculae 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, since
they are deprived of vesiculae seminales.  These  vesicles are only
evidences of a more perfect organization, seldom  met with  but  in
animals 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 hardened; 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 mucous membrane, participate  in the
erection, and all these with so much the more energy, as the semen
contained in the seminal vessels is more abundant and more con-
centrated.
   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 gelatin, some  acids and salts—articles usually found in all the
animal  fluids.   The semen, it is true, is remarkable for a very de-
cided odour—such  as we meet with  in some of the  grains of the 
       OF THE FUNCTIONS OF THE ORGANS OF GENERATION.   531

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.   However 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 stra:ned  and purified by absorption, which takes from it
whatever foreign elements it might have had. This elaboration is
continued in the epididymis, the vasa deferentia,  and above all is
most marked in the vesiculae seminales. It is there that  the semen,
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 paren-
chyma.
   In the female, the desire depends entirely on the normal excit;.- 
532
OF GENERATION IN GENERAL.
tion 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  sti-
mulus, 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-
out suffering, forego it for such a length  of time in order to suckle
and direct the physical education of her children.  Hence we never
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, there is strong desire only in 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 
       OF THE FUNCTIONS OF THE ORGANS OF GENERATION.    533

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  vesiculae seminales,
and, in animals deprived of these organs, from the seminal canals.
The seminal liquor, brought forward by the oscillatory movement
of the vesiculae 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  felt the
stimulation resulting from the presence of this fluid, the bulbo-ca-
vernous muscles which on one side envelop the bulb of the urethra
at the beginning of this canal, and on the other embrace the roots
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 their
contractions 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 ejaculator
muscles.  The remote  sympathies depend on.the lively stimulation 
534
OF GENERATION IN GENERAL.
which the brain, sensible of the irritation of the genital surfaces, in-
ternal as well as external, transmits to the nerves of relation; 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 th^ orifice of the canal, and on the Fallopian tubes,
ovaries, 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 mammae,  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. Geoffroy St. Hilaire, Tiedemann,  and
others.
  The stimulation of the vagina, produced by coitus, being, as we
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 fimbriae are applied to, and embrace the ovaries.  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

  * It  is still a moot point in the physiology of generation,  to ascertain the man-
ner and agency by which the stimulus of the semen affects the ovaries.  We have
good reason to believe that it cannot in many cases be by the direct transmission
and  apposition of the semen to these bodies.  The occasional occlusion of the
os tincx by disease, and yet conception taking place, forbids this supposition.—
Tiuxs, 
             OF THE HYPOTHESES OF GENERATION.         535

last mentioned organs is adequate to bring about conception.  Sti-
mulated 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 fim-
briae of which are still applied to the ovary, takes up, absorbs, 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, how-
ever, be reduced to the three following, now presented in a  chro-
nological 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 animalculae, 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
these animalculae 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 
536
OF GENERATION IN GENERAL.
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  evi-
dently 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 ovae, or the unfecundated
roe, have done nothing else but imagine 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-
culae, 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 of the  two sexes, and
which are to be arranged round a pre-existing mould,  is another
fiction, the more inadmissible, inasmuch 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
intended for generation; 2. the existence of another animal matter
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 ge-
nital senses,) of the two sexes;  3. the absolute necessity of the di-
rect contact of this last matter with the surface of the ovary, or with
the animal matter previously excreted from it.*

  * Even though the aura seminalis fecundates,  our position is not the less tena-
ble : the emanation from the semen is still semen. 
OF CONCEPTION.
537
  These conditions being fulfilled,  fecundation takes place: it is
in the human species, as in all other animals and in vegetables, the
work 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 mo-
lecular affinities, directed by the unknown power  which we call
life, or vital power, accomplishes the rest;  and to attempt to pene-
trate 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-ex-
isting 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 vegetable
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 be-
lieve that there can  be  any doubt  on  this subject.  Women en-
dowed with much sensibility distinguish  very  well the moment,
which  must  be  that in which the  semen, having traversed the
Fallopian tube, is brought in apposition with  the predisposed ova-
ry.  It seems to us, moreover, that the  perfect resemblance be-
tween 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 impulses?  We  do not know  whether the formation
of two twins depends 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.
   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 fimbriae of which  had remained
 attached to the ovary from the moment of conception. This humour
 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
                               68 
538              OF GENERATION IN GENERAL.

to the  fluid, leaves a yellowish point,  somewhat resisting, 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 haemorrhagic 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; superfoetations prove likewise
that the opening of the two Fallopian tubes is not always obliterat-
ed by the membranes of the foetus.   The only point not  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
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. 
               OF THE GROWTH  OF THE  FOSTUS.            539

  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 following 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 outline 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 forearms and legs,  and of the arms and thighs.   This  march
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
body 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
>akcs a growth much more rapid than the fcetus in the beginning of 
540
OF GENERATION IN GENERAL.
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 attains
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 eacb
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, aud 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
that  they  are at first in close approximation, and  then separate
while acquiring size, and allowing of the growth of the intermediate
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- 
OF THE GROWTH OF THE FQ2TUS.
541
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, only receiving from the father the impulse determining
its growth;  or that the father has the exclusive privilege of giving
to the prolific matter secreted hy 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 which 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 molecular
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 embryo derives its first nourishment from  the small mass of
fecundated gelatin 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,

  * 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. 
542
OF GENERATION IN GENERAL.
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 cavit)\  We say
to the degree of irritability, and not to the degree of distention, be-
cause, 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 in-
crease of the irritation of the uterus, than the volume 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 periodical 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 an-
nounced  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
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 
OF PARTURITION.
543
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 grasp-
ing 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 in-
closed.
   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  mammae  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  mammae 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-
dent during pregnancy, since, in proportion as the uterus acquires
size, the mammae 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 mammae  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 
644
OF GENERATION IN GENERAL.
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 mammae, they dry up, the sweat
ceases, and the uterus regains its habit of periodical congestion and
haemorrhage.  But  if the mother become nurse,  the uterus con-
tinues in a state of inaction, until the mammae 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 suckling, 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 in-
stinctive impulse, it is weaker as the child grows larger; but it pre-
serves 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.

Section III.—In what  manner the Action of the  Genital Or-
             gans  becomes the Cause of Diseases.

  The mere preliminary of the generative acts, desire, may become
a cause of disease.  As a mental emotion, when it undergoes oppo-
sition, it causes disease in the encephalon and visceral apparatus:
hence acute and chronic insanity, partial deliriums,  palpitations,
convulsions, suffocations, attacks  of asthma, constriction, and heat
in the stomach, which may lead to  latent and even acute gastritis.
In a word, there  is none of the diseases which we have referred to 
           OF DISEASES FROM THE GENERATIVE ACTS.         545

the depressing emotions, to those which are founded on the alter-
nations of pain,  anger and pleasure, that may not recognize as a
cause the mental excitation resulting from the obstacles encountered
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.
  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 orthopnoea, 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
                              69 
546
OF GENERATION IN GENERAL.
sanguineous flooding in the pericardium.  Coition, too frequently
repeated, debilitates the heart, and the circulation languishes.
  The fits of asthma, following the efforts of coition, may likewise
depend on a certain degree  of hypertroplry of the heart, plethora,
and a convulsive disposition of the bronchial tree.   It is nearly the
same with haemoptysis; 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 gastritis;
and  we know how great is the  number of the unfortunate thus
afflicted,  thanks to the prodigious vogue of the emetico-cathartic,
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
very excitable, and disposed  to  contract  inflammation under the
influence of cold,  or of stimulating drinks, or even by  the  mere
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.
  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  DISEASES FROM THE  GENERATIVE ACTS.        547

of sensibility, and  a  disposition  to take on engorgement by the
slightest irritation.  This is one of those causes which most pow-
erfully 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
immediate 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 athletae 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
phlegmasiae, 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
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 pleasures
of love, for  the medical adviser to reject, with  a degree of horror,
the emission of blood, and to have immediate  recourse to the em-
ployment of the most active stimuli. 
548
OF GENERATION IN GENERAL.
   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 per-
sons repeat, by  a kind of echo,  that  women brave  with impunity
excesses 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
diseases, 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 an  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
himself to have so much the  more  prowess and  vivacity as  he
is strong in coition, an illusion  which is the cause  of  his destruc-
tion.   I have known many, whom the fear  of losing their  advan-
tages in this latter respect kept  obstinately  away  from bleedings,
low diet, and other debilitating means, the only  ones which  re-
mained to them, in order to escape the  phthisis with  which they
were threatened.
   For the appreciation of the effects of  coition on  the  health, the
physiological physician must hold in mind the facility or difficulty
of the  seminal ejaculation  in man, and of the act which corresponds
to it in the other sex; for the more difficulty there  is  in obtaining
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 
            OF DISEASES FROM THE GENERATIVE ACTS.        549

habits, are hurried away into enjoyments which greatly exceed the
wants of their constitution.  In this way originate the haemoptyses,
aneurisms of the  heart, convulsions, paralyses, 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 haemor-
rhages, visceral congestions,  and  convulsions.   These  latter fre-
quently 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 ex-
cesses rarely fails, at those epochs of life, to bring on stupidity and
dementia.
   The adult age is that which incurs least danger from venereal en-
joyments; but they are frequently fatal to old men, less by bringing
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  or-
gan, suffocation, and fatal apoplexy, if they do not succeed in con-
quering 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
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 
550              OF GENERATION IN GENERAL.

tonics, with a view of renovating his prostrated powers.  This same
prostration renders  him also more susceptible of being affected by
the humid cold of night; and also by marshy exhalations, the influ-
ence of which is so dangerous in those climates.  It results, finally,
that these sorts of abuses are attended  with still more  inconveni-
ences 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  not cease until 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-
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 DISEASES FROM PREGNANCY.
551
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  exudation, 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 con-
ceive what  accidents must result  from such attachments, and parti-
cularly  those that would take place on the intestines, or on the  sto-
mach 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, which, not finding at
the instant  of its detachment, the tube at the proper  place for re-
ceiving it,  has necessarily fallen  into the  abdomen, and  fixed  its
placenta to the nearest part.t  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 erec-

