We are not able to explain why the nerves of any two organs, which are particularly connected in their functions, should induce them to act in concert with each other, any more than with other parts. We can only observe the fact, that such a relation does exist between the several organs; and it is one of the most wonderful of the properties of a living being. Those organs are most frequently excited to a sympathetic action, whose functions are in some measure dependent on each other. Sometimes the sympathetic action takes place simultaneously with the original one, or nearly so, and sometimes it follows it, according as in either way the joint operation of both will be the most fully and perfectly performed.

The effects of this principle of animal life are exceedingly important in every department of medical science; and they have so direct a bearing upon our present subject, that it will be useful to examine them a little more particularly. And, as in most other cases, before we can have a full view of their influence in a disordered state of the system (to which our inquiries more particularly belong), we must look somewhat to their operations in health.

Those organs are associated in their actions, which have a particular connexion with, or dependence upon each other in their functions. In many instances, the functions of a particular organ are incomplete by themselves, and only lead to a useful result, when they are taken up and completed by another organ, or perhaps by a series of organs. In other cases several organs, whose functions differ exceedingly from each other in character, are excited to action at the same time, and co-operate in producing a joint result. Or there may be sets of organs associated in this manner, some of which act simultaneously, and others in succession, and thus by the aid of all, accomplish the ultimate objects of their operations. In the process by which the human body is supported and nourished, all these varieties of associated actions are exhibited. As soon as food is placed in the mouth, the glands in the vicinity are excited to pour out the fluids,

which they separate from the blood, in greater quantity than at other times, in order that, by their mixture with the food, they may favor its digestion. This is indeed favored by the motion of the parts in mastication. But that it is principally by sympathy that these glands are thus excited to action, is manifest from the circumstance that the same effect is produced, when the food is placed in the mouth, without any such motion; and that the motion, without the food, does not produce it, in anything like the same quantity. In the same manner, when the food arrives in the stomach, the glands of that organ perform a similar office in pouring out their appropriate juices. At this time too, the liver partakes of the same influence, and is excited to an increased discharge of its peculiar fluids, which serve very important purposes in the process of digestion. And, as the food passes on through the intestines, the lacteal vessels are excited to take up such parts of it as are best suited to the growth or nourishment of the body. Thus the whole process is completed by a series of associated actions, neither of which can be dispensed with without essential injury; and neither of which can effect any useful purpose by itself alone. In this instance, the organs concerned are also connected by their relative situation in the body. But in the process by which the race is continued, by the reproduction of individuals, it is otherwise. The organs concerned in this process, in the female, have no relation, either in their situation, nor their structure, nor even in their functions, except as it respects the ultimate object for which they are designed. And yet their actions are so associated, as that one organ performs no function whatever, until it is excited by a previous action in another organ. When conception has taken place in the uterus, the mammæ enlarge and prepare for their secretions; and when the fœtus is expelled from the uterus, and not till then, the milk is actually secreted in the breasts for its support.

In like manner the act of swallowing, and that of breathing, as well as the discharge of the several secretions, are the result of the associated actions of different organs. Indeed

the same may be said of almost or quite every other operation of the human body. For, although some operations require the concurrence of more organs than others, there is scarcely any (if indeed there be one) that is performed by the independent agency of a single organ. Those parts, which are most frequently associated together by sympathetic actions in health, are generally disposed to suffer together in disease, whether the disease be spontaneous, or the effect of violence. But sympathetic diseases are by no means confined to such parts as are associated in their functions, Remote parts, which have no direct relation to each other in health, except as parts of the same being, are often connected in the symptoms produced by an injury done to one of them. A familiar example of this is found in the very common occurrence of a headache, produced by a disordered state of the stomach. And the disposition to sympathetic action is reciprocal; for a severe blow on the head will often occasion vomiting.

The extremities, in like manner, often sympathize with the disorders of the stomach, by which an almost invincible. coldness is produced; and sometimes vomiting is occasioned by applying warmth to them. So it is also with the whole surface of the body. An eruption on the skin is a very common consequence of a disordered stomach; and nausea and vomiting follow an unseasonable repression of it. Indeed the sympathies of the stomach are more extensive perhaps than those of any other organ of the body.

It might be supposed that an organ, whose functions are immediately essential to life, would be more strongly connected with the rest of the body by sympathy, than another which performs a part less directly important to our existence. But this does not appear to be the case in fact. The heart performs a part in the animal economy so essential, that life is immediately destroyed, if its functions are interrupted. And yet the heart may be diseased for a long time, and sometimes even almost to the destruction of life, before any more than occasional symptoms are excited in other organs

VOL. XIV.-NO. XXVII.

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by its sympathies. Hence it is, that diseases of the heart are sometimes so difficult of detection. The sympathies of the brain appear to be much less extensive than those of the stomach, although its functions are much more immediately vital. There are similar differences among all the other organs, in respect to their liability to produce a sympathetic effect on the rest of the system.

Where an individual organ is subject to some diseased action by sympathy, from an injury done to another, that which actually received the injury is often more or less relieved from the consequences of it. Thus in the cases to which we have referred, of sympathies with the stomach; that organ does not constantly suffer from sickness while the sympathetic effect remains; but when that is removed, the effect returns upon the original organ. When, however, it is the whole system that suffers from an injury done to a part of it, the general effect has no influence in relieving that of the injured part. The severity of a sympathetic fever is generally in direct proportion to the extent of the injury which caused it.

It is obvious, how important a knowledge of the sympathetic relations of the human body must be to the physician, in every department of the profession. In seeking the original seat of a disease, he must not confine his attention to the part which exhibits the strongest symptoms of it, but must also take into view all the sympathies of which the parts are capable. So, too, in reference to our present subject, in estimating the importance of a wound, we are not to regard the injury to a particular part alone, but must also add to this the effect of all its sympathies, either with other organs separately, or with the whole system generally. In this point of view, wounds of different parts, which in other respects are of nearly equal severity, vary exceedingly in their consequences. There seems also to be a great difference in different persons, arising from peculiarity of habit and temperament. In a person of an irritable constitution of body, a wound will produce a much greater sympathetic excitement

All these con

in the system, than in a less irritable person. siderations, therefore, must be borne in mind by the physician, when called upon to judge of the probable consequences of a wound.

Another circumstance applicable to wounds, which may affect the importance of their consequence, is where the wounded person is already subject to some disease, or to some peculiarity of constitution, or of the structure of his body, by which the injury is rendered more serious than it otherwise would have been.

The mere circumstance that he was sick, before he received the wound, and might have died without it, does not at all affect the criminality of him who gave it. It was said by the Court, in the trial of Philips (and I understand it is the language of all the law upon the subject), that 'If a man would have died soon, this furnishes no excuse for accelerating his death. If the party was sick, and might possibly have died, we are not to speculate upon the question whether he would or not. We are not to go into these considerations.'1 Indeed, within a few years a man has been tried in Massachusetts for murder, because he had advised a condemned criminal to hang himself, on the morning fixed for his public execution.

But where it is the disease itself that renders the injury fatal, so that a wound, which under other circumstances might have been comparatively harmless, produces death in consequence of the previous disease, the decision of the law might perhaps be different. The fatal result, in this case, is so intimately connected with the disordered state of the body, and so dependent upon it, that the criminality of the which is the immediate cause of death, must, it should seem, at least be reduced from murder to manslaughter, and sometimes perhaps to excusable homicide. A man, for instance, may have an aneurism. This is an affection which may

1 Trial of Henry Philips for Murder. Boston Weekly Messenger-Vol. VI. p. 247.