The People's Common Sense Medical Adviser in Plain English Part 13

How shall we distinguish the combination of organic elements, if not by the manner in which they characterize the const.i.tution? Every human being is distinguished by natural peculiarities, both mental and physical. These are indicated not only by the color of the eyes, hair, and skin, and the mental expressions, but in the conformation and capabilities of the corporeal system. The color, form, size, and texture of a leaf indicate to the expert pomologist the nature of the fruit which the tree will bear, but how much more important is it to understand the harmonies of human development. If Prof. Aga.s.siz could determine the form and size of a fish by seeing its scales, and Prof.

Owen outline the skeleton of an unknown animal by viewing a portion of its fossil, why should not the physician understand the language of temperaments, since it opens to him the revelations of human development? The sculptor blends character with form, the artist endows the face with natural expression, the anatomist accurately traces the nerves and arteries, the physiognomist reads character, which the novelist delineates and the actor personates, because there are facts behind all these, the materials wherewith to construct a science. In organization there are permanent forces which operate uniformly, thus revealing the order of nature.

THE TEMPERAMENTS CLa.s.sIFIED.

[Ill.u.s.tration: Fig. 80]

We propose to speak of four const.i.tutional variations ent.i.tled to separate consideration; the lymphatic, the sanguine, the volitive, and the encephalic. The brain controls all the voluntary, and modifies the involuntary functions of the body. A particular cerebral development modifies the functions of all the bodily organs, and thus tempers the const.i.tution. We shall, therefore, base our cla.s.sification of temperaments upon the mental and physiological characteristics, which are portrayed by cerebral development. Such an arrangement is ill.u.s.trated by Fig. 80.

THE LYMPHATIC TEMPERAMENT.

The lymphatic temperament predominates when the anterior base of the brain and the middle lobe are developed so as to exert a preponderating influence over the bodily functions. The character of this influence we have described in cerebral physiology. It is difficult to state precisely the normal influences and nerve-forces which arise from these faculties, but it is evident that they are specially related to nutritive attraction, in opposition to volitive repulsion. It is only their excessive influence which produces worthless, miserable, morbid characters. A const.i.tution marked by this development is indolent, relaxative, and an easy prey to epidemics. This treatment is also characterized by a low grade of vitality or resistance. When life is sustained by the volitive powers, it is distinguished by a softness of the bodily tissues, and the prevalence of lymph. The fact that all the organic functions are performed indolently, indicates lack of vital power. An excellent ill.u.s.tration of this temperament is found in Fig.

81, which represents a Chinese gentleman of distinction. In the lower order of animals, as in sponges, absorption is performed by contiguous cells, which are quite as effortless as in plants. Because of their organic indolence, sponges are often cla.s.sed as vegetables. A body having an atonic or a lymphatic temperament is abundantly supplied with absorbent organs, which are very sluggish in their operations. In the lymphatic temperament, there seems to be less constructive energy, slower elaboration, and greater frugality. Lymph is a colorless or yellow fluid containing a large proportion of water. It is not so highly organized as the blood, but resembles it, when that fluid is deprived of its red corpuscles. In the sanguine temperament, circulation in the blood-vessels is the most active, in the lacteals next, and in the lymphatics the least so, but in the lymphatic temperament, this order is reversed.

[Ill.u.s.tration: Fig. 81.]

Dr. W.B. Powell has observed that a lymphatic man has a large head, while a fat man has a small one, and also that fat and lymph, are convertible, one following the other, _i.e.,_ "a repletion consisting of fat may be removed, and one of lymph may replace it, and _vice versa_."

He could not account for these alternations. The bear goes into his winter quarters sleek and fat, and comes forth in the spring just as plump with lymph, but he loses this fat appearance soon after obtaining food. This simply indicates that, during lymphatic activity, the digestive organs are comparatively quiescent. But when these are functionally employed again, lymphatic economy is not required. It is the duty of the lymphatics to slowly convert the fat by such transformation, that when it reaches the general circulation, it may there unite with other organic compounds, the process being aided by atmospheric nitrogen, introduced during the act of respiration. In this way it may become changed into those chemically indefinite, artificial products, called proteid compounds. This view is supported by the disappearance of fat as an organized product in the lymph of the lymphatic vessels, indicating that such transformation has occurred. In this way, by uniting with other organic compounds, it appears that lymph may serve as a weak basis for blood; that atmospheric nitrogen is also employed in forming these artificial compounds, is indicated by the fact that there is sometimes less detected in arterial than in venous blood.

[Ill.u.s.tration: Fig. 82.

