MEDICINE IN MODEKN TIMES. 695 



Interdependence of Medicine and Physiology. That title runs 

 thus: — 'Lehrbuch der speciellen Pathologic und Therapie, mit 

 besonderer Riicksicht auf Physiologic und pathologische Ana- 

 tomic, von Dr. Felix von Nicmeyer. Sicbentc vielfach vermehrte 

 und verbesserte Auflage,' Berlin, 1868. From this work I will 

 take my first illustration of the nexus and connection of which I 

 have to speak ; and I believe that, though I am obliged to dissent 

 from the explanation therein given of the facts I shall refer to from 

 its pages, the explanation which they seem to me to bear, or rather 

 demand, shows even more clearly than the one there given the 

 intimacy of the alliance which is now becoming so close between 

 the experimentalist and the practitioner. In writing (vol. ii. p. 334) 

 of a form of neuralgia, the pain of which those who have suffered 

 from it themselves, or, indeed, have seen others suffering from it, 

 will allow is not exaggerated by the application to it of the words 

 'fast unertragliche,' Nicmeyer remarks^ that the physiologists 

 Dubois-Reymond and Dr. Mollendorff refer its origin to the ex- 

 istence of a dilated state of the arteria car oils cerehralis. This state 

 of dilatation these authorities explain by a reference to certain facts 

 in the physiology of the cervical sympathetic as discovered now 

 some seventeen years ago by Bernard, and elucidated still further 

 by Waller, Budge, and Brown- Sequard. And in like spirit, or at 

 least by a reference to certain anatomical facts in the arrangement 

 of blood-vessels, which he supposes to become dilated and distended, 

 the great Gottingen anatomist, Henle (cited by Nicmeyer, vol. ii. 

 pp. 319-339), explains the causation of certain neuralgiae. The 

 neuralgia which is apt to haunt the sixth, seventh, and eighth 

 intercostal spaces of the left side, he has suggested may be ex- 

 plained by the peculiar arrangement of the left or smaller azygos 

 vein in that region ; and the greater relative frequency of neuralgia 

 of the first than of the second and third divisions of the fifth 

 cerebral nerve, he refers to the greater quantity of dilatable veins 

 with which it is beset in passing from the inner to the outer 

 surface of the sphenoid. Now I venture, though with some diffi- 

 dence, as I find myself in opposition to such names and authorities, 

 tojdissent from the explanations thus given of these facts, which I 



1 Incorrectly however ; Dubois-Reymond himself explaining hemicrania as due to 

 a tetanus of the muscular coat of the arteries. See Reichert u. Dubois-Reymond's 

 Archiv, i860; Brown-S^quard, 'Journal de la Physiologie,' iv. 13, 1861. 



