THE FEELING OF EFFORT. g 



yet he will be found to be making powerful muscular exertion of some kind. Vulpian has 

 called attention to the fact, and I have repeatedly verified it, that when a hemiplegic 

 patient is desired to close his paralyzed fist, in his endeavors to do so he unconsciously 

 performs this action with the sound one. It is, in fact, almost impossible to exclude such 

 a source of complication, and unless this is taken into account very erroneous conclusions 

 as to the cause of the sense of effort may be drawn. In the fact of muscular contraction 

 and the concomitant centripetal impressions, even though the action is not such as is desired, 

 the conditions of the consciousness of effort exist without our being obliged to regard it 

 as depending on central innervation or outgoing currents. 



" It is, however, easy to make an experiment of a simple nature which will satisfactorily 

 account for the sense of effort, even when these unconscious contractions of the other side, 

 such as hemiplegics make, are entirely excluded. 



" If the reader will extend his right arm and hold his forefinger in the position required 

 for pulling the trigger of a pistol, he may without actually moving his finger, but by 

 simply making believe, experience a consciousness of energy put forth. Here, then, is a 

 clear case of consciousness of energy without actual contraction of the muscles either of 

 the one hand or the other, and without any perceptible bodily strain. If the reader will 

 again perform the experiment, and pay careful attention to the condition of his respiration 

 he will observe that his consciousness of effort coincides with a fixation of the muscles of 

 his chest, and that in proportion to the amount of energy he feels he is putting forth, he is 

 keeping his glottis closed and actively contracting his respiratory muscles. Let him place 

 his finger as before, and continue breathing all the time, and he will find that however 

 much he may direct his attention to his finger, he will experience not the slightest trace of 

 consciousness of effort until he has actually moved the finger itself, and then it is referred 

 locally to the muscles in action. It is only when this essential and ever present 

 respiratory factor is, as it has been, overlooked, that the consciousness of effort can with 

 any degree of plausibility be ascribed to the outgoing current. In the contraction of the 

 respiratory muscles there are the necessary conditions of centripetal impressions, and these 

 are capable of originating the general sense of effort. When these active efforts are 

 withheld, no consciousness of effort ever arises, except in so far as it is conditioned by the 

 local contraction of the group of muscles towards which the attention is directed, or by 

 other muscular contractions called unconsciously into play in the attempt. 



" I am unable to find a single case of consciousness of effort which is not explicable in 

 one or other of the ways specified. In all instances the consciousness of effort is 



than to exert the same volition over his acutely-felt lost leg. idea of an End for the fiat to knit itself to. Such a supposi- 

 Others, on the contrary, ( Fiirfe Weir Mitchell's book on Gun- tion conforms well to the utterances of two amputated 

 shot Injuries to Nerves), say they can not only will, but, as persons with whom I have conversed. They said it was like 

 far as their feeling is concerned, execute, movements of their "willing into the void," they "did not know how to set 

 amputated Hmbs. It would be extremely interesting to about it," and so forth. The recency of Dr. Putnam's ease 

 unravel the causes of these divergences. May it be that in above mentioned seems, however, to conflict with such an ex- 

 recent cases with the recollection of varied movements fresh planation and I only make the suggestions in the hope that 

 in the mind, the patient has a stock of distinct images of some one with better opportunities for observation than I 

 position on which to base his fiat; while in an inveterate possess, may become interested in the matter. I may add 

 case, either of paralysis with contraction, or of amputation that in teaching a new and unnatural movement, the starting 

 with consciousness of the limb in an invariable position, point is to awaken by its passive production a distinct sense 

 reminiscences of other positions have through long desuetude of what the movement, if effected, would feel like. This 

 become so incapable of revival that there is no preliminary defines the direction of the exertion the pupil is to make. 