  * 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.
  f The first abdominal pain was felt on the night succeeding the accident: it
persisted during the whole course of pregnancy, and was situated at the place of
insertion of the placenta in the pelvis. 
552
OF GENERATION IN GENERAL.
tion by the irritated  ovary,  remains in  apposition with it.  But
were this really the case, I am  surprised that extra-uterine  preg-
nancies should so rarely occur; for during the number of days sup-
posed 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 important  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 a source of disease to man: yet
it may happen that the sudden suppression of the spermatic excre-
tion by a powerful moral  sensation,  will develop an inflammatory
movement  in the epididymis, or in the body of the testicle.  Ex-
amples of the sort are on record; but it must not be supposed that
there can result from this the imperfect procreation of an embryo,
as some authors have  believed; inflammations, more or less intense
and painful, and, as a consequence of these, sub-inflammations, are
the only effects of these accidents.
  When the embryo, has arrived in the uterus, and begins to ac-
quire a little strength, it excites strongly this organ, already irri-
tated by the stimulating action of the semen, and  the influence of
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 exclu-
sively to call direct experiments.  The first relation noticed in ner-
vous 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 
OF DISEASES  FROM PREGNANCY.
553
chronic gastrites, or gastro-enterites.   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 dreaded,
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,  inasmuch 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 recommmend matrimony.   This latter  is consummated,  and
soon pregnancy, adding to the irritation of the stomach, develops
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, 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  inflamma-
tion of the large viscera, more particularly of the lungs; and threat-
ened with convulsions, uterine haemorrhages, 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-
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
                               70 
554
OF GENERATION IN GENERAL.
 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 of which pregnancy is usual-
 ly the 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 be-
 yond the period of utero-gestation, which, for the above purpose, is
 always too short.
   As soon  as the epoch for the expulsion of the foetus has ar-
 rived, the  efforts which  this function necessitates, produce, by in-
 terrupting 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; congestions of the lungs,
 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,
 and 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 all these
 circumstances  are too well known to accoucheurs, to require to be
 enlarged upon here.  I consequently pass on to the diseases that are
 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, x>r from the slowness of the inflam-
 mation which necessarily exists in the internal surface of this viscus, 
OF DISEASES AFTER PARTURITION-            555
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 become
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, develop in them a variety of inflammations.  In this
series the most conspicuous are the  inflammation of the mammae,
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 suspended
by pregnancy, become once  more  acute after parturition;  the cere-
bral 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 who  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 cedematous phlegmons,  particularly  in the
 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, 
556
OF THE DISEASES OF THE F02TUS.
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 pre-
cious advantage.  Cases 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 protected
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 any
thing more in them, than an irritation of the  skin  which has suc-
ceeded that of the breast, and which,  in consequence of not having
been destroyed 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-excite-
ments, with the view of evacuating a pretended milky humour.

          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, ac-
companied with enlargements of the  mesenteric glands.  The child
may carry with  it  pulmonary inflammations, and tubercles 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 adhe- 
OF THE DEVELOPMENT, CONSISTENCE, &C        557
sions to them. According to M. Geoffroy 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 monstrosity:  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; im-
portant  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.

  When the ohild 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
fibrin is in small proportion;  and  gelatin  predominates  in  the
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-
tin.  The  bones  and muscles are incomplete; sensibility  is only
aroused for the first wants, and sleep returns as soon as they are
gratified. Yet 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
from 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, re-
latively to  the others. 
558          OF THE DEVELOPMENT, CONSISTENCE,

  At this epoch the only wants which  appear at  all  well marked,
are those of respiration, nutrition, the discharges of superfluous mat-
ters, rest, sleep, and external caloric; all the others are nearly 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 a crea-
ture  of instinct, 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 are to 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   sustentation 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
suggestions.  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.
In this  interval,  absorption continues  to take  place with great
energy, the bones become incrusted with a calcareous phosphate, the
muscles are developed, and fibrin begins to exist in larger proportion
in the blood-vessels, whilst the serum and lymph are continually di-
minishing in the same proportion.  Sensibility is extreme, the ner-
vous system acquires a great degree of mobility, transmitting with
rapidity the vital erections, which  are also very numerous, and  re-
establishing the equilibrium with an astonishing promptitude.  The
intellect acquires a very great extension.  The attention is with  dif-
ficulty fixed upon abstract ideas; but memory, being singularly pre-
dominant, retraces with great facility words and the other signs of
our  ideas, although judgment has as yet acquired but little strength.
   The desires predominating from the first periods of  infancy to 
AND DECAY OF MAN.
559
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 only 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 love 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 du-
ration.
   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 vesiculae seminales, and pro-
duces the erection and growth of the penis. Stimulated by the vital
erection of the ovaries, the uterus is developed and converted into
a centre of sanguineous fluxion,  which being exalted every month,
furnishes  the menstrual  haemorrhage.  The vagina  becomes  en-
larged,  the  orifice of  the vulva  is tumefied, contracted, and sur-
rounded with fat, and the mammae are  developed.   The  changes
in 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 pulmo-
nary apparatus, the most sanguineous and arterial of all the  viscera,
undergoes, together with  the  heart and  large vessels.  The chest
soon  obtains in the male  sex  a  degree of predominance over  the
abdomen, 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 spe-
cies.  In woman, the pelvis frequently exceeds the chest in breadth. 
560          OF  THE DEVELOPMENT, CONSISTENCE,

  The limbs are enlarged and lengthened rapidly in the youth  of
both sexes, whilst, at the same  time, the vascular sanguineous  ap-
paratus becomes developed:—it is not difficult to conceive the con-
nexion of these two orders of phenomena.  The bones, which as
yet are incompletely hardened, allow for some time growth in length,
which even sometimes becomes more  rapid than before  puberty:
the rapidity 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
pathological 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 mammae,—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 roundness to
which we attach the idea of beauty.   Yet 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 consider-
able, and the vital erections very easily excited,  and very strong:
these last, owing to the nervous activity,  being always  very great,
are transmitted from one part to another with nearly as great ra-
pidity as in children.   Contractility, which is generally very con-
siderable, is particularly so in the muscular apparatus, either loco-
motive or visceral.  Reaction is very powerful; and  the  secretory
organs, and those  of the periphery, receive and dissipate with great
facility the super-excitements of the principal viscera.
   The desires 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, 
AND  DECAY OF MAN.
561
causes every object to be viewed in a different light, and curiosity,
having now a different direction, cannot fail to become more active
and general.   Perception is then very easy, the power of attention
much stronger than in children, memory is  not diminished, and
judgment, which is nothing else than reason, can draw very advan-
tageously 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 ap-
pears as if suspended.  The love of self-preservation 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 he-
roism.
   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, he  does not  remain stationary;  for though
losing insensibly the prerogatives of youth,  he yet retains them
a long time, and finds in  what is acquired 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 is not  diminished 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
time to increase in size, and if they lose on  the score  of  rapidity
of movement,  they on the other hand retain a considerable con-
tractile power.  Fibrin continues to predominate; the serum and
lymph are in  less  quantity;  and   absorption,  though still  easily
 effected,  is  not so energetic.   The secretions  are also diminish-
 ed, 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 considera-
 bly  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
                               71 
 560          OF THE  DEVELOPMENT,  CONSISTENCE,

   The limbs are enlarged and lengthened rapidly in the youth of
 both sexes, whilst, at the same time, the vascular sanguineous ap-
 paratus becomes developed:—it is not difficult to conceive the con-
 nexion  of these two orders of phenomena.  The bones, which as
 yet are incompletely hardened, allow for some time growth in length,
 which even sometimes becomes more  rapid than before  puberty:
 the rapidity 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
 pathological 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 mammae,—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 roundness to
 which we attach the idea of beauty.   Yet 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.  Circulatieti is active,
 calorification rapid, nutrition  energetic,  absorption very consider-
 able, and the vital erections very easily excited,  and very strong:
 these last, owing to the nervous activity,  being always  very great,
 are transmitted from one part to  another with nearly  as great ra-
 pidity as in children.   Contractility, which is generally very con-
 siderable, is particularly so in the muscular  apparatus,  either loco-
 motive  or visceral.  Reaction is very powerful;  and  the secretory
 organs,  and those of the periphery, receive and dissipate with great
 facility  the super-excitements of the principal viscera.
   The desires 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, 
AND DECAY OF MAN.
561
causes every object to be viewed in a different light, and curiosity,
having now a different direction, cannot fail to become more active
and general.   Perception is then very easy, the power of attention
much stronger than in children, memory is  not diminished, and
judgment, which is nothing else than reason, can draw very advan-
tageously 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  ap-
pears as  if suspended.  The love of  self-preservation 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 he-
roism.
   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, he does not remain stationary;  for though
losing insensibly the prerogatives of youth, he yet  retains them
a long time,  and finds in what is acquired 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 is not diminished  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
time to increase in size,  and if they  lose  on the score  of rapidity
of movement,  they on the  other hand retain a considerable con-
tractile power.  Fibrin continues to  predominate; the  serum  and
lymph are in  less quantity; and  absorption, though  still  easily
effected,  is not so energetic.  The  secretions are also diminish-
ed, 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 considera-
bly  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
                               71 
 562          OF THE DEVELOPMENT, CONSISTENCE,

