A Treatise on Physiology and Hygiene Part 18

[Sidenote: 23. If an exposed nerve be divided? What is proved? The course of the sensory set of fibres? Of the motor set? To what are they likened?]

23. If a nerve that has been exposed be divided, and the inner end, or that still in connection with the nerve-centres, be irritated, sensation is produced, but no movement takes place. But if the outer end, or that still connected with the limb, be irritated, then no pain is felt, but {161} muscular contractions are produced. Thus we prove that there are two distinct sets of fibres in the nerves; one of which, the _sensory_ fibres, conduct toward the brain, and another, the _motor_ fibres, conduct to the muscles. The former may be said to begin in the skin and other organs, and end in the brain; while the latter begin in the nervous centres and end in the muscles. They are like a double line of telegraph wires, one for inquiries, the other for responses.

[Sidenote: 24. The two roots of the spinal nerves? What has been found?

Difference of the two sorts of fibres? Result of their union?]

24. We have already spoken of the two roots of the spinal nerves, called from their points of origin in the spinal cord, the anterior and posterior roots. These have been separately cut and irritated in the living animal, and it has been found that the posterior root contains only sensory fibres, and the anterior root has only motor fibres. So that the nerves of a limb may be injured in such a way that it will retain power of motion and yet lose sensation; or the reverse condition, feeling without motion, may exist. Between these two sorts of fibres, no difference of structure can be found; and where they have joined to form a nerve it is impossible to distinguish one sort from the other.

[Sidenote: 25. Transient paralysis? When such is the case with the leg?

What other fact is observed?]

25. Occasionally a nerve is so compressed as to be temporarily unable to perform its functions: a transient paralysis then takes place. This is the case when the leg or arm "gets asleep," as it is expressed. When such is the condition with the leg, and the person suddenly attempts to walk, he is liable to fall, inasmuch as the motor fibres cannot convey orders to the muscles of the limb. Another fact is observed: there is no sensation in this nerve at the point of its compression; but the whole limb is numb, and tingling sensations are felt in the foot, the point from which the sensory fibres arise.

[Sidenote: 26. What does this ill.u.s.trate? Sensation? The feeling after a limb has been amputated? Striking of the "funny bone?"]

26. This ill.u.s.trates the manner in which the brain {162} interprets all injuries of the trunk of a nerve. Sensation or pain is not felt at the point of injury, but is referred to the outer extremities of the nerve, where impressions are habitually received. This is the reason why, after a limb has been amputated by the surgeon, the patient appears to suffer pain in the member that has been severed from the body; while some form of irritation at the end of the nerve in the wound, or stump, is the real source of his distress. Again, when the "funny-bone"--that is, the ulnar nerve at the elbow,--is accidentally struck, the tingling sensations thus produced are referred to the outer side of the hand and the little finger, the parts to which that nerve is distributed.

[Sidenote: 27. The spinal nerves, and two from the brain? Of the remainder?

Difference in the nerves? How accounted for? The rate of conduction along a nerve? As compared with electricity?]

27. All the spinal nerves, and two from the brain, are concerned in both sensation and motion. Of the remainder of the cranial nerves, some are exclusively motor, others exclusively sensory; and still others convey, not ordinary sensations, but special impressions, such as sight, hearing, and smell, which we have yet to consider. However much the functions of the nerves seem to vary, there is but little difference discoverable in the nerves themselves, when examined under the microscope. Whatever difference exists must be accounted for in consequence of the nerves communicating with different portions of the gray matter of the brain. The rate of motion of a message, to or from the brain along a nerve, has been measured by experiment upon the lower animals, and estimated in the case of man at about two hundred feet per second. As compared with that of electricity, this is a very slow rate, but, in respect to the size of the human body, it is practically instantaneous.

[Sidenote: 28. Functions of the anterior and posterior columns of the cord?

If the cord be divided?]

