Curiosities of Medical Experience Part 18

Mynheer Foersech further a.s.sures his gentle readers that he witnessed several of these expeditions, and entreated the culprits to bring him some branches of the tree; but two withered leaves were the only specimens he could obtain from the solitary wretch who had the good fortune to escape, and who described the tree as growing on the borders of a rivulet, being of moderate height, and surrounded by a cl.u.s.ter of young ones. The ground around them was of a brown sandy nature, and strewed with the remains of human victims. He also clearly ascertained that no living creature can exist within fifteen miles of the spot. The streams that flow near it yield no fish, and the birds that fly over it fall to the ground; several of the latter were occasionally brought to the priest,--whether he ate them, or not, the Dutchman does not inform us. Amongst various offenders doomed to death by this poison he relates the case of thirteen ladies, who, for the crime of infidelity, were inoculated in the bosom with the point of a kritz or Malayan dagger dipped in the upas; and in sixteen minutes they had ceased to live. By recent experiments upon animals this part of his narration may be credited; but, in regard to the other account, we must apply to it the French saying, "_Il vaut mieux y croire que d'y aller voir_." Indeed the whole of Foersech's account is justly considered a fiction.

However, some French travellers thought otherwise; and Mr. Deschamps, physician and naturalist attached to the expedition of Mr.

D'Entrecasteaux, when in Java, ascertained that this wonderful tree was not uncommon in the forests of the country, nor was the approach to it in the slightest degree apprehended. The juice procured by incisions in the bark was called by the natives _upas_ or _oupas_, and was of so active a nature that it caused immediate death when thrown into the circulation.

The Malays mixed it with various other ingredients more especially galanga and garlic, when they employed it. The Javanese only impregnated their arrows with it for the chase: a proof that they did not consider it as affecting the system of the slain animal. Most probably Foersech's priest was aware of this circ.u.mstance when he accepted from the privileged malefactors the game killed by the tree they had sought.

This tree, according to Deschamps, is named in the country, _pohou antiar_; it frequently rises to the height of thirty or forty feet. When one of its branches is broken, or its bark incised, a milky juice exudes, which becomes insp.i.s.sated when in contact with the atmosphere. In appearance this tree bears some resemblance to our elm. Mr. Deschamps confirms the relation of Rumphius, who stated that the Dutch, in their wars with the natives, were obliged to wear thick buff cuira.s.ses to protect them against their poisoned missiles, the wounds of which were inevitably fatal.

Further information relative to the upas has been afforded by the ingenious Mr. Leschenault, who, during his residence in Java, procured two specimens of the poisonous substance obtained in Java, and of that brought from the islands of Borneo and Maca.s.sar. In Borneo, the mountaineers of the interior, who are called _Orang-Daias_, collect it, and keep its preparation a profound secret. They carry it carefully wrapped up in palm-leaves. Their hunting arrows have heads spear-pointed, and impregnated with this substance; those that are prepared for war bear a shark's tooth fixed in a bra.s.s socket, and merely attached to the shaft by the gum resin of the ipo; the barbed point remaining rankling in the wound it has inflicted, the gum dissolves, and speedily brings on death. Mr.

Leschenault tried these arrows on dogs and other animals, and they expired shortly after in horrible convulsions.

But the latest account of this celebrated tree is given by Dr. Horsfield who was in Java during its occupation by our troops. He informs us that although the Dutch surgeon Foersech's account must have been a fabrication, yet there did exist a tree called the _Anchar_ from the sap of which the natives prepared a fatal poison. The tree belongs to the 21st cla.s.s of Linnaeus, the _Monaecia_. The male and female flowers are produced on the same branch at no great distance from each other, the females being in general above the males. The seed-vessel is an oblong drupe, covered with the calyx; the seed an ovate nut with cells. The top of the stem sends off a few stout branches, which spreading nearly horizontally with several irregular curves, divide into smaller branches, and form a hemispherical, not very regular crown. The stem is cylindrical, perpendicular, and rises completely naked to the height of sixty or seventy, and even eighty feet. Near the surface of the ground it spreads obliquely like many of our large forest trees. The bark is whitish, slightly bursting into longitudinal furrows. Near the ground this bark is, in old trees, more than half an inch thick, and when wounded yields copiously the milky juice from which the poison is prepared. This juice is yellowish, frothy, and becomes brown when exposed to the air.