 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 desire of repose and
 of sleep, increase at the same time in which that of exercise dimi-
 nishes.  The love of self-preservation  gradually increases in pro-
 portion to the diminution of the strength, combined with the in-
 creased knowledge of danger; yet it is still powerfully repressed
 by the exercise of thought.  The desire of generation is preserved,
 but grows less urgent in the male  sex; in the female, on the con-
 trary,  it disappears as she approaches the term  of the  present pe-
 riod.  The love  of observation  is still very great; intellect acts very
 powerfully, and daily overcomes, more and more, the  passions,
 which diminish with the activity of the  circulation, and the facility
 of the transmission of vital erections.   This diminution, however,
 is only very evident, in reference to the passions that originate in
 the physical wants; for those of a  moral nature continue to enjoy a
 well-marked predominance,  and always in  ratio to the previous
 exercise 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 then 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
 notice here very considerable differences, which are subordinate  to
 the strength of each individual.   Some  are  deteriorated in an al- 
AND DECAY OF MAN.
563
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
accelerated 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; fibrin
begins to be diminished in the  capillaries,  and is  concentrated in
the large vessels, whence results fulness of the principal viscera;
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 is
diminished, and, together with it, the energy of the genital erec-
tions: 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
blunted 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 precision.
  Whilst man goes through  this longer or shorter period of decline.
his wants are modified in a very remarkable manner; the want of nu-
trition diminishes; that of respiration becomes more urgent in old peo-
ple 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 day
to day, the desire of repose finally becomes predominant, although
sleep be more difficult and of shorter duration.  The desire  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 forboding sign of approaching decrepitude.   The same remark is
not applicable to woman; for the cessation of this  want announces
always in her the commencement of the  decline; the contrary is
only noticed in certain pathological states. The love of observation
l? one of thoso that experience the most sensible diminution towards 
564         OF THE DEVELOPMENT, CONSISTENCE,

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 their 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  constantly
accompanying 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
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
often before the beard and  the eyebrows, and the beard, in  some, is
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 eighteen
years of age, whose hair  was black, and whose beard was hardly
visible.   In  a  word, there is nothing more irregular than  the dis-
coloration of the hair.  Hence,  it  would  be in  vain to endeavour 
AND DECAY OF MAN.
j65
to deduce from it the progress of decay; fear, and uneasiness of
mind, may render the hair quite  white without a proportionate
diminution in  the vigour of the body.  The same obscurity attends
the falling off of  the  hair.  We  are  not  sufficiently acquainted
with the physiology of the pilous capsules, to be able to draw sa-
tisfactory inductions from  the  change of colour, and loss of the
hair.
  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 subjects
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 evidences
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 san-
guine nor too  fat, but whose muscles are vigorous,  are  those who
attain the greatest  age.  Persons of a lax habit, whose muscles pos-
sess little power, speedily reach the period  of decrepitude; 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
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 viscera, and is bent for-
wards,  which  compels the old man to seek  for support in the use ot
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 equallv progressive, and evidenced by the imperfect assi- 
566         OF THE  DEVELOPMENT,  CONSISTENCE,

milation of the fluids; scarcely have  the excretions been evacuated
from the organs, when they begin to be decomposed, and a universal
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  fibrin, or crassamentum, that the serum
is considerable, and that the gelatin, 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,
aponeuroses, and arteries.  All the apophyses of the bones become
more projecting, although the  size  and weight of the  latter them-
selves 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 disap-
pearance of the small vessels.   Absorption is feeble, for the con-
tractility 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 cede-
matous swellings which are  seen about the ancles, and which fre-
quently 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
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 disappeared,
and the reaction  of the interior towards the exterior is feeble, and  in
dangerous diseases absolutely impossible.
  The wants of 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 requires, indeed, 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 in- 
AND DECAY OF MAN.
567
exhaustible source of evils to  the  aged; the want of exercise has
almost entirely disappeared, and  that of repose has become per-
manent; but sleep, although very necessary, is at this  age ex-
tremely difficult.  The  desire of generation no longer exists; that
of observation is ver)' 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 gra-
tification  of  his wants.  Finally,  nervous power  and muscular
contractility having been exhausted, the action of the heart ceases, and
life terminates with the stoppage  of the circulation, before the ca-
pillary tissues of the mucous lining of the digestive and respiratory
apparatus have lost the power of assimilating and absorbing the ma-
 terials 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 termination 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. 
56fc               OF THE TEMPERAMENTS.
             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.: blood, bile,
phlegm, and the atrabiliarious or black bile, a kind of humour, the
source of which he located in the capsulae  renales, and which  on
this account bore the name of atrabiliary capsules. He accordingly
recognized, 1. a warm and moist temperament, which he attributed
to the blood, and which  he called sanguineous; 2. a warm and dry
temperament, which he named bilious; 3. a cold and moist tempera-
ment, which bore the title of pituitous; 4. a cold and dry tempera-
ment, which received that of melancholic.  But as the temperament
may be at the same time sanguineous and  bilious, sanguineous 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 pro-
duced by the  capsulae renales,  since it is nothing else but altered
bile or blood;  and we seek for a better foundation of the difference
between the temperaments.
   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 tempera-
 ments, which are dependent on  the development of certain appa-
 ratus. He bases the sanguine temperament upon the predominance
 of the  vascular, arterial, and nervous systems; he lays down an
 athletic temperament which arises from the  predominance of  the
 muscular system, and refers the lymphatic temperament to the  de-
 velopment 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 out, as examples, not only the melancholic of 
OF THE TEMPERAMENTS.
569
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. B6gin, 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
other 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  wljom
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
1815, 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
                              72 
570
OF THE TEMPERAMENTS.
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 particular organic
apparatus. Now, as it is necessary that these words should possess a
meaning generally adopted, and as it is not possible either to pre-
vent the term idiosyncrasy from recalling to our minds these pheno-
mena, 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 predomi-
nant development of the visceral apparatus.
   The varieties of temperament should, in our opinion, be associat-
ed 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 gastric
temperament. It is often combined with hypertrophy of the liver,
the secretion of which is in excess: this constitutes the bilious tem-
perament. 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 character-
istics.  We can only say that this great power of assimilation sup-
poses 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
for their sobriety, always have the vessels filled, and repair the loss
of blood  with aliments ever so little substantial.  The sanguineous
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 fibrin is for the most part very abundant. The athletic form 
OF THE TEMPERAMENTS.
571
is commonly combined with the simultaneous predominance of the
first assimilation and of haematosis; 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 tem-
peraments never fail to lead to obesity, so soon as they have attain-
ed 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 assimilation and haemato-
sis, 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-sanguineous
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 are
always engorged, their mucous membranes secrete freely, and their
lymphatic ganglions are  more defined  than in  the temperaments
already described.    This constitution, may, like  the preceding
ones, present all  the shades  of colour of  the  skin  and hair
from the white to the deep red, from the fair to the black.  The
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 haematosis, 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 
572
OF THE TEMPERAMENTS.
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 apparatus be  well  developed,
they possess as great energy of the intellectual faculties as the most
robust constitutions, and may be endowed with very strong pas-
sions.   But strength is wanting to enable them to  turn  these pre-
cious faculties 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
to 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
and haematosis,—forming the bilioso or  nervoso-sanguine  tempe-
rament; but it is more usually allied with the anemic temperament,
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. 
OF THE TEMPERAMENTS.
573
  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 haematosis; we cannot then assign
to it either peculiar forms or  colour.  If the encephalon be  very
large, the nervous phenomena  are more multifarious,  and neuro-
dosia becomes predominant in the mental  faculties.  If the heart
be voluminous, or the  lungs small,  the nervous phenomena will
predominate in the chest.   It will be the same case with the gastric
passages, 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 animal eco-
nomy, 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-
cholic 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. 
574
OF THE TEMPERAMENT;.
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  phlegmasiae, 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  phlegmasiae bear  in them paramount  sway.
Finally, hypertrophies of the head,  leading to hydrocephalus, gan-
glionic sub-inflammations, and softening of the bones, are the at-
tributes 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
efforts of  growth are especially directed towards the osseous sys-
tem, and in which there is the greatest formation of  gelatin 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
operation  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 
diseases during puberty.
575
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
frequent occurrence; they  are  nothing more than acute gastro-en-
terites, 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 of the lungs;  they  remain then too  narrow  relatively to
the volume  and force  of the heart,  and the excessive impetus of
blood gives rise in them to haemorrhagies and  inflammations: this
is, perhaps, the most frequent  preparatory cause of pulmonary con-
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 epigenesis; on this account the ab-
sorbent  ganglions readily contract irritation of the phlogosed tis-
sues, 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- 
576                  THE  TEMPERAMENTS
 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 also broad and deep.  Hence, in-
 dividuals of this formation present the  most regular outlines: 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 phlegmasiae  of the chest or abdomen, and woe to the
 physician who shall be so little of a physiologist as to be ignorant
 of it.  The  proneness of the uterus  to  haemorrhagic congestions,
 may protect the viscera from the bad effects of emmenagogues; but
 if this crisis fail, the visceral stimulation makes progress, 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 modified
by the  sanguineous;  they are more nervous  than  men,  always
less  athletic,  and  rarely enjoy so  decided a gastric  predomi-
nance.  This is the place to point out the diseases peculiar to each
of the temperaments  which we have admitted.   This task will be
facilitated by the considerations  into which we have already en-
tered.
  The predominance of the first  assimilation  exposes  man to the
hyper-irritations and  phlegmasiae 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 
MODIFYING DISEASES.
577
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 or 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-
cal one, and be placed in the hands  of all young people.   As we
exhibited, when treating of the diseases of the stomach, the progress
of irritations of this viscus, we need but refer the reader to the pa-
thogeny of the digestive function.
  The temperament distinguished by the predominance of haemato-
sis, exposes  those who are endowed with it to every kind of phleg-
masia 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 X*
                              73 
573
THE TEMPERAMENTS
they partake more of the gastric temperament, but likewise  to  ap-
prehend anginas, congestions in the lungs and head, especially if
they have large lungs  and a voluminous and very active heart,
which forces the blood  with impetuosity into important viscera,—a
kind of conformation this very common  with such subjects; when-
ever the sanguineous are exposed to any physical or moral commo-
tions, and that their customary evacuations of  blood are  suppress-
ed, 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 decidedly
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 their
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 mammae, 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 persbns;
hence are they very liable to phthisis pulmonalis and SGhirri 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
disorganizations are brought  about  in this description  of subjects,
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
lisorganization, on account of the extreme facility with which  the 
MODIFYING DISEASES.
579
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 tempera-
ment, leads to a neglect of exercise, and inspires with a fondness for
an idle life, the sinister effect of which is attempted to be neutralized
by the internal use of stimuli, such as tea, coffee, spirituous 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 inclin-
ed to it, as they experience comfortable feelings, and derive a facti-
tious  strength,  which makes them  for a little while forget their na-
tural  weakness;  but with such practices they rarely fail  to destroy
their health, and shorten their days.  The diseases to which the lym-
phatics are liable, are then developed, and rendered inveterate, un-
der the influence of the above regimen, and, whenever art is brought
in to  afford them some  relief, disorganization is already  too far ad-
vanced 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
of 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 phlegmasiae of
the exterior of  the body  tend to advance more and more towards
the viscera, either whenever  they  are renewed,  or  simply pro-
longed.  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- 
580
THE  TEMPERAMENTS
 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. Re-
 vulsion 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 sometimes
 produced  by the prolonged use of stimuli.  Such  a combination is
 always most sinister,  and forever excludes the  hope of perfect
 health. The purely lymphatic temperament never attains that de-
 gree of excitability characteristic of the nervous.  Avery energetic
 haematosis is not, however, incompatible  with neurodosia; but the
 force of reaction sometimes neutralizes its effects.  What we often
 meet with is the nervous temperament associated with a great ac-
 tivity of the digestive apparatus in very thin  persons.   This con-
 stitution is exposed to a number of disorders: we can readily ap-
preciate 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 different organs, we  shall find all the
disorders to  which these  temperaments are liable; for  the  brain,
moral  affections by which they  are  tormented, cephalalgias, me-
grims, vertigoes;  for the heart and lungs, palpitations, suffocations,
dry  coughs, called nervous; for the  digestive apparatus, a great
number of painful sensations, contractions, cramps, gastralgias, py-
roses, 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 hypo,
chondriasis;  and we may even assert, that they rarely escape that
wearisome disease,  if the greatest care be not taken to preserve
their stomachs,  for  the  slightest  gastritis provokes their general 
MODIFYING DISEASES
581
irritability, and carries it to a degree 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 gastric passages. Is it possible for the brain
to resist the united influences 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 rela-
tion, which are placed in unison with the visceral  apparatus of the
abdomen.   In our  opinion, hypochondriasis differs from hysteria
only in the viscera whence emanate the sympathetic influences ex-
ercised 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 aber-
ration of the  sensitive and motific powers,—phenomena, the ap-
pearance of which always announces a temperament eminently ner-
vous.  Shall  I speak of the surprising  derangements of the senses
so often observed 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 phlegmasiae  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.
which  can only be done in  populous cities and among the most cul-
tivated 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 apparatus in which vital
action predominates, and that it is important to attend to the parti
cular 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  i* af 
582
THE  TEMPERAMENTS
 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 a factitious,
 indeed, 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  phlegmasiae.
 The haemorrhoidal 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 atmo-
spherical 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
predominant in the duodenal region, and productive of 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 
MODIFYING DISEASES.
583
haemorrhages, and in those who have for a series of years kept  up
gastrites.  Mental emotions, excesses at table, coition, the impres-
sions from cold, falls, violent efforts, are commonly the exciting
causes of apoplexy; but the predisposition had existed.  The exces-
sive fulness  of the  body acquired at this time by certain sanguine
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 freshness 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 ex-
plained by the diminution  of the activity of the sympathies, 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 phlegmasiae in persons approaching  to advanced
life; they only suffer under such from some extraordinary stimula-
tions; but on these occasions they have to dread a fatal termination,
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 certain exceptions,  (for  there are some who attain old  age,
 under  great disorders,) have known how to husband their powers,
 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. 
5S4
THE TEMPERAMENTS MODIFIED
   In fact, apoplexies, palsies, aneurisms, pneumonias, and gastrites,
 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 ob-
 servable in old men attacked with disorganizations by which nutri-
 tion is rendered imperfect, and it is only by dint of great care that
 art succeeds in prolonging their frail existence.  An error of appa-
 rently the slightest kind is  irreparable: but to undertake to enu-
 merate all the infirmities of this  age, would be in anticipation  of
 pathology.  What we most  frequently observe is, that the senile
 marasmus, which comes on in spite of the  best directed attentions,
 is an infallible  presage of approaching  death; but we are inclined
 to regard it as more frequently the primary or secondary deteriora-
 tion of the digestive organs,  than that of an exhaustion produced
 by age; for, in the order of nature, the'digestive function ought
 to persist to the last moment,  and death, in our opinion, to happen
 from the exhaustion of the contractility vof the heart, which ceases
 to beat.

