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mouth excites the secretion of the salivary glands, and that of chyme in the duodenum augments the secretion of the liver. In CT DE the same manner a purgative, as calomel, which acts upon the upper part of the intestinal canal, becomes a cholagogue; and duodenitis occasions a copious biliary secretion. These cases have, however, been considered by many, to belong more appropriately to functional correlation, as it is presumable that the propagation of the irritation from the orifice of the excretory duct takes place directly, and along branches of the same nerves as those that supply the glandular organs. It is by this sympathy of continuity that we explain the action of certain medicines. In bronchial irritation, for example, the cough will frequently be mitigated by smearing the top of the larynx by a demulcent,—the soothing influence of which extends to the part irritated.
A variety of sympathy, differing somewhat from this, is the sympathy of contiguity or contiguous sympathy, in which an organ is affected by an irritation seated in another immediately contiguous to it.
The association in action, between the lining membrane of the heart and the muscular tissue of the organ, has been adduced as an instance of this kind, and chiefly from the experiments of Bichat and Nysten, which showed that any direct irritation of the muscular tissue of the heart has not as much influence as that of the membrane which lines it. A similar association is presumed to exist between the mucous and muscular coats of the alimentary canal, and the same kind of evidence is adduced, to prove that the connexion is sympathetic.
Other instances of sympathy are, the convulsive contraction of the diaphragm and abdominal muscles in vomiting consequent on the condition of the stomach, as well as the convulsive action of the respiratory muscles in sneezing, coughing, &c.
The general uniformity in the motion of the two eyes has been adduced as an additional instance; but Adelon has judiciously remarked, that the evidence in favour of this view is insufficient. For clearness of vision it is necessary that the luminous rays should impinge upon corresponding points of the two retinæ, and should fall as nearly as possible in the direction of the optic axes. For this purpose, the muscles direct the eyes in the proper manner; and subsequently, from habit, the balls move in harmony. We constantly hear, also, a fact adduced from pathology as an instance of sympathy. A molar tooth is lost on one side of the jaw; and it is found, perhaps, that the next tooth that decays is the corresponding molar tooth of the opposite side:—or a tooth has become carious, and we find the one next to it soon afterwards in the course of decay. These have been regarded as evidences of sympathy, remote and contiguous. This is not probable. The corresponding teeth of the two sides are similarly situated as regards the supply of nerves, vessels, and every anatomical element; and experience
shows us that the molar teeth—and especially the second great molares—decay sooner than the others. If one, therefore, becomes carious, we can understand why its fellow of the opposite side should be more likely to suffer. The opinion, that contiguous teeth are likely to be affected by the presence of a carious tooth, either by sympathy, or by direct contact, is almost universally believed, and promulgated by the dentist. Both views are probably alike erroneous. If the inner side of the second molaris be decayed, we can understand why the corresponding side of the third should become carious, without having recourse either to the mysterious agency of sympathy, or the very doubtful hypothesis of communication by contact,—especially as the caries generally begins internally. The contiguous sides of the teeth are situated almost identically, as regards their anatomical elements; and, consequently, if a morbid cause affects the one, the other is the next likely to suffer, and is very apt to do so. Extracting the diseased tooth prevents this, because it removes a source of irritation, which could not but act in a manner directly injurious on the discharge of the functions of the tooth next to it.
The fact of the sympathy that exists between organs of analogous structure and functions is familiar to every pathologist. That of the skin and mucous membranes is the most intimate. In every exanthematous disease, the danger is more or less dependent upon the degree of affection of the mucous membranes; and the direct rays of the sun, beaming upon the body in warm climates, induce diarrhoea and dysentery.
Acute rheumatism is a disease of the fibrous structures of the joints; but one of its most serious extensions, or metastases, whichsoever they may be called, is to the fibrous structure of the pericardium. Barthez, a most respectable writer, gives a case of this kind from Theden which is inexplicable, and probably of doubtful authenticity. A patient, affected with paralysis of the right arm, applied a blister to it, which produced no effect, but acted on the corresponding part of the other arm. The left becoming afterwards paralyzed, a blister was put upon it, which also acted upon the other arm, not on the one to which it was applied!
