Chapter XII: Section II (7)

There is certainly a very great difference between asphyxia that happens to an adult, and the state in which the fœtus is found, since, if the first is prolonged, organic life ceases, while this life is in full activity in the fœtus. Thus there is no resemblance in the composition of the black blood in the arteries in asphyxia and that in the arteries of the fœtus. These two states, however, have a sort of analogy, especially under the relation of the remarkable diminution, of even the absence of animal life, which characterize both. Now in producing asphyxia in an animal at will, by fixing a stop-cock upon the wind-pipe, I have always observed that this life is annihilated when the black blood penetrates the brain, and that when it is in part suspended, it suddenly revives and re-appears by opening the stop-cock, and permitting red blood to enter the brain, nerves, and all the parts. These experiments can, then, to a certain point, give us an idea of the part the red blood takes at birth, in the development of animal life; I say the part, for it is not, as we shall see, the only cause that puts it in action.

For a long time after birth and during the whole of the growth, the nervous system and the brain, which is the centre of it, predominate in their development over the other systems; this predominance is not uniform at all the periods; it diminishes at puberty, when the nervous system is in equilibrium with the others, and the genital organs succeed it in superiority.

This predominance of the nervous system in the infant has an influence on the one hand on the sensations, on the other upon the voluntary motions.

The first influence is very striking. Infancy is the age of sensations. As every thing is new to the infant, every thing attracts its eyes, ears, nostrils, &c. That which to us is an object of indifference, is to it a source of pleasures. As a man receives great enjoyment from a show he never witnessed before, which is blunted by habit if often repeated. It was then necessary that the nervous cerebral system should be adapted, by its early development, to the great degree of action which it is then to have. In fact, all the organs that receive external impressions, the nerves that transmit them, and the brain that perceives them, are really in the infant when awake in permanent excitement, who in the midst of the same objects as the adult, fatigues these organs three times as much as he to whom a great part of these external objects is indifferent, because they have heretofore excited him. Thus observe that the periods of activity of animal life are much shorter in the infant who fatigues his organs in a few hours, in whom, consequently, the want of sleep returns oftener, and in whom this state of intermission of animal life is more profound. It is rare that infants, in the first months, can pass the whole day awake, especially if many objects engage them. We might prolong their wakefulness by removing them from light, sounds, &c.

The multiplicity and frequency of the sensations of the infant, lead necessarily to a number of motions which have not strength, because of the weakness of the muscles, but which are, like the sensations, extremely numerous. As the sight incessantly presents new objects to the infant, it wishes constantly to touch; its little hands are in continual agitation, its whole body is also in constant motion. It is necessary that the nerves which serve to transmit the principle of these motions, should be adapted by their development, like those of the sensations, to their constant action.

These two things, the great development of the nervous system and the frequency of its action in the infant, make the diseases of this system the predominant ones at that age. So great is the susceptibility of the brain in answering to sympathetic excitements, that if pains are at all severe in any part, they immediately produce convulsions, which are at least four times more frequent at this age than any of the following. I would observe upon this subject, that the different systems are more or less disposed in the different ages, to answer to sympathies, according as their predominance in the economy is more or less decided. The same morbific cause, fixed upon any organ, which produces convulsions in an infant by acting sympathetically upon the brain, would give to a young girl a suppression of the catamenia, by influencing the womb, which then begins to predominate; to a strong vigorous young man, a peripneumony; to an adult, in whom the gastric viscera predominate, an affection of these viscera, &c. It is thus that the same passions that would give to this one a jaundice, engorgement of the liver, &c. would produce more particularly in an infant an epilepsy, which attacks the brain.

The nervous functions are not only frequently deranged by sympathy in infancy, but it is particularly at this age that the greatest number of organic diseases is found in the brain, the spinal marrow, the nerves, or the organs that depend upon them. Cerebral fungi, hydrocephalus, spina bifida, &c. are a proof of this. The great quantity of blood that goes at that period to the nervous system has much influence upon this phenomenon; now this quantity is brought there by the predominance of the vital forces.