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

  Man at birth brings with  him the  temperament of his parents;
 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, dryness
 and humidity, light and darkness,  regimen and habits,  on the con-
 stitution of our fellow men.
  Atmospherical  heat is a stimulant; it tends to exalt  the  pheno-
 mena 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 medium
temperature, and  the winter short, man grows freely  in all the ex-
ternal parts of his body; he is muscular  and robust;  the sanguine 
BY THE CIRCUMFUSA, HABITS, &C.            585
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 expanded,
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 characteristics of the South
with those of the North; the vital energy  is, in such cases consi-
derable, as in France and a part of Germany.  In the regions en-
tirely northern, near the poles, in which the soil is sterile, exces-
sive cold is opposed to  the  growth of the extremities, 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 tempera-
ture tend to impress  on the  temperaments; but  they are modi-
fied by the nature of the  soil, exposure to  certain winds, build-
ings, the  emanations  with which the atmosphere is  loaded, and
by the kind  of nourishment.   Thus on the sides of mountains  ex-
posed to the south and east, and well ventilated, man is always of a
dry habit of body, very muscular, perfectly well  grown, and  ex-
tremely 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 temperament is predo-
 minant.  Dry, stony, elevated, and sterile situations, exhibit  the
 inhabitants less robust  than  those of the mountains,  but they  are
 thin. */ile, and tolerably healthy. In low,  fertile, and shaded plains
                              74 
586
THE  TEMPERAMENTS MODIFIED
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 mountaineer, 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  is
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  of
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, compensatefor the weakness 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; wit-
ness 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 debili-
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 vis-
cera filled with  blood and lymph.   Add to these agencies frequent
morbid visceral congestions, either of the continued or intermittent
type, and  we shall  find sufficient cause for the lymphatic or lympha-
tico-sanguine temperament, which prevails in the countries above
described.
  If we inquire into the influence of exercise  in the large cities, 
               BY THE CIRCUMFUSA, HABITS, &C.           587

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  wanfj,
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 excesses in eating  and drink-
ing, which occur from time to time,  (at least once a week,) con-
trasting 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, 1 say, we hold in mind all these noxious agencies, we  can 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 phlegmasiae, on the point of yielding,
are renewed  by the slighest 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
entered into  that state, their children cannot be raised; they do not
pass the epoch of dentition, or else they are carried off by  scrofulas
and  the eruptive  phlegmasiae;  and  families  thus become extinct
after a few generations.
   But if, in return, you transport to the country, and to a favoura-
ble situation, shattered constitutions, they may acquire strength,
and have healthy children, who will become parents of others still
better constituted; hence we can conceive of restoration to a vigour
of temperament, as well as degradation of the most robust.  But man
experiences as great a repugnance to leave the city, and become an 
588           THE TEMPERAMENTS MODIFIED, &C.

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 fa-
milies, 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. 
INDEX.
Abernethy, his observations on the cu-
  taneous functions, 418-19.
Absorption  of  nutritive  substances,
  354-7.
---------, general, how  performed,
  496-8.
Acephali, 231.
Acid, hydrocyanic, vapours from  dele-
  terious to the lungs, 289.
----, carbonic, its  formation in  the
  living  body,  280-3.—see  carbonic
  acid.
---, lactic, 418.
Acids are excitants, 47.
Adipose  tissue, see fat.
Adynamia, how treated, 238.
Aeration of the blood, 274-85.
Affections founded on sensations,  129.
Affective movements, 145.
Alard on elephantiasis, 433.
Albinus quoted, 355.
Albumen in the brain and spinal marrow,
  31.
—------in cartilages, 220.
Albuginea or peritestis, 525.
Alimentary bolus, 317.
Amaurosis from excessive excitation of
  the brain, 196.
Ambition, 139.
Ampullae in the veins, 404, 409.
Amygdalae mucous glands, 445.
Aneurism caused by coughing or sneez-
  ing, 288.
--------of the aorta, 403.
-------- of the heart, 210, 214.
.—. i   —, varicose, 368.
Anger, effects of, 148-54,212-15.
------may be caused by gastritis, 285.
Angiotenic fever, an  erroneous  term,
  404-5.
Angina from speaking and singing, 286.
        from  excessive repletion, 347,
350.
from hypertrophy, 519.
pectoris, in what it consists, 396.
Animals, their composition, 26.
------, their social disposition, 110
------, their limited intellect, 111.
______, cold-blooded, 283;
       -, warm-blooded, 283.
.______, wild, change their haunts, 110.
Animal life, 52.
Anselmino, his experiments on  sweat,
  418.
Aorta, 365.
  ---, aneurism of the, 403.
     -, changes in the, 405-6.
Aponeuroses, 220.
Apoplexy from  great excitement  of
  the brain, 196, 200.
  ------from melancholy, 210.
  —i----from anger, 213.
          from  hypertrophy  of the
heart, 402.
       ■ from  suppressed  perspira-
tion, 433
from  hypertrophy  of  the
brain, 519.
      -, pulmonary, 407.
Apparatus defined, 30.
--------, osseous, 30.
--------, muscular, 30.
--------, muscular, of relation, 219.
--------, locomotive, 30.
--------, digestive, 305.
         •, chyliferous, 354.
---------, ocular, sympathies of, 69.
                 -, ganglia of, 70.
Apthae, 460.
xVrachnitis, 333.
Arachnoid membrane, 89.
                  -, lesions of, 488.
Arbor vitae, 86.
Arteries described, 364-5.
------, vital properties of the, 366-8
------, functions of, 368-70.
------, capillary, 365.
------, renal or ernulgent, 421.
       , collateral or secerning, 450.
Arteritis, how caused, 403.
         does not constitute inflamma-
  tory fever, 404.
Articulations, 221.
           - affected by the  passions,
inflamed  by  excessive
205.
  exercise, 234.
Arseniated hydrogen, an irritating poi-
  son, 289.                   .   .
Ascites  from suppressed perspiration,
  434.
Asphyxia from pulmonary mucous irri-
  tation, 288.
Assimilation, function of, 305-30.
___.—,----, how performed, 319, 
590
INDEX.
Assimilation, abnormal, 331-60.
Asthma, 210, 239, 519.
-------from certain odours, 288.
-------from hypertrophy of the heart,
  402.
Atmosphere, pressure of, 49.
Attraction, 48.
Avarice, 189, 216-17.
Azote absorbed by the lungs, 281.
-----exhaled from the lungs, 281.
-----is negatively injurious, 288.
-----absorbed by the skin,  419.
-----exhaled by the skin, 418.