Owing to this consent of parts, Broussais has established the pathological law,—that when an irritation exists for a long time in an organ, the textures that are analogous to the one which is diseased are apt to contract the same affections.
As examples of the more distant kinds of sympathies, we may cite the effect, produced upon the stomach by distant organs, and Amongst the earliest signs of pregnancy are nausea and vomiting; loathing of food; fastidious appetite, &c. These symptoms are manifestly induced by a sympathetic connexion between the uterus and stomach; inasmuch as they are not adventitious, but occur more or less in all cases of pregnancy. Their absence, at least, is a rare exception to the rule. Hunger or dyspepsia,
again, impresses a degree of languor,—mental and corporeal,which is proverbial; whilst the reception of food and its vigorous digestion give a character of energy, and buoyancy, greatly contrasting with opposite circumstances. In disease, too, we find sympathies existing between the most distant portions of the frame, and although these are not apparent to us in health, we are perhaps justified in considering, that an occult sympathy exists between them in health, which only becomes largely developed, and obvious to us, when the parts are affected with disease. It is probable, too, that in the successive evolution of organs at different periods of life, new sympathies may arise which did not previously exist or were not observable. The changes that supervene in the whole economy at puberty strikingly illustrate this;—changes which do not occur in those who, owing to malformation, are not possessed of the essential parts of the reproductive system, or who have had them abstracted prior to this period.
The effect of the intellectual and moral faculties on the exercise of the functions of other parts is strongly evidenced, especially in disease. The influence of the mind over the body is, indeed, a subject which demands the attention of every pathologist.
In health, we notice the powerful effect induced by the affective faculties upon every function. All these arc caused by sympathetic association with the brain; the action of the organs being in a state of excitation or depression, according to the precise character of the emotion. The intellectual manifestations probably exert their influence in a manner less evident, but not the less certain. The effects of one of them, at least, on the bodily functions are remarkable. We allude to the imagination; to which we can ascribe most of the cures that are said to have been effected by modes of management,—often of the most disgusting character,which have been from time to time in vogue, have fretted their hour on the stage and then sunk into that insignificance from which they ought never to have emerged.
We have had occasion to allude to the excited imagination of the maniac, the hypochondriac, and the nervous, and have remarked, that hallucinations may exist in those of sound mind;—phantoms created by the imagination; pains felt in various bodily organs, &c.; and we can hence understand, that, under particular circumstances, we may have actual disease produced in this manner; and, at other times, the feeling,—which may be as distressing to the patient, of a disease, which has no existence except in the imagination. It is to the effect produced by the imagination that we must ascribe the introduction into medicine of magic, sorcery, incantations, Perkinism, Mesmerism, Hohenlohism, and other offsprings of superstition or knavery. The enthusiasm, that has attended the application of these three last modes of acting upon the imagination in our own times, is most extraordinary. Perkinism, it is well known, is the product of our own soil. Its proposer,
Dr. ELISHA PERKINS of Connecticut, is represented to have been a man of strict honour and integrity; but manifestly of an ardent imagination, and unbounded credulity. Impressed with the idea, that metallic substances might exert some agency on the muscles, and nerves of animals, and be inservient to useful purposes as external agents, in the treatment of disease, he professed to institute various experiments, until he ultimately fancied he had discovered a composition, which would serve his purpose, and of which he formed his metallic tractors. These consisted of two instruments, one having the appearance of steel, the other of brass. They were about three inches long, and pointed at one extremity; and the mode of their application was to draw the points over the affected parts in a downward direction for about twenty minutes each time. The effects seemed to be miraculous. The whole class of diseases on which the imagination is known to exert its efficacy; rheumatism; local pains of various kinds, and in various parts; paroxysms of intermittents, &c. &c. yielded as if by magic. The operation was termed Perkinism, by the Faculty