Judge Green, of the United States Court. ]

This temperament is indicated by lymphatic repletion, soft flesh, pale complexion, watery blood, slow and soft pulse, oval head, and broad skull, showing breadth at its base. Fig. 82 ill.u.s.trates this temperament combined with sanguine elements. In all good ill.u.s.trations of this temperament, there is a breadth of the anterior base of the skull extending forward to the cheek bones. There is likewise a corresponding fullness of the face under the chin, and in the neck, denoting a large development of the anterior base of the cerebrum. The cerebral conformation of the Hon. Judge Green indicates mental activity, and we have no reason to suppose that lymph was particularly abundant in his brain.

[Ill.u.s.tration: Fig. 83.]

While this description of the lymphatic temperament is correct, when ill.u.s.trated by the civilized races of men who are accustomed to luxury, ease, and an abundance of food, it does not apply with equal accuracy to the cerebral organization of the American Indian. His skull, though broad at its anterior base, and high and wide at the cheek bones, differs from the European in being broader and longer behind the ears.

Fig. 83 is an excellent representation of a noted North American Indian.

While a great breadth of the base of the brain indicates morbid susceptibilities, yet these, in the Indian, are opposed by a superior height of the posterior part of the skull. Consequently, he is restless, impulsive, excitable, pa.s.sionate, a wanderer upon the earth. The basilar faculties, however, are large, and he is noted for instinctive intelligence. His habits alternate from laziness to heroic effort, from idleness and quiet to the fierce excitement of the chase, from vagabondism to war, sometimes indolent and at other times turbulent, but under all circ.u.mstances, irregular and unreliable. In this case, lacteal activity is greater than lymphatic, as his nomadic life indicates.

Nevertheless, he manifests a morbid sensibility to epidemic diseases, especially those which engender nutritive disorders and corrupt the blood. Figs. 84 and 85 represent the brain of an American Indian, and that of a European, and show the remarkable difference in their anatomical configuration. Evidently it is a race-distinction. Observe the greater breadth of the brain of the Indian, which according to cerebral physiology indicates great alimentiveness, indolence, morbid sensibility, irritability, profligacy, but also note that it _differs materially in the proportion of all its parts_, from the European brain.

Judging the character of the Indian from the aforesaid representation, we should say that he was cunning, excitable, treacherous, fitful, taciturn, or violently demonstrative. His const.i.tution is very susceptible to diseases of the bowels and blood. His appet.i.te is ungovernable, and his love of stimulants is strong. Syphilitic poison, small-pox, and strong drink will annihilate all these tribes sooner than gunpowder. Their physical traits of const.i.tution are no less contradictory than their extremes of habit and character, for while there is evidence of _lymphatic elements_, yet it is contradicted by the color of the hair, eyes, and skin. This peculiar organization will not blend in healthful harmony with that of the European, and this demonstrates that the race-temperaments require separate and careful a.n.a.lytical consideration.

[Ill.u.s.tration: Fig. 84.

American Indian.

Fig 85.

European.

(FROM MORTON'S CRANIA AMERICANA.)

In the American Indian, the anterior lobe, lying between _AA_, and _BB_, is small, and in the European it is large, in proportion to the middle, lying between _BB_ and _CC_. In the American Indian, the posterior lobe, lying between _C_ and _D_ Is much smaller than in the European. In the Indian, the cerebral convolutions on the anterior lobe and upper surface of the brain, are smaller than the European. If the anterior lobe manifests the intellectual faculties--the middle lobe the propensities common to man with the lower animals--and the posterior lobe, the conservative energies, the result seems to be, that the intellect of the American Indian is comparatively feeble--the European, strong; the animal propensities of the Indian will be great--in the European, more moderate; while reproduction, vital energy, and conservation of the species in the Indian is not as great as with the European. The relative proportions of the different parts of the brain differ very materially.]

By physical culture and regulation of the habits, the excessive tendencies of this temperament may be restrained. Solid food should be subst.i.tuted for a watery diet. If it be limited in quant.i.ty, this change will not only diminish the size, but increase the strength of the body.

The body should be disciplined by daily percussion until the imperfectly constructed cells, which are too feeble to resist this treatment, are broken and replaced by those more hardy and enduring. Add to this treatment brisk, dry rubbing, calisthenic exercises, and daily walks, which should be gradually extended. Continue this treatment for three months, and its favorable effects upon the temperament will surprise the most skeptical; if continued for a year, a radical alteration will be effected, and the hardihood, health, and vigor of the const.i.tution will be greatly increased.