                  B.
Baglivi  referred to, 27.
Barthez quoted, 512.
Bashfulness,  161.
Batrachia, their instinct, 104.
Beclard quoted, 61.
Bee, instinct of the, 102.
B£gin, his  view of the  temperaments,
  569.
Benevolence, 141, 161.
■-----is instinctive, 142-3.
Berzelius quoted,  366, 418, 448-9.
Bichat,  his view of physiology, 27.
      , his  division  of the  functions,
  52.
------, his opinions, 100, 115,116,273,
  356, 360, 361, 370, 410, 470.
Bile,  its course, 319,  322.
----, its composition, 449.
•----, its properties, 458.
Bird, instinct of a, 102.
Bitters,  their bad effects on  digestion,
  346.
Bladder, functions of, 428.
———-, diseases of, 435-8.
Blood, the, 34.
-----, aeration of, 274-7, 280-5.
———,--------, impeded,  a cause of
  typhus fever, 289.
——, decarbonization of, interrupted,
  causes asphyxia, 289.
    -, circulation  of the, 360, 415.
Blood-letting, caution in use of, 290.
•——-------, copious in  pleurisy and
  pneumonia, 291.
——-------, local, whence its utility,
  414.
Body, human, composition of the, 29.
Bones,  composition of, 220.
-----, heads of the, 221.
-----, morbid alterations of the, 486-7.
Bouillaud,  his experiments on the cere-
  bellum, 298.
Brain, description of the, 84.
----, consists mostly of albumen,  84.
----> S^y matter of the, 84.
Brain, white matter of the, 84.
----, hemispheres of the, 86.
----, convolutions of the, 86.
----, its functions, 114.
----, alteration of,  by  the passions,
  199.
----, necessity of, to respiration, 229-
  32.
----, its various states and functions,
  240-4.
----, congestions of,  favours  sleep,
  181.
----, reaction of, on the viscera and
  muscles, 243.
----, must be supplied with red blood,
  285.
----, its state in sleep, 178, 181.
----, its  influence  over  the  heart,
  258.
——, its connexion with the sympathe-
  tic  nerve, 252-70.
----, effects  of  intense thought  on,
  198.
----, irritation of, 226.
Brodie, his experiments on respiration,
  283.
Bronchitis from smoke and odours, 288.
Bronchial vesicles, 271.
—^—— .        have  a  contractile
  power, 276.
Brown, bad effects  of the system of,
  351.
Buffon, his hypothesis of generation,
  535.

                  C.
Cabanis, his opinion of the origin of in-
  stinct, 100.
Calculi, renal, 438.
Caloric, an  excitant of vitality, 45.
------, evolution of,  by respiration,
  283-285.
Calyces of the kidneys, 421.
Capillaries, functions of the, 370-85.
--------,  circulation through, 381-5.
--------,  disorders of, 406-9.
Capsule of Glisson, 388, 449.
Carbonic  acid, how formed in living
  bodies, 280-3.
———-— ----,  negatively  injurious,
  288.
------------, formed in the alimen-
  tary canal, 282.
------------, exhaled from the skin,
  418.
Cardiac region, the  principal seat of
  gastric digestion, 326.
Cartilages, composition  of, 220.
--------,  articular, 221.
Carunculae myrtiformes, S28. 
INDEX.
591
Cataract from inflammation of the eye,
  465.
Catarrh, pulmonary,  from vapours and
  powders, 288.
------,------,  from suppressed per-
  spiration, 432.
------,------, uterine, from suppres-
  sed perspiration, 432.
Caterpillars, their instinct, 102.
Cauda equina, 89.
Cephalalgia, 350.
Cerebral organs  possessed by all ani-
  mals, 93.
           ---,  plurality of,  121, 143,
178.
of, 291.
hemispheres, effects of wounds

       -, their functions, 292.
Cerebellum, how formed, 86-7.
—-------, its functions, 291, 304.
----------calls into action the loco-
  motive muscles, 292.
Cerumen, its composition, 444.
Chancres defined, 460.
Chaussier,  his opinion, 297, 355.
Chevreuil, experiments of, on carbonic
  acid, 282.
Chemistry, vital or organic, 42,  472-4,
  509-13.
Child, growth of, 558.
Cholera morbus, 353.
Chorion of the placenta, 538.
______or derma of the skin, 59-61.
Choroid coat, 66.
Chyme, its mode of formation unknown,
  319.
.-----, its properties,  320.
Chyle, itsformationandappearance, 322.
Circulation of the blood, 360.
___________.--------- quickened by
   muscular contraction, 234, 243.
_________, capillary, 360, 370-85.
      ----, foetal, 364, 391.
          ., accelerated, two  kinds of,
Colon, 310-11.
-----, arch of the, 311.
Cold diminishes vital phenomena, 46.
----, effects of, on the viscera, 423-4.
----1-------, otherwise, 483.
----diminishes action  of skin, 431-4.
----, influence of, on nutrition, 518.
----, effects of, on temperaments, 585.
Collard de Martigny's experiments on
  the function of skin, 418-19.
Compassion, 161, 190, 217.
Commissures of the brain, anterior and
  posterior, 86.
Concha of the ear, 74.
Conception, conditions for, 536.
Congestions of the  brain  favour sleep,
   181.
            in the viscera, 407-8, 412.
380-3.
-, venous, 388.
-, great route of the, 390.
-, venous abdominal, 390.
Cistema Chyli, 355.
Clitoris, 528.
Cloquet, his anatomical discovery, 24y.
Cochlea of the ear, 73.
Coition, desire for, 529-34.
______, indulged,  a  cause of diseases,
  545-50.
Colic, its seat, 312.
____9 how produced, 352-3.
----, nephritic, 435.
----, hepatic, 468.
Colitis, 352.
Conjunctiva, 68.
Contractility defined, 33.
__________inherent in fibrin, 34.
----------evinced in gelatin, 35.
          — is very slight in albumen,
 36.
---------is a vital property, 37.
-------— opposed to atmospheric
 pressure, 49.
---------in muscles, 223-5.
          - in ratio to the respiration,
284.
           -, its office in digestion, 320.
Contraction, muscular, in what it con-
  sists, 243.
Contra-stimulants, 47.
Coecum, 310, 322.
Cornea, 67.
Cornets spiral bones of the nose, 77.
Corpus callosum, 86.
-----striatum, 85.
------luteum, 538.
       Highmorianum, 525.
Corpora cavernosa, 527.
------pyramidalia, 86
        restiformia, 86.
Coryza from mineral vapour and  vege-
  table powders, 288.
        from suppressed perspiration,
  432.
Coster, his memoir on the nervous sys-
  tem, 291.
Coughing, 97, 278.
         -, morbid effects of, 286-7.
Courage, on what founded, 120.
Coutanceau, his experiments on respi-
  ration, 281.
Crura or peduncles of the brain, 85.
Cruikshank quoted, 355.
Croup  from suppressed  perspiration,
  432.
Cysts, 520. 
592
INDEX.
                 D.
Dartos membrane, 526.
Debility, muscular,  from over-contrac-
  tion, 234.
Defecation, how performed, 329-30.
--------, defect of,  a cause of dis-
  ease, 353.
Defloration, 528.
Deglutition, how performed,  81, 305,
  317-18.
Dementia, 210.
Depuration, in what consisting, 416.
---------, cutaneous, 417-20.
---------,--------, nature of, 418-
  19.
---------, renal, 422-6.
---------,----, influenced by the
  state of the stomach, 423-5.
---------,----, influenced by the
  state of the stomach and of the liver,
  425.
■---------, pulmonary, 429-31.
---------,--------, is in the  ratio
  of the blood in the lungs, 429.
---------, how affected by  poisons,
  439-41.
---------, chiefly performed by the
  gastric passages, and ganglionic ner-
  vous apparatus, 440.
Derma, or chorion, 59-61.
Destruction, its end is in nature, 105.
Desportes on asphyxia, 282.
Diabetes, how caused, 434-5.
Diarrhoea from gastric irritation, 347.
-------of indigestion, 352.
-------, mucous, from cold, 434-5.
Digestion, by what performed, 305.
--------, described, 305-12.
--------, second, 320-3.
.--------f------f ;n  what time  com-
  pleted, 328.
--------, disordered, 335-7.
Digestive apparatus, 305.
-------canal, its three regions, 306.
■------------, its  three  membranes,
  306.
Diploe, an osseous areolar tissue, 474.
Diseases are the effect of morbid irrita-
  tion of the viscera, 443.
Dog, its varied instincts, 108-9.
Duct of Warthon, 447.
----, parotid, or of Steno, 447.
Dunbar on the nervous system, 298.
Ductus communis choledochus, 449.
Ducti cjaculatores, 526.
Duodenum,  or small stomach,  describ-
  ed, 309.
---------, latent inflammation of, 3-19
---------, spasm of,  468.
Dura mater, 90.
Dutrochet, his experiments  and opi*
  nions, 41, 496-8, 513-14.
Dysentery succeeding diarrhoea, 352.
Dyspeptics, caution to, 237.