of Copenhagen, in honour of the discoverer; and institutions were formed in great Britain and elsewhere, which were, for a time, regarded as sources for the dispensation of health to multitudes of wretched sufferers. Yet, in a very brief space of time, the enthusiasm and the institutions died away; and no one, at the present day, believes, that the effect was any thing more than an additional case showing the success, that must ever follow, for a time, the efforts of quackery; and exhibiting the total failure of the same agents, when deprived of the mystery that had previously enthralled them. Whilst the delusion, regarding Perkinism or tractoration, was at its height, Dr. Haygarth determined to ascertain how far the effects could be ascribed to the power of the imagination. He, accordingly, formed pieces of wood into the shape of tractors, and with much assumed pomp and ceremony applied them to a number of sick persons, who had been previously prepared to expect something extraordinary. He not only employed them in nervous diseases, but in all kinds of cases; and the effects were found to be most astonishing. Obstinate pains of the limbs were suddenly cured. Joints that bad been long immovable, were restored to motion, and "in short," says Dr. Bostock, "except the renewal of lost parts, or the change of mechanical structure, nothing seemed beyond their power to accomplish."
The history of these operations leads us to be still more impressed with the extensive influence, that may be exerted by the mind over the body: they teach the practitioner the importance of having its co-operation, whenever it can be procured; and the dis-, advantages which he may expect to ensue, where the imagination is either arrayed against himself personally, or the plan of treatment which he is adopting. The physician, who has the confidence of his patient, will be successful—if he adopt precisely the same plan
of treatment that would be pursued by one who has it not—in cases where the latter would totally fail.
Again, pathology is invoked as affording us perhaps the best evidences of the existence of extensive sympathetic relations between various parts of the frame, which are supposed to be constantly going on unseen during health, but become developed, and more obvious, in disease. The case, we have previously given, of the general effects produced upon the system by local irritation of a part, shows the extent of such association. An insignificant portion of the body may become inflamed, and, if the inflammation continues, the stomach is disordered,—as indicated by loss of appetite, nausea and vomiting; the respiration is hurried, as well as the circulation;the senses are blunted; the intellectual and moral faculties obscured; and languor and lassitude indicate the nervous irritation and constraint.
The moral consideration of sympathy does not concern us. It is a subject, and one of interest to the moral philosopher,—to account not only for these secret causes which attract individuals towards each other, but which repel them, and occasion antipathies. To a certain extent, however, it trends into the province of the physiologist. The tender, susceptible individual, from observing another suffering under pain, feels as if labouring under the same inconvenience, and by a very rapid, yet complex, intellectual process, constituted of numerous associations, may be so powerfully impressed as to sink under their influence; thus, the sight of blood will so powerfully impress the mind, in this sympathetic manner, that the individual may faint, and the vital functions. be for a time suspended. The sight and suffering of a woman in labour will cause abortion in another; and hence the propriety of excluding those, who are pregnant, from the chamber of the parturient female. Hysteric and convulsive paroxysms are induced in a similar way; of which the convulsionnaires of all times must be regarded as affording singular and instructive examples.
Lastly; the mysterious consent, which we observe between various parts of the body, has given rise to some of the most strange and absurd superstitions that can be imagined.
It was believed, for instance, almost universally in the 15th century, that an intimate sympathy exists, not only between parts of a body forming portions of one whole, but also between any substance that had previously formed part of a body and the body itself: that if, for example, a piece of flesh was sliced from the arm of one person and made to unite to that of another, the grafted portion would accurately sympathize with the body of which it had previously formed part, and undergo decay and death along with it; and it was even proposed to turn this sympathy to account. It was recommended, for instance, that the alphabet should be traced on the ingrafted portion; and it was affirmed, that when any of the letters, so traced, were touched, the party from whom the