In proportion as the infant grows, its nervous system and the brain, which is the centre of it, lose by degrees the predominance that characterize them. Their diseases become less frequent. They are brought finally to the level of the other systems.

III. _State of the nervous system after growth._

At puberty, the empire of the brain, which is insensibly diminished, gives place to that of the genital organs, which have a sudden increase. The cerebral nerves appear to me to have but little influence upon their development, as well as upon that of most of the other systems. Observe, in fact, that all the phenomena of generation are governed by the organic forces, which, as we have seen, are absolutely independent of the nerves. Thus the great excitement of the genital organs, from which arise satyriasis, nymphomania, &c. have no analogy with convulsions whose principle is in the brain; as the destruction of the venereal appetite is wholly disconnected with the phenomena of palsies. This is so true, that often during those that affect the lower half of the body by a fall on the sacrum, or by any other cause, the secretion of semen and venereal desires take place as usual.

Beyond puberty, and towards the adult age, when the general equilibrium is more nearly established among the different systems, the nervous is not affected more than those of which we have had occasion to speak in treating of this system.

IV. _State of the nervous system in old age._

At this period of life, the nervous cerebral system has but very few functions to perform. As to sensation, this being almost blunted by habit, is the reason why external bodies make but little impression upon the organs of sense; many of these, especially the eye and the ear, are often shut to sensations before general death. The nerves have then but little to transmit, and the brain but little to perceive. As to motion, there is but little in old age, because but little is felt; for feeling and motion are two things that generally follow the same proportion. The brain and the nerves are almost inactive in this respect. The first is not put in action by the intellectual functions; memory, imagination, judgment, attention, &c. all are enfeebled, none are exerted with clearness.

Changes of structure constantly accord with these changes of functions. In the fœtus, the brain is almost fluid; in old age, it is extremely firm. This organ has passed through a variety of gradations between the two extreme ages. We know that anatomists always select the brain of an old person in order to study this viscus, all the parts of which are broken with difficulty. I would observe upon this subject, that what is natural at this age, indicates in a young person a morbid alteration. In general, we have not yet sufficiently studied the comparative anatomy of the different ages, to make applications of it to the examination of dead bodies.

The vessels diminish in the brain in proportion as its hardness increases. In this respect it has an inverse arrangement at the two extreme ages of life. Its colour becomes more dull in old age. It is rare that it is ossified; there are, however, some examples of it. The phenomena, that the action of different re-agents presents, are very much slower in taking place than in the adult and especially in the infant. The solution by alkalies is a remarkable proof of this.

We cannot doubt but that this organic state of the brain in old age, has much influence upon the preceding phenomena; to this must be referred the less acuteness of pain at this age. A cancerous tumour of an old person, exactly analogous in its position, form, size and nature to that of an adult, produces much less suffering. Cancers of the womb, the stomach, the breast, &c. furnish examples of this. All the local causes of pain show also the same thing. In the numerous experiments I have made upon living animals, I have uniformly observed, that young ones, when the sensible parts are cut, give signs of the most acute pain; whilst old ones show infinitely less expression of it under similar circumstances. I would make one other remark upon this subject; it is that the variety appears in dogs, in a certain degree to have an influence upon the acuteness of their sensations. All the large varieties make but little noise, and are not much agitated, when their skin, their nerves, &c. are cut; whilst all the small ones, though they may be old, struggle, are agitated, and manifest upon the slightest cause, the most acute sensibility.

As to the influence of age upon pain, it is not astonishing that the animal sensibility having become very obscure in a natural state, should preserve the same character in disease. An old person suffers then much less than the adult, and especially than the infant, under the influence of the same causes; it is a compensation for the diminution of their enjoyments. The infant finds in every thing that surrounds him, a cause of pleasure or of pain; thus smiles and tears succeed each other a hundred times a day upon his little face. An old person on the contrary is always calm; indifference is his natural state.

