840 OF THE FUNCTIONS OF THE NERVOUS SYSTEM. 



performance of which is an indication of the torpor that has supervened upon 

 the functional activity of the Cerebrum. 



Xii. It is the Sensorium that is primarily, and (it may be) solely affected, 

 in the state of Coma ; which differs from ordinary sleep only in the complete- 

 ness of the suspension of the functional activity of the Sensory Ganglia. This 

 suspension not merely prevents impressions transmitted from the organs of 

 sense, from affecting the consciousness as Sensations ; but it also interposes the 

 same obstacle to that mental recognition of Cerebral changes which, when the 

 Sensorium is closed to the outer world, constitutes the state of Dreaming ; and 

 thus the comatose subject is not merely insensible to external impressions, but 

 is cut off from all perception of self-existence. There seems reason to believe 

 that, in the simpler forms of Coma, such as we frequently meet with in hysteri- 

 cal subjects, there is no perversion of the functions of the Cerebrum ; for we 

 observe that, if the insensibility suddenly supervene in the midst of a sentence 

 which is being uttered by the patient (a circumstance of no uncommon occur- 

 rence), the series of words is taken up and completed the moment that the 

 coma passes off, the patient being unconscious of the interruption ; showing 

 that there is none of that confusion of the Intellect which marks Cerebral dis- 

 order. In a large proportion of cases, however, it is obvious from the order in 

 which the symptoms manifest themselves, that the Cerebrum is affected as well 

 as the Sensorial centres ; of this the best evidence is afforded by the phenomena 

 of alcoholic intoxication, and the agency of narcotic poisons ; and where Coma 

 results from pressure within the cranium, this must act alike upon the Cere- 

 brum and the Sensorium. Of the causes which induce the state of Coma, there 

 are many which, when operating in smaller quantity, or in less intensity, pro- 

 duce delirium. This is particularly the case with the whole group of truly nar- 

 cotic poisons; and is not merely true of those which are introduced as such from 

 external sources, but also with regard to those which are generated within the 



places" of her childhood. As her intellect gradually expanded, and her ideas became more 

 numerous and definite, they manifested themselves chiefly in the form of emotions; that 

 is, the chief indications of them were through the signs of pleasure and pain. The last 

 were frequently exhibited in the attacks of insensibility and spasmodic rigidity, which 

 came on at the slightest alarm. It is worth remarking that these attacks throughout this 

 remarkable period, were apt to recur three or four times a day, when her eyes had been 

 long directed intently upon her work ; which affords another proof how closely the emo- 

 tional cause of them must have been akin to the influence of sensory impressions, the 

 effects of the two being precisely the same. The mode of recovery of this patient was 

 quite as remarkable as anything in her history. Her health and bodily strength seemed 

 completely re-established, her vocabulary was being extended, and her mental capacity was 

 improving, when she became aware that her lover was paying attention to another woman. 

 This idea immediately and very naturally excited the emotion of jealousy ; which, if we 

 analyze it, will appear to be nothing else than a painful feeling connected with the idea of 

 the faithlessness of the object beloved. On one occasion this feeling was so strongly ex- 

 cited, that she fell down in a fit of insensibility, which resembled her first attack in dura- 

 tion and severity. This, however, proved sanitary. When the insensibility passed off, 

 she was no longer spellbound. The veil of oblivion was withdrawn ; and, as if awakening 

 from a sleep of twelve months' duration, she found herself surrounded by her grandfather, 

 grandmother, and their familiar friends and acquaintances, in the old house at Shoreham. 

 She awoke in the possession of her natural faculties and former knowledge ; but without 

 the slightest remembrance of anything which had taken place in the interval from the 

 invasion of the first fit up to the present time. She spoke, but she heard not ; she was 

 still deaf, but, as she could read and write as formerly, she was no longer cut off from 

 communication with others. / From this time she rapidly improved, but for some time con- 

 tinued deaf. She soon perfectly understood by the motion of the lips what her mother 

 said ; they conversed with facility and quickness together, but she did not understand the 

 language of the lips of a stranger. She was completely unaware of the change in her 

 lover's affections which had taken place in her state of second consciousness ; and a pain- 

 ful explanation was necessary. This, however, she bore very well, and has since reco- 

 vered her previous bodily and mental health. 