In making these researches Dr. Horsfield had some difficulty with the native labourers, who feared a contagious eruption, but nothing more. The Doctor further informs us that it is fatal to animals,--destroying dogs in an hour, mice in ten minutes, monkeys in seven, and cats in fifteen, while a buffalo subjected to the experiment was two hours and ten minutes dying.

The natives of Maca.s.sar also call this venomous production _ipo_. They have two varieties of the tree, as in Java; the one called _upas antiar_, and the other, much more violent and prompt in its action, _upas tieute_ In the preparation of the poison for use much mystery is observed by the natives, and various ingredients are mixed up with it; but as they are known to be harmless, such as onion and garlic juice, pepper, ginger, galanga, they are most probably employed to deceive the curious who might wish to ascertain the nature of this deadly composition.

Mr. Leschenault having brought home a small quant.i.ty of this poison, it was tried by Messrs. Delile and Magendie in several experiments, when it was found to act more or less violently, according to the age and size of the individual, or the quant.i.ty of the upas. One grain and a half inoculated in a young dog killed it in four minutes, only producing one convulsive fit. In a dog weighing fourteen pounds, half a grain of upas occasioned death at the expiration of one hour and fifty-seven minutes, during which the animal experienced several violent convulsions. A few drops of diluted upas, injected in the chest of a dog, weighing twenty pounds, occasioned a lock-jaw, which destroyed him in a minute and a half.

Eight drops injected in the jugular vein of a horse produced immediate teta.n.u.s and speedy death. For further information regarding these cruel experiments we must refer to the experimenter's publication. It appears, however, that the power of this venomous substance is so intense that time does not weaken it; for the upas employed in these experiments had been collected and kept for upwards of seven years, when its effects were as prompt as when tried in a recent state. The natives of Java consider sea-salt as the best antidote, but Mr. Delile found it quite inert: various experiments induced him to think that in these cases death is produced by asphyxia; and he considers the means employed to restore suspended animation in persons supposed to have been drowned, as the most likely to save the life of individuals who might be wounded with this substance. The rapidity with which poisonous substances are absorbed in the system is truly terrific, more especially in such as are of a narcotic nature. The latter act by abolishing all nervous energies, but when applied locally their effects are also local, as is shown by the following experiments of Muller:

"I held the nerve of a frog's leg which was separated from the body, in a watery solution of opium for a short time, and that portion of the nerve lost its irritability, i.e. its property of exciting twitchings of the leg when it was irritated; but below the part that the poison had touched the nerve still retained this function."

It is therefore evident that before narcotic poisons can exert a general influence they must be carried into the circulation. Duprey and Brachet, two French physiologists, have sought to prove that animals cannot be destroyed by narcotic poisons, introduced in the stomach, if the _nervus vagus_ has been divided on both sides; at least, that they do not die so soon. However, Wernscheidt, in thirty experiments on mammalia, could not perceive this difference, provided the animals were of the same size and species.

Prussic acid exerts its influence so rapidly that it cannot be supposed to have been thrown into the circulation. The spirituous solution of the extract of nux vomica introduced in the mouth of a rabbit, produces immediate death, whereas when applied to any nerve distant from the brain it produces no general symptoms.

