68 PROCEEDINGS OF THE CANADIAN INSTITUTE. 
of spinal action.” He further remarks that the physiologist may 
produce the same condition in three ways: (1) by exaggerating the 
excitability of the spinal system by irritation of the centripetal 
nerves; 2) by exaggerating directly the action of the cord itself ; 
and (3) by suppressing the functions of the brain. 
These three conditions have each their pathological analogies, and 
they contain in themselves the totality of the pathogenic conditions 
of hysteria. Whatever has been the causation of this malady» 
he further says, we have always these two fundamental elements 
united, viz.: (1) the weakening of cerebral action, especially that 
of the will, and (2) the exaggeration of the automatic or spinal 
action (hyperkinesie spinale). 
Thus we see that in these hysterical patients we have emotional 
subjects who are readily impressed by whatever may affect the 
sympathetic system, in other words, who are ruled too frequently by 
the emotions and too seldom by the will,—or as M. Jaecoud so well 
expresses it: ‘‘There is at least temporarily present a cerebral 
paresis.” Now physiologically what does this mean? It must mean, 
if we adhere rigidly to the belief that the more or less complete 
abeyance of functional activity in a part is necessarily dependent 
upon a corresponding temporary absence of force-producing materials 
in the part, and, so far as we know, this means arterialized blood. 
For instance, pallor is an anaemia of the capillaries of the skin ; 
while we have, unfortunately, too many examples showing that the 
functional activity of an arm or leg depends directly upon its nutri- 
tion. Moreover, our best authors give among the causes of hysteria, 
loss of blood, prolonged lactation, &c. The first of these shows 
that other than purely female disorders may be causes of this malady, 
i. e., hysteria may occur in delicate and impressionable males as well 
as in females. : 
In claiming the anaemia theory as explaining these states I am 
perfectly well aware that there are some authorities, notably Brown. 
Sequard, who are opposed to it as being in many cases a sufficient 
explanation of either hysteria or epilepsy. I find in notes taken from 
his lectures on the peripheral irritation of nerves, that his explana- 
tion of these pathological conditions is not on the supposition of any 
-slow or sudden unequal distribution of blood to the brain, but that 
he considers the attacks essentially due to reflex action from peri- 
pheral sensations creating impressions upon the brain centres, Then 