                 E.
Ear, structure of the, 73-4.
Ecchymosis, 408, 481.
----------from intense passion, 202.
Edwards, his experiments  on respira-
  tion, 281-2, 284.
-------on the office of the  skin,  418
  -19.
Educability of animals  dependent on
  their cerebral hemispheres, 106-7.
Eighth pair of nerves distributed to the
  lungs, 275.
Elasticity a property of the arteries, 367.
-------not dependent on fibrin, 373.
Elastic fibrous tissue, 373.          •
Electricity, 50, 497.
Elephantiasis of the Arabs, 433, 486.
---------- of the Greeks, 486.
Emaciation from coition, 522.
--------- from  exalted  sensibility,
  522.
Embryo, when formed, 537.
------, how obtains  its temperature,
  284.
Emetics, danger of, in gastric irritation,
  344.
Eminentia pyramidalia, 85.
Emulation, 139.
--------in animals,  139.
Encephalon, 84.
Endosmosis explained, 496-8, 513-14.
Ennui, cause and  effects of, 168-71.
Epidemics  after  long  and  forced
  marches, 237-8.
Epidermis, 60-61.
Epididymis, 525.
Epigastrium, pain of the, from the pas-
  sions, 200, 211.
---------, percussions of the, occasion
  sudden death, 200.
---------, pain of the, in libertines,
  207.
Epiglottis,  271.
Epilepsy kept up by onanism, 206.
-------caused by melancholy, 210.
-------caused by anger, 214.
Erections,  vital, explained, 43, 44, 49,
  57, 225, 413.
Erysipelas caused b)r anger, 214.
--------kept up by irritation of the
  skin, 431.
Etiology, connexion of, with  history oi
  health, 29.
Eustachian tube, 73.
Excrement, when formed, 322. 
INDEX.
593
Excrelors, 4j0.
Exlialations, internal, 472.
            how performed, 478.
483
----,  external, suppression of,
Exosmosis explained, 497-8, 514.
Eye, its structure, 66-7.
----, muscles of the, 67.
----, inflammation of the, 71, 465.
----, humours of the, 480.
Eyelids,  68.
Gall bladder, 449, 457-8.
Galvanism, 50.
Gastric sense, its influence over the en-
  cephalon, 325.
          -, how depraved, 344.
■, occlusion of,  how  produced,
------  juice, opinions respecting  it,
  308-9.
Gastritis, influence  of, on the disposi-
  tion, 95.
-------, caused by  anger, 214.
         from excessive muscular exer-
180-1.
Fabre, Pierre Antoine, quoted, 370-1.
Falx cerebri, 90.
Fallopian tubfls, 528.
Fanaticism, 120, 186, 190.
--------, its operation, 159.
Fat or adipose tissue, 220.
-----------------, its secretion, 474.
-----------------, uses of, 478-9.
----.------------—, excess of,  488.
Fear, effects of, 155-6, 210.
----and despair, 189.
Fever, pretended, essential,  349.
-----, phenomena of, 396.
-----, accelerated  circulation in, 380.
Fibrin in muscles, 31, 220.
----- in the blood, 32.
----- how arranged, 220.
Fibrous membranes, 220.
Fimbriae of the Fallopian tubes,  528.
Fishes, their instinct, 103.
Flourens, his experiments on the ence-
   phalon, 291, 293, 294, 298, 304.
Follicles of the skin, 60.
.------or cryptae mucosae, 445.
Foetus compared with the adult, 391.
_____, growth of, 539-40.
Foramen ovale of the ear, 74.
 Fornix, 86.                         .
 Foville and Pinel  Grand-Champ, then-
   experiments  on  the   encephalon,
   297-8,303.
 Friendship, on what founded,  136-7,
   188.
 Functions, organic, 52, 247.
 ._____..— of relation, 51-8.
 k________________, summary  of the,
240-4.
G.
 cise, 236.
-----provoking to cough, 287.
      - from pregnancy, 553.
Gastro-enteritis from hypertrophy of the
  heart, 402.
              from suppressed perspi-

             - the basis of the varieties
Galen, his hypothesis  of  generation,
  535.
_____, his division oi the temperaments,
  568.                      .     Q.
Gall, his opinions and observations, 84,
  85, 90, 91, 93, 107, 231, 297,  298,
  299, 540.
ration, 432.
of typhoid fever, 441.
            in pregnancy, 553
289.
347.
-, with what confounded,

■from excessive repletion,

■  from  stimulating  in
  gestae, 353.
Gelatin in bones and membranes, 31.
Gcmmulae or buds of the skin, 60.
Generation,  524-57.
---------,male  organs of, 525-7.
---------, female organs of, 527-9.
-----,----, hypotheses of, 535-6.
Generosity,  141.
Genital organs, effects of sleep on the,
  179'                   t.          r
Geoffroy St. Hilaire  on the cause oi
  anencephali, 557.
Glands, their structure, 443.
-----, lacteal, 355.
-----, sebaceous, 444.
       , salivary, their functions, 455-7.
—, mucous, 445.
___}-------, their function, 453.
—, Cowper's, 527.
   ■ of Meibomius, 447.
Gland, lachrymal, its structure, 446-7
_____}________, its  functions, 454-5.
-----, parotid, its structure, 447.
            -, inflammation of, 465.
-----, sub-maxillary, its structure, 447.
-----, sub-lingual, its structure, 447.
-----, prostate, 427, 527.
Glottis, 271.           , ,         .,
Gout supervening on indulgence m the
  passions, 205, 214.     .
  1___________ on gastric irritation
  350
— connected with arteritis, 406.
____from suppressed perspiration, 432, 
594
INDEX.
Gray matter of the brain, 84.
-------------------, supporter and
  origin of the white, 84.
Grief, 145, 215.
                 H.
Hair, its origin under the skin, 60.
----, colour of, changed, 564.
Halle, his division of the temperaments,
  568.
Haller quoted, 355.
Hallucinations, 150-4.
Hartsoeker, microscopical observations
  of, 535.
Hatred, 187.
Hearing, sense of, 65.
------, mechanism of, 75.
Head-ache, sick, caused by anger, 214.
Heart, whence its stimulus to contrac-
  tion, 257-8.
-----, hypertrophy  of, 197,  210, 214,
  400.
-----, palpitations of, 396, 400.
-----, aneurism of, 197, 210, 214.
-----, morbid states of, 394-403.
-----, spasm of, from passion, 199.
-----, rupture of, from  passion, 200-
  206.
-----, description of, 360-2.
-----, its functions, 362-4, 394.
Heat, atmospherical, effects of, 584-5.
Helvetius, his doctrines, 121, 132.
Hemispheres of the brain, 86.
Hen, its instinct to incubation, 94.
Hepatitis from suppressed perspiration,
  432.
Hernia may be caused by coughing and
  sneezing, 288.
Herpes, 197, 459.
—>---from gastro-enteritis, 350.
-----from cutaneous irritation,  431.
-----connected with arterites,  406.
-----caused by anger, 214.
Hiccup, how excited, 318.
Hippocrates, his hypothesis of genera-
  tion, 535.
Honour, on what founded, 138.
Hope, 189.
Horror,  159.
-----at certain objects, 160.
Horse, its superior instinct, 107.
Howard referred to, 143.
Haemorrhages from strong passions, 201,
  202, 206, 213.
-----------from laughter, 286.
-----------phenomena of, 412-15.
Haemoptysis from anger, 214.
---------from hypertrophy of  the
  heart, 401-2.
Ihtmorrhoids, not caused by  varicose
  veins, 410.
Haemorrhoids from nephrites, 4Ji.
Humiliation, 211.
Humour, vitreous, 66.
-------, aqueous, 67.
Hunger, horrors of, 99.
-----, on what founded, 312.
-----, morbid effects of, 351-3.
Hydrogen gas, animals made to breathe
  in it, 281.
--------— is only negatively injurious,
  288.
Hydrocephalus, 519.
Hydrophobia, how kept up, 95.
Hymen, 528.
Hypertrophies, 481, 518-20.
Hypochondriasis, in what it consists, 218.
Hysteria, 210.
                  I.
Ideas, in what they consist, 112.
----, simple, 184.
----, abstract, their origin, 123.
----, in relation with the wants of the
  viscera, 124-7.
----, abstract, are conclusions, 184.
Idiosyncrasies, 569.
Idiotism, from great excitement of the
  brain, 196.
Ileon, 309, 310, 323.
Ileo coecal or coecal valve, described,
  310.
----------------------, its office,
  322.
Impatience, 154,190.
Incus, a bone of the ear, 74.
Indigestion, by excessive excitation of
  the brain, 197.
Individual welfare, how understood, 132.
Inflammation produced by the passions,
  204, 205, 210, 213.
-----------, from violent  muscular
  contraction, 234, 235.
-----------, cellular, 482.
----------- hastens  decomposition,
  523.
-----------, phenomena of, 412-15.
Infundibula of the kidneys, 421.
Infusoria have no vessels, 374.
Ingesta, in  what order they pass the
  pylorus,  320-2.
Innervation defined, 252.
Insanity from  great excitation  of the
  brain, 196.
------from pride, 208.
------suppressed perspiration, 433,
insects, their instinct, 10i-2.
Instinct, phenomena of, 93.
-----,  influence  of the  viscera on,
  93-6.
-----, when governed by  intellect,
  119-20 
INDEX,
595
Intellect always stimulated by the  vis-
  cera, 187.
     ----, its undue exercise a cause of
  disease, 194-8.
------— enfeebled by venery, 207.
Intellectual faculties, on what they de-
  pend, 111.
Iris,  an erectile tissue, 67.
Irritation, 43.
-------, transmitted, same as primary,
  45.
Irritability from excessive excitement of
  the brain, 196.
Janson, his use of* leeches in small pox,
  508.
Jaundice, in what it consists, 468.
Jealousy, 143, 188, 216.
Jejunum, 309, 310, 322, 349.
Joy, 189.
Judgment, in what it consists, 112.
Juriue on the formation  of carbonic
  acid, 282.