This rapid effect of prussic acid is supposed to arise from its great volatility and powers of expansion, by which it is diffused more quickly through the circulation than the blood. According to Schrader one drop of this substance introduced in the bill of a bird killed it in four or five minutes. Hydrocyanic acid gas mixed with atmospheric air has when inhaled destroyed dogs, cats, rabbits, and various birds, in from two to ten seconds. Magendie found that the introduction of one drop of the acid in the jugular vein caused instantaneous death; a gla.s.s tube dipped in this perilous substance applied to the tongue of a dog, produced a similar effect, which was also the result when applied to the eye.

It is not generally known that tobacco and its preparations are deadly poisons, one drop of oil of tobacco introduced in the mouth of a dog produced violent convulsions with hurried breathing; a quarter of an hour after, the unfortunate animal seemed to be recovered, when the introduction of another drop killed it in two minutes. M'Cartney and Orfila obtained similar results, though no such effects were produced when it was applied to a nerve or the surface of the brain.

The French poet Santeuil died from having drank wine in a gla.s.s containing some snuff. In all cases of death produced by this substance the lungs are found dense and livid.

It is not only in the upas that the Indians seek the means of poisoning their missiles. In America they employ the _Ticronas_ a juice extracted from various plants, and the preparation of which, transmitted from one generation to another is considered a valuable secret. La Condamine a.s.serts that its mere odour is sufficient to destroy the criminals doomed to smell it, but Fontana has found by many experiments that this a.s.sertion was made upon report, which travellers too frequently rely upon to save themselves the trouble of investigation. Arrows saturated with this poison, become more active after having been dipped in hot water.

The Indians of Guiana dip their arrows in the juice of the _Woorara_, and the _Curara_, which also occasions rapid death and decomposition of the lungs. Humboldt informs us that the _Curara_ is obtained from the bark of a tree called _Vejuco_ de _Mavacure_; it is insp.i.s.sated over a slow fire and then mixed with a gum drawn from the _Kiracagnero_. The Abbe Salvador Gilii tells us in his history of America, that he has seen the strongest animals succ.u.mb instantly when thus wounded, but the poison does not produce any effect on their meat.

h.o.m.oPHAGOUS AND POLYPHAGOUS.

These are appellations given to certain individuals of a depraved appet.i.te, that enables them to devour raw meat, and various other substances which most unquestionably would destroy any person not gifted or cursed with such an omnivorous digestion.

Various are the ancient stories related of such voracious wretches. Ovid describes one Erisichthon, who, as a punishment for cutting down the groves of Ceres, (very possibly to obtain fuel to cook his food,) was sentenced to perpetual hunger, and terminated his gluttonous career by eating up his own limbs. Theagenes thought nothing of an ox for his dinner; and the famed Crotonian athlete, Milo, knocked down bullocks with his fist for his daily meals, which usually consisted of twenty _minae_ of meat and the same ration of bread. Vopiscus relates that a man was brought before the Emperor Maximilian, who devoured a whole calf, and was proceeding to eat up a sheep, had he not been prevented. To this day, in India, some voracious mountebanks devour a live sheep as an exhibition.

Dr. Boehmen of Wittenberg witnessed the performance of one of these polyphagous individuals, who commenced his repast by eating a raw sheep, a sucking-pig, and, by way of dessert, swallowed sixty pounds of prunes, stones and all. On another festive occasion, he ate two bushels of cherries, with several earthen vases, and chips of a furnace. This meal was followed up by sundry pieces of gla.s.s and pebbles, a shepherd's bagpipe, rats, various birds with their feathers, and an incredible number of caterpillars. To conclude his dinner, he swallowed a pewter inkstand, with its pens, a pen-knife, and a sandbox. During this deglut.i.tion he seemed to relish his food, but was generally under the influence of potations of brandy. His form was athletic, and he could carry four heavy men on his shoulders for a league. He lived to the age of seventy-nine, but died in a most emaciated state, and, as might be imagined, toothless.