This temperament may be improved physiologically, by being blended with the sanguine and volitive. The offspring will be stronger, the structures firmer, the organization more dense. Nutrition, a.s.similation, and all the constructive functions will be more energetic in weaving together the cellular fabric of the body. The sanguine temperament will add a stimulus to the organic activities, while the volitive will communicate manly, brave, and enduring qualities. When this temperament is united with the encephalic, if such a union does not result in barrenness, it adds _expending_ and _exhaustive_ tendencies to the _enfeebling_'ones already existing, and, consequently, the offspring lacks both physical power and intellectual activity.

The peculiarities of this temperament are observed in the diseases which characterize it. It is specially liable to derangements of digestion, nutrition, and blood-making. The blood is easily poisoned by morbid products formed within the body, as well as by those derived from the body of another. This is seen in pyaemia, produced by the introduction of decomposing pus, or "matter," into the blood. This condition is most likely to occur when the vital powers are low and the energies weak, for then the fibrin decreases, the red corpuscles diminish in number, the circulation becomes languid, the pulse grows fluttering and weak, and this increases until death ensues. An individual of this temperament is more easily destroyed than any other "by the poison of syphilis, small-pox, and other contagious diseases. If the blood has received any hereditary taint, the lymphatic glands not only reproduce it but often increase the virulency of the original disease. This temperament indicates a necessity for the employment of stimulating, alterative, and antiseptic medicines. The torpid functions need arousing, the blood needs depuration, i.e., the elimination of corrupting matter, and the system requires alteratives to produce these salutary changes. The secretions need the correcting influence of cleansing remedies for the purification of the blood.

Persons of this temperament are more liable to absorption of morbid products within the body, which are in a state of decomposition, producing an infection of the blood, technically termed _septicaemia_.

The fatal results which so suddenly follow child-bed fever are thus produced. This kind of poisoning sometimes takes place from the absorption of decomposed exudation in diphtheria, and, though rarely, from decomposing organic products collected in the lungs. Whenever the absorption of poison does take place, fatal consequences usually follow.

This pa.s.sive temperament is more likely to sink under acute attacks of disease, especially alimentary disorders, such as diarrhea, dysentery, and cholera. It quickly succ.u.mbs to their prostrating effects, such as depression, congestion, and fatal collapse which rapidly succeed one another. Venesection and harsh purgatives are contra-indicated, and the physician who persists in their employment kills his patient. How grateful are warmth and stimulating medicines! The most powerful, diffusible, and nervous stimulants are required in cholera, when the system is devastated by the disease, as the plain is laid waste by the fierce tornado.

THE SANGUINE TEMPERAMENT.

Lymph is the characteristic of the lymphatic temperament, and its specific gravity, temperature, and standard of vitality are all lower than that of red blood. In the sanguine temperament all the vital functions are more active, the blood itself has a deeper hue, its corpuscles carry more oxygen, the complexion is quite florid, and the arterial currents impart to every faculty a more hopeful vigor. The blood-vessels are the most active absorbents, eagerly appropriating nutritive materials for the general circulation, while the respiration adds to it oxygen, that agent which makes vital manifestation possible.

This temperament exhibits greater sensibility, the conceptions are quicker, the imagination more vivid, the appet.i.te stronger, the pa.s.sions more violent, and there is found every display of animal life and enjoyment.

A full development of the basilar faculties, indicated by an unusual breadth and depth of the base of the brain, accompanies this temperament. Its cerebral area includes the posterior and inferior portions of the cerebrum, the entire cerebellum, and that part of the medulla which connects with the spinal cord, all of which sustain intimate relations to vital conditions. Accordingly, such a development indicates good digestion, active nutrition, vigorous secretion, large heart and lungs, powerful muscles, and surplus vitality. The violent faculties, such as Combativeness, Destructiveness, and Hatred, are natural adjuncts, and their excess tends to sensuality and crime. They are not only secretive, appropriative, selfish, and self-defensive, but when redundant are aggressive and tend to destructiveness, the gratification of animal indulgence, intemperance, and debauchery. The correspondence between the cerebral conformation and the physical development is very obvious. Lower orders of animals possess these faculties, and their spontaneous exhibition is called instinct. They possess the acquisitive, destructive, and propagative propensities, which lead them to provide for their wants and secure to themselves a posterity. The exercise of their bodies causes a continual waste which demands incessant reparation, and they are governed measurably by these animal impulses.

All of these lower psychical faculties have a physiological significance. Acquisitiveness functionally expresses a.s.similation, accretion, animal growth, and tends to bodily repletion. Secretiveness expresses concealing, separating, withdrawing, and functionally signifies secretive action. Secretion is the separating and withdrawing from the blood some of its const.i.tuents, as mucus, bile, saliva, etc.