                 K.
Kidnevs, their structure and  functions,
  420-6.
------, secretion from,  increased by
  fear, 202.
       -, irritation of, from suppressed
perspiration, 434.
     -, irritation  of, from  diuretics,
434.
Labiae, 527.
Labyrinth, 74.
Lachrymal gland, 68.
Lacteal vessels, 307, 322.
-----------~, their origin, 354.
Lallemand on extra-uterine pregnancy,
  550-1.
Laminae spirales, 73.
Lancisi quoted, 373.
Laughter, how produced,  166-8, 278.
-------, a cause of disease, 286.
Laws, vital, 42.
----, physical, 48.
La Mcdusc, the crew of, sufferers from
  hunger, 99.
La Peyronnie, observations  on the ce-
  rebellum, 298.
Leucorrhoea from suppressed perspira-
  tion, 434.
Leuwenho;ck,  microscopical observa-
  tions of, 535.
Le Gallois, his experiments, 87, 228,
  229, 230, 258, 294.
Life, animal, 52.
 —, organic, 52, 57.
Ligament, suspensory, 448.
Ligaments, office of", 222.
         -, lateral,  475.
Ligamenta lata, 528.
Lips, judge of the temperature, 81.
Liver, its structure, 448-9.
----, secretory functions, 457.
----, its secretory action varies with the
  state of the alimentary canal, 467.
----, inflammation of the, 469.
----, secretion  from,   influenced  by
  thought and the passions, 203.
----, its sympathy with gastric irrita-
  tion, 334.
----, excessive secretion from, 349.
----, obstruction of, 350.
----, reservoir and diverticula for the
  blood, 391-2.
-.---, enlarged in diseases of the heart,
  411.
Lobulus spigelii,  448.
Lobstein of Stratsburgh, his  opinions,
  28, 90,  254.
Localities  modifying   temperaments,
  585-8.
Locomotive apparatus, influence of the
  mind on, 203-4.
Locomotion, the  desire of,  instinctive,
  140.
Love, 187.
----, sexual, 134.
----of offspring, 134.
----of ourselves, 132, 187-8.
----, maternal, 544.
Lungs  described, 271-3.
        a diverticulum for the  blood,
  392.
------, oedema of, 411, 438.
Lymphatics of digestion, 307.

                 M.
Magendie, his work on physiology, 68.
          his experiments,  232, 282;
  298, 320, 440.
Malleus, a bone of the ear, 74.
Malpighi quoted, 355.
Mammae, structure of, 529.
       -, secretion from, 544.
Man, idea of, 25.
Mania, 210.
Manhood, characteristics of, 561
 -------, desires in, 562.
         •, diseases in, 577.
Marasmus, 481
        -, senile, 523.
Marrow, or medullary tissue, its situa-
  tion, 221.
------, secretion of, 474.
------, use of, 479.
Mascagni quoted, 355, 
590
INDEX,
Mastication, 81-2, 317.
Matter, animal, 26.
-------------, its principal forms, 29.
Meatus auditorius externus, 74.
Measles, 439.
Medicines, when pernicious, 344-5.
Medulla oblongata, 85.
=---------.-------, the central point of
  all the nerves of the human body, 85
  -7, 240.
—----—, the centre of the encephalon,
  292.
Medusa frigate, sufferings of the crew
  of, from hunger, 99, 314.
Melancholy, 146.
----------kept up  by gastritis, 146-7.
----------effects of, 208-10.
Membranes, fibrous,  220.
----------, synovial, 221.
----------, mucous, 240, 306.
----------, serous, 475.
Memory, in what it consists, 112, 184.
Meninges of the brain, 36, 89.
Mental alienation, 350.
------reflection, in  what it  consists,
  111.
Mercury,  its use in syphilis, 464.
Mesentery, the grand central fold of the
  peritoneum, 310.
Mesenteric glands, swelling of, 350,358.
--------------, their structure, 355.
Mesocephalon, 87.
Metaphysicians, their province, 183.
Metritis, 432.
Miasmata produce asphyxia, 289.
Middle age, diseases of, 582-3:
Milk, secretion of altered, and suppress-
  ed by the passions, 203.
Mollusca, their instinct, 103.
--------, their structure, 375.
Mons veneris, 527.
Morbus maculatus, 408.
Morgagni quoted, 355.
Moscow, campaign of, 238.
-------, retreat from, 99.
Mucus, altered secretion of, by strong
  passions, 203.
 Mucous membranes, 240.
------  membranes of digestive canal,
  306.
------body of the skin, 59.
 Muscles, their contractility, 223.
-------,  contraction of, 243.
-------,  ———----, is a vital erection,
   225.
-------,----------, when  immode-
   rate,  is a cause of disease,  223, 234-
  40.
-------of relation,  219.
-----—,  their composition, 220,
Muscles, wasting of, 223.
-------, splanchnic, 257.
-------, cephalic, 219, 225-7, 243.
-------, cephalo-splanchnic, 219, 227,
  244, 257.
-------, inspiratory, 275.
—-----, expiratory or abdominal, 276.
       , visceral, influenced by the pas-
  sions, 204.
Muscular action, how a cause of disease,
  234-40, 244.
--------tissue, how altered in rheuma-
  tism, 484-5.

                  N.
Nails, 60.
Nephritis from suppressed perspiration,
  432.
--------from gonorrhoea, 435.
Nerves, two sets of, 90.
------, extra cerebral, 90, 241.
------, intra cerebral, 90, 241.
------,  influence of,  on contractility,
  224.
-      converge  at the basis  of  the
  brain, 240.
------, spinal, double function of, 232.
------,--------------doubtful, 302.
       , hypertrophy of, 519.
------for organic functions, 249.
------ for digestion, 307.
Nervimotion, 41.
Nervimotility, 41.
Nervous system, conditions for the per-
  formance of its functions, 302.
Neurosis after great exercise, 240.
Neurilema, 36, 89.
Nose, 77.
Nutrition, 247-8.
--------, how accomplished, 513 14
--------,  excessive, 517-20.
Nymphse, 528.
Nymphomania, 545.