Helwig knew an old man who was in the habit of eating eighty pounds of different articles of food daily. Real Colomb mentions an omnivorous glutton, who, in the absence of any salutary aliment, satisfied his cravings with any other substance, and was once known, when hungry, to eat the contents of a sack of charcoal, and then to swallow the bag to facilitate its digestion. One of the attendants on the menagerie of the Botanical Gardens in Paris, who bore the euphonious name of _Bijou_, used to devour all the offals of the theatre of Comparative Anatomy, and ate a dead lion in one day. He was active, and lived to the age of sixty. A cannibal once desolated the Vivarais, by dragging human victims to his den, where he devoured them. On the opening of the corpse of a convict in the galleys of Brest, there were found in his stomach about six hundred pieces of wood, pewter, and iron.

All these accounts might appear most exaggerated, perhaps fabulous, had not many physicians in Paris known the celebrated Tarrare. The history of this monster is as curious as his habits were disgusting. He commenced his career in life in the capacity of clown to an itinerant quack, and used to attract the notice of the populace by his singular powers of deglut.i.tion, swallowing with the utmost ease corks, pebbles, and basketsful of apples.

However, these experiments were frequently followed by severe pain and accidents, which once obliged him to seek a.s.sistance in the Hotel Dieu of Paris. His sufferings did not deter him from similar experiments; and he once tried to exhibit his wonderful faculties by swallowing the watch, chain and seals, of Mr. Giraud, then house-surgeon of the establishment.

In this repast he was foiled, having been told that he would be ripped up to recover the property. In the revolutionary war, Tarrare joined the army, but was soon exhausted on the spare diet to which the troops were obliged to submit. In the hospital of Sultzen, although put upon four full rations, he was obliged to wander about the establishment to feed upon any substance he could find however revolting, to subdue his voracious hunger.

These singular powers induced several physicians to ascertain how far these omnivorous inclinations could carry him in his unnatural cravings.

In presence of Dr. Lorentz he devoured a live cat, commencing by tearing open its stomach, and sucking the animal's blood with delight. What was more singular, after this horrible feast, like other carnivorous brutes, he rejected the fur and skin. Snakes were to him a delicious meal, and he swallowed them alive and whole, after grinding their heads between his teeth. One of the surgeons, Mr. Courville, gave him a wooden lancet-case to swallow in which a written paper had been folded. This case was rejected undigested, and the paper being found intact, it became a question whether he might not be employed to convey secret correspondence; but having been taken up at the Prussian outposts as a spy, being disguised as a peasant without a knowledge of the language, he received a severe bastinado, which effectually cured him of an appet.i.te for secret service, and on his return he had recourse to the safer means of obtaining food in kitchens, slaughter-houses, and dunghills. At last, a child of fourteen months old having disappeared under suspicious circ.u.mstances, he was driven out of the hospital, and lost sight of for four years, when he applied for admission into the hospital of Versailles, in a state of complete exhaustion, labouring under a violent diarrhoea, which terminated his hateful existence in his twenty-sixth year. He was of the middle size, pale, thin, and weak; his countenance was by no means ferocious, but, on the contrary, displayed much timidity; his fair hair was remarkably fine and soft; his mouth was very large, and one could scarcely say that he had any lips; all his teeth were sound, but their enamel was speckled; his skin was always hot, in a state of perspiration, and exhaling a constant offensive vapour. When fasting, the integuments of his abdomen were so flaccid that he could nearly wrap them round him.

After his meals the exhalation from his surface was increased, his eyes and cheeks became turgid with blood, and, dropping into a state of drowsiness, he used to seek some obscure corner where he might quietly lie down and digest. After his death, all the abdominal viscera were found in a state of ulceration.

Instances are recorded where a similar facility to swallow fluids had been observed. At Strasburg the stomach of a hussar was exhibited who could drink sixty quarts of wine in an hour. Pliny mentions a Milanese, named _Novellus Torquatus_, who, in presence of Tiberius, drank three _congii_ of wine. Seneca and Tacitus knew a man of the name of Piso who could drink incessantly for two days and two nights; and Rhodiginus mentions a capacious monster called _the Funnel_, down whose throat an amphora of liquor could be poured without interruption.