This latter process indicates complex conditions of organization, so that the higher and more complex the tissue, the greater the number of secretory organs. Unrestrained selfishness, while it naturally conserves the individual interests, in its ultimate tendencies, is the very essence of human depravity. Without qualification, clearly, it is crime, for blind devotion to the individual must be in utter disregard for the good of others. The ultimate tendencies of these faculties are, therefore, criminal.

Exaggerate the faculty of acquisitiveness, and it becomes avariciousness. Develop secretiveness and selfishness, and they become cunning and profligacy, desperation and crime. Their functional development tends to produce physical disorder and violent disease. All of these faculties are vehement, contentious, thriving by opposition.

Life itself has been called a forced state, because it wars with the elements it appropriates, and trans.m.u.tes their powers into vitality.

[Ill.u.s.tration: Fig. 86.]

We find men and women of this temperament, who are models of character and organization. George Washington is an excellent ill.u.s.tration. The impression that his presence made upon the Marquis de Chastellux, is given in the following words: "I wish only to express the impression General Washington has left on my mind; the idea of a perfect whole, brave without temerity, laborious without ambition, generous without prodigality, n.o.ble without pride, virtuous without severity." Gen.

Scott, Lord Cornwallis, Dr. Wistar, Bishop Soule John Bright, Jenny Lind Goldsmidt, and Dr. Gall are good representatives of this temperament.

Fig. 86 is an excellent ill.u.s.tration of it, finely blended and well balanced, in the person of Madame de Stael. This temperament requires fewer tonics and stimulants than the lymphatic. This const.i.tution is best able to restore vital losses. It is a vital temperament, in other words, it combines favorably with all the others, and better adapts itself to their various conditions. Some regard it as the best adjusted one in all its organs and tissues, and as the most satisfactory and serviceable.

[Ill.u.s.tration: Fig. 87.]

Excess of nutrition tends to plethora, to animal indulgence, and gross sensuality. Not only do the propensities rouse desire, but they excite the basilar faculties, and portray their wants in the outlines of the face, mould the features to their expression, and flash their significance from the eye. Who can mistake the picture of sensuality represented by Fig. 87? It is enough to shock the sensibility of a dumb animal, and to say that such a face has a beastly look, is an unkind reflection upon the brute creation. A large neck and corresponding development of the occipital half of the brain indicate nervous energy, yet nutrition is not absolutely dependent upon it, for the nutritive processes are active before a nervous system is formed. The lower faculties of the mind exert a remarkable influence over nutrition, secretion, and the molecular changes incident to life. Anger or fear may trans.m.u.te the mother's nourishing milk into a virulent poison. The following incident, taken from Dr. Carpenter's Physiology, ill.u.s.trates this statement: "A carpenter fell into a quarrel with a soldier billeted in his house, and was set-upon by the latter with his drawn sword. The wife of the carpenter at first trembled from fear and terror, and then suddenly threw herself between the combatants, wrested the sword from the soldier's hand, broke it in pieces, and threw it away. During the tumult, some neighbors came-in and separated the men. While in this state of strong excitement, the mother took up her child from the cradle, where it lay playing, and in the most perfect health, never having had a moment's illness; she gave it the breast, and in so doing sealed its fate. In a few minutes the infant left-off sucking, became restless, panted, and sank dead upon the mother's bosom. The physician who was instantly called-in, found the child lying in the cradle, as if asleep, and with its features undisturbed; but all resources were fruitless. It was irrecoverably gone. In this interesting case, the milk must have undergone a change, which gave it a powerful sedative action upon the susceptible nervous system of the infant."

Anxiety, irritation, hatred, all tend to the vitiation of the disposition and bodily functions, perverting the character and const.i.tution at the same time. Depravity of thought and secretion go together. Degradation of mind and corruption of the body are concomitants. There is a very close affinity between mental and moral perversion and physical prost.i.tution, of which fact too many are unconscious. Nervous influence preserves the fluidity of the blood and facilitates its circulation, for it appears that simple _arrestment_ of this influence favors the coagulation of the blood in the vessels; clots being found in their trunks within a few minutes after the brain and spinal marrow are broken down. Habitual constipation is the source of many ills. Perversion of the functions of the stomach, and of the circulation of the blood, produce general disaster.

Diseases which characterize this temperament are acute, violent, or inflammatory, indicating repletion and active congestion; intense inflammation, burning fevers, severe rheumatism, a quick, full pulse, great bodily heat, and functional excitement are its morbid accompaniments. These diseases will bear thorough depletion of the alimentary ca.n.a.l, active, hydragogue cathartics being indicated.

