Metabolism in Diseases of the 

 Neuromuscular System 



FEANCIS H. McCBUDDEN 



BOSTON 



Microchemical methods have been devised by means of which, under 

 ' special conditions, it is possible to demonstrate metabolism in an isolated 

 active nerve. But in a sick patient we do not study the metabolism of an 

 isolated nerve, or even of the whole nervous system alone; we study the 

 metabolism of the body as a whole. And the quantities of energy and mat- 

 ter involved in the metabolism of the purely nervous activities alone are 

 so very minute in comparison with the total metabolism of the body as a 

 whole that it is not possible at present to recognize pathological changes 

 in the metabolism of the nervous system in disease. All attempts to demon- 

 strate either metabolic changes resulting from purely psychic or nervous 

 activities, or metabolic changes in the nervous system in disease have 

 given negative results (Gumprecht, Mott, Benedict (a), Donath, Folin and 

 Shaffer, Luciani(&), Oppenheim, Schtscherbak, Singer and Goodbody, 

 Speck) . 



But diseases of the nervous system may lead to changes in the metabo- 

 lism of other organs. 



All the activities of the body take place in response to stimuli. A 

 stimulus may arise in one part of the body; the corresponding activity 

 may take place in another part of the body. A slight stimulus may produce 

 a profound reaction ; a strong stimulus a slight reaction; A single stimulus 

 may call forth several activities ; numerous stimuli may result in a single 

 response. A chemical stimulus may call forth a physical reaction; a 

 mechanical stimulus may give rise to a chemical reaction. The end result 

 is purposeful activity; the activities fulfill some useful function. This 

 adaptation of responses to stimuli is brought about through the nervous 

 system. All centripetal impulses pass to the nervous system, where they 

 are coordinated into useful forms which then pass out to the various organs 

 as a stream of controlling centrifugal impulses. It is such impulses that 

 determine the nature and extent of all the activities of the organs. 



The foregoing applies, not only to physical activities, such as muscular 



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