To what are we to attribute these uncommon, nay, these unnatural faculties? Neither physiological experiments during life, nor anatomical investigation after death, have hitherto enabled us to form an opinion.

Great as the progress of science has been, we are still doubtful as to the nature of the digestive process. All the hypotheses on the subject are liable to insuperable objections. Hippocrates and Empedocles attributed digestion to the _putrefaction_ of food. Experiments have clearly demonstrated the fallacy of this doctrine: rejected food is never in a state of putridity; on the contrary, meat in a perfect state of putrescence has been restored to sweetness and freshness on being received into the stomach. Dead snakes have been found with animal substances, part of which had been swallowed and the remainder hanging out of their mouths; when the swallowed portion was fresh, and the portion exposed to the atmosphere in a state of corruption. Galen, and after his school, Grew and Santarelli, ascribed digestion to a _concoction_, during which, food was maturated by the stomach's heat, like fruit by the solar rays. Pringle and Macbride advocated the doctrine of _fermentation_; while Borelli, Keil, and Pitcairn resolved the question by the mechanism of _trituration_, making a mill of the stomach, which ground down food, according to Pitcairn's calculations, with a pressure equal to a weight of one hundred and seventeen thousand and eighty pounds. Boerhaave endeavoured to reconcile the opinions of the _concocters_ and _grinders_, by combining the supposed theory of _concoction_ and _trituration_.

Lastly, Cheselden fancied that digestion was operated by a peculiar secretion in the stomach, called _gastric juice_; and Haller, Reaumur, Spallanzani, Blumenbach and most other modern physiologists, concur with him in the same opinion, although admitting that this function is most probably a.s.sisted by various accessory circ.u.mstances.

This juice was found, upon experiment, to be endowed, not only with the antiseptic power of preserving the contents of the stomach from putrefaction, but with the property of being a most powerful solvent.

Pieces of the toughest meats and bone have been enclosed in perforated metallic tubes, and thrust down the stomach of carnivorous birds, and in the s.p.a.ce of about twenty-four hours the meats were found to be diminished, or, in other words, digested to three-fourths of their bulk, while the bones had totally disappeared. Dr. Stevens had recourse to a similar experiment on the human stomach, by means of a perforated ivory ball, and with the same result. The gastric juice of the dog dissolves ivory; and that of a hen has dissolved an onyx, and diminished a golden coin. Not long since, upon examining the stomach and intestines of a man who died in a public-house, he was found to have been a _polyphagous_ animal, since several clasp-knives that he had swallowed were discovered with their blades blunted and their handles consumed. Since these experiments, however, Dr. Montegre of Paris, who was gifted with the faculty of discharging the contents of his stomach at will, has fully proved that this gastric juice, when not in an acid state, is subject to putrefaction when submitted to external animal heat; that this corruption did not occur when an acid prevailed, and saliva intermixed with vinegar was equally free from a similar decomposition. He moreover a.s.serts, that he had recourse to numerous experiments to digest food artificially in this supposed solvent, but without obtaining results similar to those advanced by Spallanzani; and, finally, he found little or no difference between the gastric juice and saliva. This acid, which generally exists in the gastric juice, has been ascertained by Dr. Prout to be the muriatic, both free and in combination with alkalis: while Tiedemann and Gmelin maintain that, in its natural state, no acid is to be met with; but that, when food is commingled, an acid which they consider the acetic acid is produced in considerable quant.i.ty.[17]

The ostrich, that may be considered a connecting link between birds and quadrupeds, is gifted with powerful digestive organs, and is known to swallow stone, gla.s.s, and iron; but this faculty appears to be a gift of all-bounteous Providence, to enable the creature to digest the various substances it meets with when traversing burning deserts for hundreds of miles, when these hard bodies actually perform the function of teeth in the animal's stomach, by aiding the comminution of its indigestible food.