                  O.
Obesity, 197.
Q-'.sophagus described, 305.
Old age, phenomena of, 563
-------, duration of, 565.
-------, desires of, 566.
-------, decay in, 567.
-------, diseases of, 583-4.
Omentum, great, 311.
Onions,  exhalation from, irritates  the
  eyes, 465.
Ophidia, their instinct, 104.
Ophthalmia, when occurring, 71, 212,
  347, 350, 465.
----------from gastro-enteritis, 488,
Orfila referred to, 410. 
INDEX.
579
Organ defined, 29,
Organic life, 52.
Organs, cerebral, 91.
Os orbiculare, a bone of the ear, 74.
Ovaries, 528.
Ovum, when detached, 538.
Oxide  of carbon, negatively injurious,
  288.
Oxygen gas, its absorption by the lungs,
  281.
---------• more  consumed  in winter
  than in summer, 284.
            more  consumed by adult
 than by young animals, 284.
-------— may become a poison, 290.
--------absorbed by the skin, 419.
Petrous portion of the temporal bone,
  73.
Pharynx described, 305.
Philosophy, advantages of, 219.
Phlegmasia, secondary mixt, 507.
Phosphuretted hydrogen an irritating
  poison, 289.
Phrenitis from suppressed perspiration,
  433.
Phthisis pulmonalis hastened by exces-
  sive enjoyments, 206.
                —, with melanosis, 239.
                — from gastric irrita-
Pain alternating with pleasure, 165.
Painful passions, 143,187.
.-------------without reaction, 208-
with reaction, 212-19.
12.
Pancreas, structure of, 449.
       -, secretion from, how affected,
470.
-, effect of the passions on, 203.
Papillae of the skin, 59-61
------of the kidneys, 421.
I'assions defined, 128.
------sustained by visceral sensations,
   128, 191-3.
■------, morbid effects of, 198, 219.
------, how understood, 131.
------, compound or mixed, 133, 158
   -9.
-------in direct ratio to the heat of
   the blood, 285.
Paralysis  from great excitation of the
   brain, 196, 213.
Parturition, 542-3.
_________, diseases from, 554.
Peduncles, or crura of the brain, 85.
Pelvis of the kidneys, 421.
Perception, centre of, 292.
Perceptions, sources of, 185.
_________, conditions for, 241.
Pericardium described, 361.
Pericarditis, symptoms of, 399.
Perichondrium, 220.
Periosteum, 220.
Peritoneum described, 306-7.
 Peritonitis from  excessive  coughing,
   287
 ____J___stops the secretion of urine,
   425.
 ________from  suppressed perspira-
   tion, 432.
 Petit de Namur, his idea oi the cerebel-
   lum, 298,
  tion, 350,
Physiology defined, 25.
--------, medical, 28
         ■, its limits, 511
Pia mater described, 84, 89.
Picromel, 449.
Pinel Grand-Champ, and Foville, their
  experiments on the encephalon, 297
  -8, 303.
Pity,  217.
Placenta, 539-40.
Pleasure, 157, 187.
         •, passions founded on, 133.
Pleasures, physical, 129.
          moral, 129.
Pleura described, 273.
Pleurisy from suppressed perspiration,
  432.
Pneumonia from anger, 214.
           from  hypertrophy  of  the
  heart, 401-2.
--------from suppressed perspiration,
  432.
Pneumo-gastric or eighth pair of nerves,
  273, 275._
Poisons, acrid, 351.
            -, effects of, 439-41.
Polyphagi, their feats and untimely end,
  345.
Polypi have no vessels, 374.
Polysarcia, how produced, 488, 517,
Pons Varolii, 85, 86, 87.
Portio mollis, 73.
Power, vital, 41.
Pregnancy, 538.
         •, extra-uterine, 542, 550-2,
—, diseases from, 552-4.
Prescience, 184, 189.
Priapism, 545.
Pride, on what founded, 137.
Prostate gland, 427, 527.
Puberty, changes at, 559.
       -, desires in, 561
______, diseases in, 575-6.
Puerperal state, effects of, 484, 554-6,
Pulmonary arteries, 272,
________veins, 272, 
".96
INDEX.
 Pulse, its state in sleep, 175,
 Pupil, 67.
 -----, dilated, 70.
 Pustules, sudoral, how formed, 431,
 Pylorus, 308, 320-1, 342.
 Pythagoras, his observations on  absti-
   nence,  285.
                  R.
 Raphe of the perineum, 526.
 Rasori, his practice hazardous, 344.
 Reaction, vital, 45.
 Recurrent nerve, 273.
 Rectum, 312, 329.
 Reflecting faculty, great varieties in, 113.
 Reflection, mental, in what it consists,
   112.
 Rega quoted, 27.
 Regimen, the white, in what it consists,
   347.
 Reissessen observed the fibrous tissue of
   the trachea, 272.
 Relation,  muscular apparatus of, 219,
 Renal capsules, 421, 568.
 Reservoir of Pecquet, 355, 357.
 Respiration, an instinctive want, 97.
 ---------, a  want perceived by the
   brain, 228.
 ~--------, how performed in different
   animals, 270.
 ---------, puerile, 400.
 Retina, 66, 71.
 Rheumatism, 214.
 ----------after fatigue, 235.
 ----------after repletion, 347.
 ----------connected with  arteritis,
   406.
 ----------, chronic, effects of, 484.
 ----------, -----,  in what it con-
  sists, 485.
 Rolando, his experiments on the ence-
  phalon, 291,  293, 294, 304.
 Roussel quoted, 560.
 Rumination, 342.
                  S.
 Sadness, 145, 189.
 Saliva altered by strong passions, 203.
-----, its properties, 456.
---—, excessive secretion of, 466.
 Salivary concretions, 466.
 Salivation from suppressed perspiration,
  466.
 Sarlandiere, his observations on diges-
   tion, 321.
---------on the circulation, 371, 372.
 Satiety, of two  kinds, 327.
 Sclerotica, 66.
 Scrofula, connected witli arteritis, 406.
 ------, phenomena of, 502-7.
 Scrofulous diathesis, in what it consists,
  487, 502.
Scoutetten, observations on arachnitis,
  333.
--------, observations on  inflamma-
  tion, 415.
Scrotum, 526.
Scurvy, causes and phenomena of, 520-1.
Sebaceous glands, 444.
Secretions, 443-71.
--------, how performed, 451.
--------, morbid cutaneous,  459-60.
--------, effect of the passions on,
  202-3.
Self-love, 138, 188.
.-------, wounded, 157.
Semen, effect of the passions pn, 203.
      , the stimulus  to  sexual  desire,
  529.
-----, secretion of, 531.
Semicircular canals, 73.
Sensation, when evidenced, 122, 226,
Sensations, study of the, 92.
--------, how gratified, 229,
Sense, auditory, 72.
---—, of sight, 65.
-----, of smell, 77.
-----,------, its mechanism, 77.
-----,------, morbid state of, 78.
-----, of taste, 79.
-----, respiratory, 274-5.
-----, oesophageal, 318.
-----, gastric, 3*21-2, 324-5.
-----, cardiac, 326.
Senses,  weakened  by excessive plea-
  sure, 207.
Sensibility defined,  33.
----•-----analysed, 38.
--------is intermittent, 115,
--------a forced state, 118.
—-----— how far intellectual, 122,
--------, remarks on, 315.
--------, elective, 356.
--------more  delicate in advanced
  life, 330.
Septum lucidum, 86.
Serres, his observations on the  nervous
  system, 231.
Serum, how furnished, 475.
Sexes, the union of, 529.
Shame, 160.
Sight, sense of, 65.
Skin, the universal sense, 58.
----, its  two-fold function, 58.
----, diseases of, by intense thought, 197,
----, accelerated circulation in, 381,
----, discharges from, 417-20.
Sleep defined, 173.
-----, phenomena and effects of, 173-82.
-----, influence of the sympathetic on,
  182.
Smell, sense  of, 77. 
INDEX.
599
Smiling, how caused, 167.
Smoke, irritating to the eyes, 465.
Snake, its singular power over  other
  animals, 104-5.
Sneezing, 97, 279.
--------, morbid effects of, 286-7.
--------1 cure of, by leeches round the
 - nose, 287.
Sobbing,  162, 278.
------, morbid effects of, 286.
Somnambulism, 178.
------------, a proof of the plurality
  of cerebral organs, 178.
Spain, expedition to, 237.
Spallanzani, his experiments on  respi-
  ration, 281.
Spasm, state of, 43, 413.
Spermatic cord, 526.
Spinal marrow, 88.
Spinal nerves, double functions of, 232.
Spina ventosa, 486.
Spirituous liquors, operation of on ani-
  mals, 96.
Spurzheim,  his  observations   on the
  nervous system, 231.
Stag, a trick of, 111.
Stahl referred to, 370, 410.
Stapes, a bone of the ear, 74.
Stomach described, 307-8.
------, its power of selection, 342-3.
St. Vincent of Paul,*  referred to, 143.
Sulphuretted  hydrogen,  an irritating
  poison, 289.
Sweat suppressed by fear, 202.
-----, composition of, 418.
-----, vaporised by febrile heat,  419.
-----, evidence of intense suffering,
  420.
-----, excessive, from sudorifics, 431.
Sympathetic nerve, not sensible  in its
  natural state, 256.
---------------,  the  movements it
  regulates, 257.
---------------,  its  influence over
  the heart, 257-8.
---------------,  its  influence over
  the other splanchnic muscles, 259-60.
----------------,  its  influence over
  the visceral membranes, 260.
---------------■,  its  influence  over
  the secretors, 260.
---------------,  its  influence  over
  the arteries,  261-3.
---------------,  presides over nutri-
  tion, 263.
.---------------,  its connexion with
  the cerebral nerves, 252, 264, 266.
----—---------, its agency  in caus-
  ing sleep, 267-9.
Sympathetic nerve, summary of its func-
  tions, 269.
---------------, excitation of, 253
System, defined, 30.
-----, synovial, 30.
-----, serous, 30.
-----, fibrous, 30.
-----, osseous, 30.
-----, muscular, 30.

                 T.
Tarsi, 68.
Tartrate of antimony and potass, its bad
  effects, 344.
Taste, sense of, 79.
----, its mechanism and sympathies, 81.
-----, morbid state of, 83.
Tears shed from various motives, 162-3,
----, effects of their flow, 212.
----, secretion of,  454-5.
Temperaments, 568.
■------------, varieties of, 570.
■------------, alterations of, 584,
Temperament, gastric, 570.
-----■-----, sanguine, 570.
-----------, bilious, 570.
-----------,   lymphatico-sanguine,
  570.
-----------,---------diseases  of,
  576-7.
-----------, anemic, 571.
---'-------,-----, diseases of, 579
  -80.
      ■-----, nervous,  572.
-----------,------, diseases of, 580
  -1.
1      -----, nervoso-sanguine, 572
-----------, melancholic, 573.
Tendons, office of, 220.
Tentorium cerebelli, 90.
Terror, 156.
Testicles, 525.
Tetanus from anger,  214.
Thalamus nervi optici, 85.
Thenard quoted, 449.
Thirst, phenomena of, 314.
-----produced by the stimulation uf
  chyme, 328.
-----morbid effects of, 333.
Thoracic duct, 354, 357.
Tickling, effects of, 62, 63.
Tiedemann  on foetal growth, 540,
Tinea, 459.
Tissue, cellular, matrix of all the organs,
  32.
-----, vital properties of, 33.
-----•, morbid alterations of, 482.
■-----, areolar, 474.
,~_---, serous, 476.
* riiis, by miilakc, h printed Vincent St, Tan!, in the body ot the n oik 
f)00
INDEX.
 Tissue, adipose, 476.
 -----, medullary, 476.
 Tongue, the principal seat of taste, 79.
 Touch, its seat in the skin, 61.
 *-----, effects of, on the viscera, 62-5.
 Trachea described, 271-2.
 Tri-splanchnic or sympathetic nerve,
   28.
 ■-----------, how influencing respira-
   tion, 230.
 Tubercula quadrigemina, 85.
 Tubuli uriniferae, 421.
 Tunica vaginalis, 526.
 Typhus fever, how caused, 351-2.
 Tympanum, cavity of, 73.
 ---------, membrane of, 73.

                 U.
 Ulcers, varicose, 410.
 Urea, 422.
 Urethra, 527.
 Ureters, 427.
 Urine, composition of, 422.
 -----, organs for excretion of, 427.
 Uterus, 528.
 Uvula connected with taste,  81.

                 V.
 Valve, ileo-coecal, 310, 322.
 Valvulae conniventes, 306.
 Vanity, on what founded, 137-8.
 Vasa vasorum, 366.
 -----------, engorged, 410.
 ----afferentia, 355.
 ----efferentia, 355.
 Vas deferens, 526.
 Veins, their structure, 386-8.
 ----, their function, 388.
 -----have  a centripetal  contractile
   movement, 389.
 ----, varicose, 409,  411.
 Velum palati, 80, 81.
 Vena portae, how formed, 307, 388, 449.
 ---—---, engorgement of, 411.
 Vertebral column, 222.
•Verumontanum, 527.
 Vesiculae seminales, 526.
 Vessels do not pervade  all pails, 374;
   383.
 ■----- do  not pervade  all  parts, nor
   perform nutrition, 374.
 Vestibule, 73.
Virgil quoted, 170.
Virus, venereal, considered, 461-4.
Vis a tergo, 388, 389, 390.
Viscera, influence of the, on instincts
  93-6, 100.
------, influence of the, on the ce-
  phalo-splanchnic muscles, 228.
Viscus, inflamed, stimulates the brain,
  98.
Vision, mechanism of, 68.
-----, local phenomena of, 69.
------, converted into disease, 70.
Vital power, 41.
---- chemistry, 42.
---- laws, 42.
---- erections, 43.
----reaction, 45.
Voice, how formed, 277-8.
Vomiting, from masticating disagreea-
  ble matters, 318.
—------, from gastric  irritation, 337,
  347.
-i-------, its perturbating effects, 338.
■  ■   ----is easy in children, 339-40.
-------, mechanism of, 340-2.
-------, natural, 343-4.
-------, from cold  applied to  the
  skin, 434.
Vulva, 527.

                 W.
Wants, their origin, 53, 185.
------, dependent on the  condition of
  the viscera, 54-8.
-----, physical, enumerated, 185.
------, source of all the relations, 240.
------, moral, 185.
Warm-blooded animals, 283.
Will defined, 112.
Willis, his view of the office of the  ce-
  rebellum, 297.
Wolf, its cunning, 110-11.
Wounds aggravated by anger, 214
-------, their effects,  482.

                 Y.
Yawning,  mechanism  and  effects  of,
  171-3.

                 Z.
Zoophytes, their instinct, 102
THE  END 
§
                                ERRATA.

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     497,  "  14 of the note, for  * the zinc or most dense to the copper or least
                  dense pole,' read, the zinc or least dense to the copper or
                  most dense pole. 
 
 
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