28. THE FUNCTIONS OF THE SPINAL CORD.--As the {163} anterior and posterior roots of the spinal nerves have separate functions, so the anterior and posterior columns of the cord are distinct in function. The former are concerned in the production of motion, the latter in sensation. If the cord be divided, as before in the case of the nerve, it is found that the parts below the point of injury are deprived of sensation and of the power of voluntary motion on both sides of the body, a form of paralysis which is called _paraplegia_.

[Sidenote: 29. Paraplegia? Result and danger to life? When the injury occurs in the neck?]

29. This form of disease, paraplegia, is sometimes seen among men, generally as the result of a fall, or some other severe accident, by which the bones of the spine are broken, and the cord is crushed, or pierced by fragments of bone. The parts which are supplied by nerves from the cord above the point of injury are as sensitive and mobile as before. The results are similar, whether the division happens at a higher or lower portion of the spinal cord; but the danger to life increases proportionally as the injury approaches the brain. When it occurs in the neck, the muscles of inspiration are paralyzed, since they are supplied by nerves issuing from that region; and as a result of this paralysis, the lungs are unable to act, and life is speedily brought to a close.

[Sidenote: 30. Experiment of cutting the spinal cord of an animal? What inference is drawn?]

30. When the spinal cord of an animal has been cut, in experiment, it may be irritated in a manner similar to that alluded to when considering the nerves. If, then, the upper cut surface be excited, it is found that pain, referable to the parts below the cut, is produced; but when the lower cut surface is irritated, no feeling is manifested. So we conclude that in respect to sensation, the spinal cord is not its true centre, but that it is merely a conductor, and is therefore the great sensory nerve of the body. When the lower surface of the cut is irritated, the muscles of the {164} parts below the section are violently contracted. Hence, we conclude that, in respect to the movements ordered by the will, the spinal cord is not their source; but that it acts only as a conductor, and is, accordingly, the great motor nerve of the body.

[Sidenote: 31. What singular fact is noticed? What does the result show?]

31. DIRECTION OF THE FIBRES OF THE CORD.--If one lateral half of the spinal cord be cut, or injured, a very singular fact is observed. All voluntary power over the muscles of the corresponding half of the body is lost, but the sensibility of that side remains undiminished. This result seems to show that the motor fibres of the cord pursue a direct course, while its sensory fibres are bent from their course. And this has been proved to be the fact; for immediately after the posterior roots--the conductors of sensory impressions--join the posterior columns, they enter the gray matter of the cord, and pa.s.sing over, ascend to the brain on the opposite side.

Accordingly, the sensory fibres from the right and left sides interlace each other in the gray matter; this arrangement has been termed the _decussation_, or crossing of these fibres. This condition serves to explain how a disease or injury of the cord may cause a paralysis of motion in one leg, and a loss of sensation in the other.

[Sidenote: 32. Direction of the anterior or motor columns? In the cord itself? In the medulla oblongata? The decussation?]

32. The direction of the anterior, or motor columns of the cord, is downward from the brain. In the cord itself, the course of the motor fibres is for the most part, a direct one; but in the medulla oblongata, or upper extremity of the cord, and therefore early in their career, these fibres decussate, or cross from side to side in a ma.s.s; and not separately, as in the case of the posterior fibres just mentioned. This arrangement is termed the _decussation_ of the anterior columns of the medulla.

[Sidenote: 33. Result of the double interlacing of fibres? Where is the seat of pain when the right hand is hurt? The moving of the foot? Loss of sensation in one side of the body?]

33. From this double interlacing of fibres results a {165} crossed action between the original and terminal extremity of all nerve-fibres which pa.s.s through the medulla; namely, those of all the spinal nerves. Consequently, if the right hand be hurt, the left side of the brain feels the pain; and if the left foot move, it is the right hemisphere which dictates its movement. For the same reason, when a loss of sensation and power of motion affecting the right side of the body alone is observed, the physiologist understands that the brain has been invaded by disease upon its left side.

This affection is termed _hemiplegia_, or the "half-stroke." The full-stroke, which often follows the rupture of a blood-vessel in the brain, is commonly called _paralysis_.