The structure of the ostrich has a near resemblance to that of the camel, destined to perform the same dreary journeys. The wings are not designed for flight, and in speed he equals the horse. Adanson affirms that he had seen two ostriches at the factory of Podore, that were broken in to carry single or double riders, and the strongest and youngest would run more swiftly with two negroes on his back than the fleetest racer.

Spallanzani endeavoured to prove that the pebbles and gravel swallowed by various birds were of no use in the process of digestion; but Hunter, who had found two hundred pebbles in the gizzard of a turkey, and one thousand in that of a goose, demonstrated their utility in the trituration of their food, since these birds were found to be unable to digest, and consequently to thrive upon their nourishment when deprived of this mechanical aid. It is curious that the owl, which easily digests meat and bones, cannot be made to digest bread or grain, and yet dies if confined to animal food. The eagle, and other birds of prey, can dissolve both. A singular process of digestion is observed in the stormy petrel, which lives entirely on oil and fat substances whenever it can obtain them; but when fed with other articles of food, Nature, true to her laws, converts them into oil; the bird still discharges pure oil at objects that offend him, and feeds his young with the same substance. The petrel must, no doubt, be a bilious subject, for he delights in misery, and his presence is a sure presage of foul weather to the experienced seamen; and when

The wrathful skies Gallow the very wanderers of the dark, And make them keep their caves,

he is seen riding triumphantly on the whirlwind, and skimming the deepest chasms of the angry waves. This bird is said to be named 'petrel' from Peter, since, like that saint, he is supposed to have the power of walking on the waters.

The singular appet.i.tes which have been noticed seem to have been individual peculiarities, uninfluenced by a morbid condition; but there are cases in which a depraved appet.i.te is symptomatic of disease, where we see persons otherwise possessed of sound judgment longing, not only for the most improper and indigestible food, but for substances of the most extraordinary and even disgusting nature. Thus we have seen patients, more especially young females and pregnant women, devouring dirt, cinders, spiders, leeches, hair, tallow, and paper. An ingenious writer affirms that "more literature in the form of paper and printed books has been thus devoured, than by the first scholars in Christendom."

Dr. Darwin tells us that he saw a young lady about ten years of age that used to fill her stomach with earth out of a flowerpot, and then vomited it up, with small stones, bits of wood, and wings of various insects. John Hunter has described an endemic disease among the Africans in Jamaica, in which they devoured dirt. Mason Good, when speaking of this affection, says, "that the longing for such materials is, in this disease, a mere symptom, and rarely shows itself till the frame is completely exhausted by atrophy, dropsy, and hectic fever, brought on by a longing of a much more serious kind,--a longing to return home, a pining for the relations, the scenes, the kindnesses the domestic joys, of which the miserable sufferers have been robbed by barbarians less humanized than themselves, and which they have been forced or trepanned to resign for the less desirable banquet of whips, and threats, and harness, and hunger."

Roderic a Castro relates the case of a lady who could eat twenty pounds of pepper, and another who lived upon ice. Tulpius mentions a woman who, during her pregnancy, longed for salt herrings, and ate fourteen hundred at the rate of five herrings per diem. Longius affirms that a lady in Cologne, who was in that state that ladies wish to be who love their lords, took such a fancy to taste the flesh of her husband that she actually a.s.sa.s.sinated him, and, after indulging in as much fresh meat as the weather permitted, salted the remainder for further use. This cannibal inclination seems not to be uncommon. The said Roderic a Castro knew a woman in the same thriving condition, who felt an inexpressible desire for a bit of the shoulder of a neighbouring baker, and her husband was persecuted by her constant prayers and lamentations to prevail on the worthy man to allow her one bite for charity's sake: but the first bite was so heartily inflicted, that the crusty baker would not submit to a second.