The nerves experience the same changes as the brain; they harden gradually with age; however their proportion of hardness in the first and last ages is much less remarkable than that of this organ; this arises from the nervous coat; for the effect upon the medullary substance appears to be the same. This medullary substance has appeared to me to be less abundant in the optic nerve of an old person; however it is difficult to determine the quantity. The colour of the nerves becomes dull, like that of the brain. They receive fewer vessels. They are never ossified.

Sometimes we say that the extremities of the nerves have become callous; it is a vague expression, to which no meaning can be attached. When will medical language cease to refer to the empty and inaccurate hypotheses that formerly constituted medicine? Most of these hypotheses have passed away, yet the names to which they gave birth remain.

The nervous system and the brain frequently lose beforehand, in old people, a part of their functions; hence hemiplegia is almost as frequent at that age, as convulsions which are its opposite, are in infancy. It is necessary to distinguish the hemiplegias of old people from those of adults. They are of the same nature as the blindness, the deafness of old people; the difference is only in the injury of sensation or motion.

NERVOUS SYSTEM OF ORGANIC LIFE.

GENERAL REMARKS.

No anatomist has yet considered the nervous system of the ganglions in the point of view in which I shall present it. This point of view consists in describing each ganglion as a distinct centre, independent of the others in its action, furnishing or receiving particular nerves as the brain furnishes or receives its own, having nothing in common, except by anastomoses, with the other analogous organs; so that there is this remarkable difference between the nervous system of animal life, and that of organic life, viz. that the first has a single centre, and that it is to the brain that every kind of sensation comes, and that it is from it every kind of motion goes; whilst in the second, there are as many little separate centres, and consequently little secondary nervous systems, as there are ganglions.

We know that all anatomists, even those who, without affixing to the expression any very definite meaning, have called the ganglions little brains, have taken them for dependancies, for enlargements of the nerves, in whose course they are found; and as most of them are met with in the great sympathetic, they have presented them as a distinctive character of this nerve. But from the general idea I have just given of the ganglions, it is evident that this nerve has no real existence, and that the continuous thread that is observed from the neck to the pelvis, is nothing but a succession of nervous communications, a series of branches that the ganglions placed above each other, send reciprocally to each other, and not a nerve going from the brain or the spine.

The first considerations that induced me to think that the great sympathetic is not a nerve like the others, but a series of anastomoses, were the following. 1st. These communications are often interrupted, without any inconvenience, in the organs to which the great sympathetic goes. There are subjects, for example, in whom is found a very distinct interval between the pectoral and lumbar portions of this pretended nerve, which seems cut in this place, because the last pectoral ganglion and the first lumbar do not send branches to each other. I have often seen also the sympathetic nerve cease, and afterwards appear again between two ganglions and from the same cause, whether in the loins, or in the sacral region. 2d. Every one knows that the opthalmic ganglion, the spheno-palatine, &c. are constantly distinct, and that they do not communicate by their branches except with the cerebral nerves. It uniformly happens that there is between them and those of the great sympathetic, what we sometimes see between these last, viz. a complete deficiency of communication. 3d. In birds, as has been observed by Cuvier, the superior cervical ganglion is also found constantly distinct; it never communicates with the inferior. The filament which in quadrupeds descends the length of the neck, is wanting in them. In many other animals we frequently find interruptions in this succession of anastomoses of ganglions, which constitute what is called the great sympathetic. 4th. The communications of the ganglions are usually made by a single branch; but sometimes many go from one of these organs to the other, so that if the great sympathetic was a nerve like the others, it would present, in this respect, an arrangement wholly different from that of the cerebral nervous system. 5th. Whence does the great sympathetic arise? From the sixth pair? But all the nerves diminish as they go from the brain towards the organs; but this presents then an arrangement entirely different; it increases as it sends off branches. Does it arise from the spinal marrow? But then the branches with which it furnishes a region would come from the branches that it receives from the spinal marrow in this region. Thus the great and small splanchnic would arise from certain intercostal pairs, now they are evidently much larger, the first especially, than the sum of the branches from which they would derive their origin. Observe then that all anatomists have been of a different opinion upon the origin of the great sympathetic. How could they agree upon a thing that has no real existence?