[Sidenote: 34. What other important use has the cord? What is the activity denominated?]

34. THE REFLEX ACTION OF THE CORD.--We have already considered the cord as the great motor and sensory nerve of the body, but it has another and extremely important use. By virtue of the gray matter, which occupies its central portion, it plays the part of an independent nerve centre. The spinal cord not only conducts some impressions to the brain, but it also arrests others; and, as it is expressed, "reflects" them into movements by its own power. This mode of nervous activity is denominated the _Reflex Action_ of the cord.

[Sidenote: 35. Example of the fowl? Centipede? Frog? What do they prove?]

35. A familiar example of this power of the cord is found in the violent movements which agitate a fowl after its head has been cut off. The cold-blooded animals also exhibit reflex movements in an astonishing degree. A decapitated centipede will run rapidly forward, and will seemingly strive to overturn, or else climb over obstacles placed in its way. A frog similarly mutilated will sustain its headless body upon its feet, in the standing posture, just as it might do if it were still alive.

If pushed over, it will regain its feet; and if the feet are irritated, it will {166} jump forward. There can be no doubt that, in the lower animals, movements may take place which are completely divorced from the will, sensation, and consciousness; for in those animals, as well as in man, these faculties have their princ.i.p.al seat within the brain.

[Sidenote: 36. What is necessary in most cases to awaken reflex movements?

In the case of the fowl? Convulsions which follow decapitation?]

36. An irritation is necessary, in most instances, to awaken reflex movements. In the case of the decapitated fowl, its muscles are excited to convulsive action by reason of its being thrown upon the hard ground and roughly handled. Let it be treated differently, and the convulsions will not take place: let it be laid gently upon soft cotton, and the body will remain comparatively quiet. It may comfort some people to know that the convulsions which follow decapitation are not attended with pain; nor are they a necessary part of the "act of death," as some suppose.

[Sidenote: 37. Actions in the human body distinct from voluntary efforts?]

37. In the human body, likewise, actions are excited that are entirely distinct from the ordinary voluntary efforts. It is not permissible, desirable, nor even necessary to decapitate a man that the body may be disconnected from his brain, in order to test the effect of irritation upon the spinal cord; although the bodies of beheaded criminals have been experimented upon, and caused to move by powerful galvanic batteries. The resort to such means of experiment is rendered unnecessary by the occurrence of certain deplorable cases of disease and injury, which effectually sever all communication between the brain and a large part of the body.

[Sidenote: 38. Reflex action after injury of the cord? Why not due to the muscles?]

38. Thus, the cord may be so far injured, as the result of accident, as to terminate all sensation and voluntary motion in the lower half of the body, the patient seemingly becoming lifeless and powerless from the waist downward. And yet, by tickling or pinching either foot, the leg {167} of the same side may be made to jerk, or even to kick with considerable force; but, unless the patient is observing his limbs, he is wholly unconscious of these movements, which are, therefore, performed independently of the brain. And they are in nowise due to the muscles of the limb; for, if the cord itself becomes diseased below the point of injury, the muscles cease to contract.

[Sidenote: 39. What are the requisites for the production of this form of nervous action?]

39. For the production of this form of nervous action three things are requisite--(1) a nerve to conduct messages from the surface of the body, one of that variety formerly described as sensory, but which are now incapable of awakening sensation; (2) a portion of uninjured spinal cord which shall reflect or convert impressions into impulses; and (3) a motor nerve to conduct impulses outward to the muscles. The power of the cord to enforce reflex acts resides in the gray matter, into which the reflex nerves enter and from which they depart, by means of their posterior and anterior roots respectively.

[Sidenote: 40. Why do we not readily recognize the reflex activity of the cord in our own bodies? How best studied in others? Example?]

40. THE USES OF THE REFLEX ACTION.--The reflex activity of the cord is exhibited in the healthy body in many ways, but since it is never accompanied with sensation, we do not readily recognize it in our own bodies. Reflex movements are best studied in the cases of other persons, when the conditions enable us to distinguish between acts that are consciously, and those that are unconsciously performed. For example, if the foot of a person soundly asleep be tickled or pinched, it will be quickly withdrawn from the irritation.

