GENERAL RECAPITULATION, PATHOLOGICAL APPLICATIONS. 835 



are solely dependent upon this cause. The functional disturbance of the Cere- 

 brum induced by the irregular action of other parts of the Nervous System, 

 is a part of the Etiology of Insanity which has been as yet but very little at- 

 tended to, but which deserves a careful study. Numerous examples of it are 

 furnished by certain peculiar forms of disordered Mental action, which are con- 

 nected with " hysterical" states of the female system, especially mutability and 

 irritability of temper and disposition to deceit; 1 but we are probably also to refer 

 to this cause, in part at least, those very distressing states of mind which arise out 

 of disorders in the sexual apparatus of the male, or even from irritation of neigh- 

 boring parts. 3 It frequently happens that agencies of both classes contribute 

 to the result ; some long-continued defect of nutrition (very often arising from 

 hereditary constitution) serving as the " predisposing cause," whilst some vio- 

 lent mental emotion, or depravation of the blood by some noxious matter, acts 

 as the " exciting cause " the two conjointly producing that effect, which neither 

 would singly have brought about. 



IX. Without any Mental perversion, however, indicative of structural or func- 

 tional disorder of the Cerebrum, there may exist a partial severance of its con- 

 nection with the Sensori-motor apparatus ; so that it cannot receive sensory im- 

 pressions from particular organs or parts of the body, or call forth muscular 

 movement in respondence to volitional determinations or to emotional excite- 

 ment. Or, again, there may be a weakening of Voluntary power over the mus- 

 cles in general, whilst they still remain amenable to the stimulus of Emotion; 

 and in such cases, as might be expected, the influence of sensory impressions in 

 directly exciting muscular movements is obviously manifested. 3 Of the precise 

 pathological alterations which give rise to these peculiar conditions (which fre- 

 quently manifest themselves in regard to particular groups of muscles, such as 

 those of vocalization), nothing whatever is known. Nearly allied to this state is 

 that which gives rise to the " jactitating convulsion/' interfering with volitional 

 movement, which is known as Chorea. On the physiological views here advo- 



1 See Dr. Laycock's " Treatise on the Nervous Diseases of Women," in which these 

 sympathies are fully dwelt on. 



2 See M. Lallemand's " Treatise on Spermatorrhoea," translated by Mr. McDougal. In 

 some of the cases recorded by M. Lallemand, the most extreme mental depression was en- 

 gendered by the presence of ascarides in the rectum ! 



3 Of this curious state, the following example was communicated to the Author, about 

 four years since, by his friend Mr. Noble. " Mr. R., set. 41, of a sanguine nervous tempera- 

 ment, a married man, and father of several children, the youngest being but two months 

 old, exhibited the following symptoms, first experienced in a slight degree about five years 

 ago, and since then having become much aggravated, the climax having apparently been 

 attained about two years ago. There was partial paralysis of voluntary motion upon the 

 left side, exhibiting under ordinary circumstances the customary phenomena; but with this 

 peculiarity that although Volition was comparatively powerless, any incident excitor im- 

 pression of an unusual character, by exciting, as it were, Consensual action, would give 

 effect to the voluntary intention ; thus when the affected arm was raised by another to a 

 certain height, the patient was unable by mere volition to elevate it still more ; but if the 

 hand were smartly struck or blown upon either by himself or by another, movement of a 

 rapid character would at once ensue, and that too in conformity with the Volitional effort. 

 Upon inquiry, moreover, it appeared that any unwonted impression upon the internal as 

 well as the external senses was capable of leading to a realization of the effort vainly at- 

 tempted by the mere will ; hence, by accomplishing the commencement of a run or trot by 

 aid of some undue impression, he could go on ; he stated, on the case being proposed, that 

 if, in utter paralysis of voluntary power over the muscles, a hundred-pound note were sud- 

 denly placed before his vision, and he were told tKat on seizing it the same should be his, 

 he should at once be equal to the requisite effort. When in health, Mr. R. stated that he 

 had excellent controlling power over the Emotions, but that now the pleasure and the pain 

 attendant upon their excitation were exalted, and the consensual phenomena quite irre- 

 sistible ; and on further inquiry it appeared that, in the matter of laughing and crying, he 

 exhibited very much of the hysterical condition. In early life, Mr. R. had been what is 

 called a free liver; both in regard to women, and to alcoholic stimulants." 