In the Philosophical Transactions there is a case related of a woman whose fancies were not quite so solid, and who used to gratify her aerial appet.i.tes by putting the nozle of a bellows down her throat, and blowing away until she was tired. These longings of parturient women are most common; but it is rather curious, that, among our negroes in the West Indies, the husbands pretend to long for their wives, and endeavour to gratify them by proxy. Possibly such might have been the fancy of Cambes, the Lydian prince, who, according to aelian, took it into his head one night to eat up his beloved wife.

CAUSES OF INSANITY.

Madness is attributed to moral and physical causes. Physicians do not agree as to the prevalence of either of these sources of human misery.

Some of them, most unjustly accused of materialism, seem to lean to the opinion that, generally speaking, physical causes can be traced in _post mortem_ examination; while others, equally skilled in accurate anatomical investigations, maintain that these organic derangements are very seldom met with.

Lawrence affirms that he had "examined after death the heads of many insane persons, and had hardly seen a single brain which did not exhibit obvious marks of disease;" and he further states, "that he feels convinced from his own experience, that very few heads of persons dying deranged will be examined after death without showing diseased structure, or evident signs of increased vascular activity." The celebrated Morgagni gives similar results of his extensive dissections. Meckel and Jones are of the same opinion. However, Pinel, whose anatomical pursuits on the subject were most extensive, clearly declares that he never met with any other appearance within the cavity of the skull than are observable in opening the bodies of persons who have died of apoplexy, epilepsy, nervous fevers and convulsions. Haslam, whose experience in this matter was also very great, a.s.serts that nothing decisive can be obtained in reference to insanity from any variations of appearance that have hitherto been detected in the brain. Greding observed in two hundred and sixteen maniacal cases which he examined, the whole of whom died of disorders unconnected with their mental ailments, that three of the heads were exceedingly large, two exceedingly small; some of the skull bones were extremely thick, others peculiarly thin; in some the frontal bones were small and contracted, in others the temporal bones compressed and narrow.

In this confusion and clashing of opinions, when unfortunately each theorist views, or fancies that he views, functional or organic derangements sufficiently evident (in his eyes at least) to support his doctrine, it is no easy matter to come to a fair conclusion. It can only be observed, that, as the wonderful sympathies of the brain with other organs especially the viscera of the abdomen, are universally acknowledged, the morbid condition in which the brain is occasionally found may have arisen from a primary morbid condition of some other organ.

Hence it is difficult to say whether insanity is most generally a primary or a secondary affection. Physical causes act both upon the brain and the abdominal system. Concussion and compression of the brain will occasion nausea, vomiting, and hepatic affections, and the presence of worms in the intestines will excite convulsions and epilepsy. In regard to moral causes, they may also act directly or indirectly upon the brain, or the parts that sympathize with it. Sudden or violent emotions are known to produce an immediate effect upon our digestive functions, which may in turn by their sympathetic connexion act upon the brain and the mind, although the connexion between brain and mind is not yet proved in any conclusive manner.

However, in a practical point of view, whatever discrepancy of opinion may prevail on this subject, I think it will be found advisable to consider most, if not all recent cases of insanity, as arising from physical causes, and therefore to submit the patient to such a medical treatment in addition to moral aid, as the prevalence of morbid symptoms of local derangement are more or less evident. My own experience has fully convinced me that a morbid condition of the cerebral organ, and the viscera of the thorax and abdomen, are invariably met with, and must have proved of sufficient importance to develop symptoms which the slightest observations might have detected. How far the organic derangement may have been either the cause or the result of insanity I am not prepared to say, but they have generally borne the appearance of having originated in undue excitement.

On this most important subject I feel much gratification in quoting the following opinion of the experienced Pinel: "It appears in general that the primitive seat of insanity is in the region of the stomach and intestinal ca.n.a.l, and it is from this central part that mental aberration is propagated as by irradiation." Esquirol is of opinion that insanity arises from a lesion of the vital functions of the brain, and not unfrequently from a disturbance in the various points of sensibility in different parts of the system.