[Sidenote: 41. Similar movements? Arm of a person? Melted wax or heated coin on the hand?]

41. Similar movements may be observed in cases where the consciousness and sensation are temporarily obliterated by disease, or by means of narcotic poisons. If the arm of a person who has been rendered insensible by {168} chloroform, be raised, and then allowed to fall, it will be noticed that the limb does not drop instantly, like a lifeless member, but a certain amount of rigidity remains in its muscles, which resists or breaks the force of its descent. Again, when a substance like melted sealing-wax, or a heated coin, falls upon the hand, the limb is s.n.a.t.c.hed away at once, even before the feeling of pain has been recognized by the brain. When jolted in a rapidly moving car, we involuntarily step forward or backward, so as to preserve the centre of gravity of the body.

[Sidenote: 42. Result of healthful reflex activity? When may the reflex energy be deficient?]

42. These and similar acts are executed by the same mechanism as that previously described in the case of paralysis from an injury of the spinal cord. The muscles thus called into play, are those which are ordinarily under the sway of the will, but which in these cases act through this reflex action of the cord, altogether independently of the will. A healthful reflex activity produces an elasticity, or "tone," of the voluntary muscular system, which, in a great measure, explains the existence in the young and vigorous of a feeling of buoyancy and reserve power. Its possessor is restlessly active, and it may appropriately be said of him, "he rejoiceth as a strong man to run a race." But this reflex energy may be deficient. This is true when the blood is poor and wanting in its solid ingredients, or the circulation is feeble; the muscles, then, are flabby and weak, and the person himself is said to be "nerveless," or indisposed to exertion. Shivering from cold, and trembling from fear, may, in part, be referred to a temporary loss of tone, resulting from a powerful impression upon the brain.

[Sidenote: 43. Excess of this activity in disease? Hydrophobia, etc.? The difference in severity of the convulsions?]

43. An excess of this activity may also be observed in disease. In this condition, the excitability of the cord is unnaturally aroused, and frequent and violent movements {169} of the limbs and body, called convulsions, are the result. The convulsions of young children, and the nervous agitation of _ch.o.r.ea_, or St. Vitus's dance, are reflex in character; as are also the symptoms attending poisoning by strychnine, and those terrible diseases, _teta.n.u.s_, or "locked jaw," and _hydrophobia_. The severity of the convulsions is not the same in all cases of these disorders; but, in those last mentioned the most violent spasmodic movements are provoked by the slightest form of irritation--such as the sound of pouring water, the sight of any glittering object, the glancing of a mirror, the contact of cool air, or even the touch of the bedclothes.

[Sidenote: 44. Another variety of reflex motions? What are they? What is stated of the mind in connection with these movements?]

44. Another variety of reflex motions takes place in certain involuntary muscles, and over these the cord exercises supreme control. They are princ.i.p.ally those movements which aid the performance of digestion and nutrition, the valve-action of the pylorus, and other movements of the stomach and intestines. In these movements the mind shares no part. And it is well that this is so; for since the mind is largely occupied with affairs external to the body, it acts irregularly, becomes fatigued, and needs frequent rest. The spinal cord, on the contrary, is well fitted for the form of work on which depends the growth and support of the body, as it acts uniformly, and with a machine-like regularity.

[Sidenote: 45. Consciousness in these operations? Physical wants?]

45. These operations are not accompanied by consciousness; for, as a general rule, the attention is only called to them when they become disordered. Many a person does not know where his stomach is situated, until he discovers its position by reason of a feeling of distress within it, produced by giving that organ improper work to perform. In this manner the higher and n.o.bler faculties of the mind are liberated from the simply routine duties of the {170} body; and we are thus left to direct the attention, the reason, and the will to the accomplishment of the great ends of our existence. If it were otherwise, we could only find time to attend to our ordinary physical wants.