461 



SECRETION. 



by tne restoration of the uterine flux, or by 

 the establishment of a similar discharge from 

 some other organ. Hence cases of vicarious 

 menstmation may really be placed on the same 

 footing with those of metastasis of secretion ; 

 and they serve to illustrate and establish the 

 same general truth. Such cases are by no 

 means uncommon, the menstrual flux being 

 replaced by haemorrhages from various parts 

 of the skin, from the mucous membranes, or 

 from glandular surfaces, especially the mammae. 

 The following case, quoted by M. Brierre de 

 Boismont* from the " Medecine Pratique" of 

 Pinel, is of peculiar interest from the variety 

 of phenomena which it presents. 



" Madlle A. had been subject, from the age 

 of eleven, to attacks of hysteria, which were 

 followed by vomiting of blood. She men- 

 struated at fourteen ; her health was re-es- 

 tablished, and the catamenia continued to flow 

 regularly for several months. A sudden 

 fright suppressed the menses, and again hys- 

 teria came on. Vicarious menstruation now 

 occurred. The legs swelled and were covered 

 with vesicles, and during six months blood 

 was regularly discharged from them. The 

 left arm swelled, and the legs recovered ; and 

 for a year there was a regular sanguineous 

 discharge from the arm. A third deviation 

 occurred from the left thumb, which had been 

 slightly wounded; the catamenia flowed from 

 this opening for six months. In the fourth 

 year two wounds were formed on the face 

 from an attack of erysipelas ; one, on the side 

 of the nose, the other on the upper eyelid. 

 For two years the periodic discharge took 

 place from these openings, and it no longer 

 occurred from the thumb. The abdomen in 

 its turn was attacked with erysipelas, and for 

 five months regularly there was a discharge 

 from the navel at each menstrual period. For 

 four months the discharge proceeded from 

 the inner ankle of the left foot; for two 

 months from the left ear ; for three from the 

 left nipple. When the discharge did not flow 

 from any one part, bleedings at the nose and 

 vomitings of blood took place, preceded by 

 convulsions, pains in the head, and giddiness. 

 After remaining some time at the Sal- 

 petriere, the health of this young female im- 

 proved, and regular menstruation was es- 

 tablished." 



It is probable that although the statement of 

 Haller, already quoted, is universally true as 

 a possibility, yet that it is practically verified 

 only in the case of the excretions, the mate- 

 rials of which differ considerably from the nu- 

 tritious elements of the blood, and accumulate 

 in it when their usual exit-pipe is no longer 

 open, forcing their way (so to speak) through 

 other channels. If it be true, as we have 

 suggested, that the materials of the recremen- 

 titious secretions, as they have been termed, are 

 nothing else than the materials of the blood 

 itself, slightly modified for their special pur- 

 pose in the very act of elimination, we see 



* De la Menstruation considered dans scs Rap- 

 ports Physio 1 og'ques et Pathologiques. 



why, when they are suspended, there is no 

 accumulation of their materials in the circu- 

 lating system, and no attempt at the sepa- 

 ration of them by other organs. 



Influence of the nervous system on the 

 secreting process. That the eliminating ac- 

 tion of the various secreting organs, and the 

 amount and nature of their products, are 

 greatly influenced by the conditions of the 

 nervous system, cannot be doubted by any one 

 who takes a general survey of the facts of 

 this department of physiology. For although 

 we can no more increase, diminish., or other- 

 wise alter any one of our secretions by a 

 mere effort of the will, than we can, " by 

 taking anxious thought, add one cubit unto 

 our stature," yet there is ample evidence that 

 the state of the feelings has a powerful in- 

 fluence upon many of them, increasing or 

 diminishing their amount, or altering their 

 character.* 



A brief review of the phenomena which 

 manifest this influence, will serve as the most 

 appropriate foundation for an inquiry into its 

 nature and extent. 



The mammary secretion affords, perhaps, 

 more remarkable evidence than any other, of 

 the influence exercised over it by states of 

 mind, in increasing or diminishing it, or in 

 producing a complete change in its properties. 

 Of the increase in the development of the 

 gland at puberty, and still more during lacta- 

 tion, no definite explanation can be given ; to 

 say that it takes place by " sympathy " with 

 the genital organs, being obviously a mere 

 verbal evasion of the difficulty. But the ac- 

 tivity of its function, when once it has been 

 fully established, is mainly dependent upon 

 the sensations and emotions connected with 

 the act of suction, and with the thought of the 

 offspring. Although the formation of milk 

 may be constantly going on, yet it is greatly 

 increased by the application of the infant to 

 the breast. The quantity which can be 

 squeezed from either breast at any one time, 

 and the secretion of which may have occupied 

 several hours, is about two ounces; and yet 

 during a quarter of an hour's suction, an in- 

 fant may draw three or four times that amount. 



* True it is that there are cases in which secre- 

 tions -would seem to be voluntarily produced, as 

 when real tears are shed by performers on the stage, 

 in the personation of their assumed parts. But in 

 such instances, a strict investigation of the mental 

 state leads to the conclusion, that the emotions pro- 

 per to the assumed character are for a time really 

 felt ; the effort of the will being rather exerted in 

 the change of individuality ( so to speak ) than in 

 the production of the several movements of gesture 

 or expression which are significant of the mental 

 state. And it is always observable that where the 

 actor, possessing the requisite qualifications, can 

 thus transform himself into the character he is per- 

 sonating, so that his tones, looks, and gestures shall 

 be the spontaneous and natural expression of his 

 temporary feelings, he produces a much greater in- 

 fluence upon the spectators, than he can do by the 

 most careful voluntary realisation of his intellectual 

 idea of the mode in which the character should be 

 manifested. In these cases, then, as in all others, it 

 is through the emotions, not directly by the will 

 that the secretion is really excited. 