Sedatives and anodynes are also essential to modify the circulatory forces, and to relieve pain. Violent disturbance must be quelled, and among the remedial agents required for this duty we may include Veratrum, Ipecac, Digitalis, Opium, Conium, and Asclepias. While equalizing the circulatory fluids, restoring the secretions, and thoroughly evacuating the system, and thus endeavoring to remove disturbing causes, we find that the conditions of this temperament are exceedingly favorable for restoration to health. True, many chronic diseases are obstinate, yet a course of restorative medication persistently followed, promises a fortunate issue in this tractile temperament.

Hygienic management of the lymphatic and sanguine temperaments consists in the vigorous toning of the former, while restraint of the latter will greatly exempt it from the anxieties, contentions, and vexations which excite the mind, disturb the bodily functions, and end in chronic disease. People of the latter organization love mental and physical stimulants, are easily inflamed by pa.s.sion, and their excitability degenerates into irritability, succeeded by serious functional derangements, which prematurely break down the individual with inveterate, deep-seated disorder. Serenity, hope, faith, as well as firmness, are natural hygienic elements. It is a duty we owe ourselves to promptly relinquish a business which corrodes with its cares, and depresses with its increasing troubles. Constant solicitude, and the apprehension of financial disaster, frustrate the bodily functions, disconcert the organic processes, and lead to mental aberration as well as physical degeneracy. Melancholy is chronic, while despair is acute mania, whose impulses drive the victim desperately toward self-destruction. The chronic derangement of these organs exerts with less force the same morbid tendency. Hence the necessity for exercising those hygienic and countervailing influences born of resolution, a.s.surance, and confident trust, and the belief which strengthens all of the vital operations.

Doubtless, this temperament is the source of the reproductive powers. It is the corner-stone essential to the foundation of all other temperaments. It has been supposed by some that the cerebellum is the seat of s.e.xual instinct. The fact appears that an ample development of the posterior base of the cerebrum and the cerebellum indicates nutritive activity, which is certainly a condition most favorable to the display of amativeness. In a double sense, then, this temperament is a vital one; both by nutritive repletion, and by reproduction. It is the blood-manufacturing, tissue-generating, and body-constructing temperament, causing growth to exceed waste, and promptly repairing the wear which follows continual labor.

While the sleazy structures of the lymphatic temperament are favorable to the functions of transudation, exhalation, and mutual diffusion of liquids, the sanguine, as its name indicates, is adapted to promote the circulation of the blood, to favor nutrition and reproduction. The former temperament does not move the world by its energies, or impress it vividly with its wisdom, and the latter is more enthusiastic, enjoyable, and quickening. Each temperament, however, possesses salient qualities and advantages.

THE LIFE LINE.

Dr. W.B. Powell, in his work on "The Human Temperaments," announces the discovery of a measurement which indicates the tenacity of life, and the vital possessions of the individual. He has observed that some persons of very feeble appearance possess remarkable powers of resistance to disease, and continue to live until the machinery of life literally wears out. Others, apparently stronger and more robust, die before the usual term of life is half completed. He also noticed that some families were remarkable for their longevity, while others reached only a certain age, less than the average term of life, and then died. He remarked also that some patients sank under attacks of disease, when, to all appearances, they should recover, and that others recovered, when, according to all reasonable calculations, they ought to die. He, therefore, not only believed that the duration of human life was more definitely fixed by the organization than is supposed, but he set himself to work to discover the line of life, and the measure of its duration. He made a distinction between vital vigor, and vital tenacity.

_Vital vigor_ he believed to be equivalent to the condition of vitality, which is indicated by the breadth of the brain found in the sanguine temperament; and _vital tenacity_ to be measured by the _depth_ of the base of the brain. Dr. Powell was an indefatigable student of nature, and followed his theory through years of observation, and measured hundreds of heads of living persons, in order to verify the correctness of the hypothesis. His method of measuring the head may be stated as follows: He drew a line from the occipital protuberance on the back of the head to the junction of the frontal and malar bones, extending it to a point above the center of the external orbit of the eye, near the termination of the brow. Then he measured the distance between this line and the orifice of the ear and thus obtained the measure indicating the vital tenacity or duration of, life. Fig. 88 is a representation of the skull of Loper, who was executed for murder in Mississippi. He might have attained a great age, had not his violent and selfish faculties led him into the commission of crime. In this ill.u.s.tration, B represents the occipital protuberance, and A the junction of the frontal and malar bones at the external angle of the eye. The distance between this line (A B) and the external orifice of the ear, is the measure of the life-force of Loper at the time of his: execution.