These different considerations render probable the opinion that I have entertained for some time, that the great sympathetic nerve does not really exist, that this cord is but a succession of communications between little nervous systems placed above each other, and that it is not essential that these communications should exist, as is seen constantly between the ophthalmic ganglion and the spheno-palatine, between that and the superior cervical, of which many animals furnish examples. Then I began to regard each ganglion as a separate centre of a little nervous system, wholly different from the cerebral, and distinct even from the little nervous systems of the other ganglions. By considering the functions of the nerves going from these centres, I became more and more convinced that they did not belong to the cerebral system. In fact, these nerves have properties very different from theirs, as we shall see; they do not serve for sensations; they have uniformly no connexion with voluntary locomotion; we see them only in the organs of internal life; hence why they are found concentrated in the trunk, in the thorax and abdomen particularly; why they are not met with in the head, where almost all the organs belong to animal life; why they are not seen in the extremities, which are exclusively dependant upon this life.

Distributed almost every where to the organs of the internal life, the ganglions and their nerves derive their character from it; and this is it. 1st. They are not symmetrical; thus the nerves of all the plexuses of the abdomen, those of the cardiacs, &c. have a remarkable irregularity. 2d. There are numberless varieties in the form of these plexuses and in that of the ganglions; it is thus that, sometimes lenticular, sometimes triangular, sometimes divided into many portions, that which is under the diaphragm is never seen twice alike. Hence the error of every name derived from the figure; a remark that is applicable generally to the organs of internal life. We might rather borrow the names of forms for animal life in which these forms are more invariable. On the other hand, the existence of many ganglions varies; sometimes there are three of them in the neck, at others but two. The arrangement of one side does not produce a similar one on the other. I have frequently remarked that the number of filaments arising from the superior cervical ganglion differs very much from those that take their origin from the opposite side. There are two analogous organs at each side; but several attributes of structure destroy the general character of symmetry; it is like the lungs and the kidnies. We can, then, establish as a distinctive character between the two nervous systems, the symmetry of one and the irregularity of the other; now, this character is one of those which distinguish the two lives, as I have remarked before.

From all this it is evident that a line of demarcation separates the nerves of the ganglions and those of the brain, and that the method is inaccurate which considers them as forming a single nerve, arising by some origin from this last. Their communications no more prove it to be a general nerve, than the branches which pass from each of the cervical, lumbar, or sacral pairs, to the two pairs that are superior or inferior to it. Notwithstanding these communications, we consider each pair in a separate manner, and not as one nerve by their union. So that each ganglion should be described separately, notwithstanding the branches it sends to others.

The description of the system of the ganglions should be analogous to that of the cerebral nerves. For example, I describe first the lenticular ganglion, as was done for the brain; then I examine its branches, among which is found the great splanchnic; for it is very improper to say that this nerve gives origin to this ganglion. The same in the neck, in the head, &c. each ganglion is first described; then I treat of its branches, among which are found those of communication. There are, then, almost as many descriptions as there are separate ganglions. For example, we ought not to treat of the ophthalmic nerve with the common motor; to be convinced of this, it is sufficient to see how much the ciliary nerves differ from the others, which, belonging to animal life, are also contained in the orbit.

From all that has been said, it is evident that there are two things to be examined in the nervous system of organic life, 1st. the ganglions; 2d. the nerves that go from them.

ARTICLE FIRST.

OF THE GANGLIONS.

I. _Situation, forms, relations, &c._

The ganglions are little reddish or greyish bodies, situated in different parts of the body, and forming so many centres, from which goes an infinite number of nervous ramifications. Their position most generally is along the vertebral column, where are seen successively below each other, the superior and inferior cervical, the intercostal, the lumbar, and the sacral. It is these especially whose communicating branches form the great sympathetic. But besides these ganglions, which are placed as it were in a row, we find many separate ones in different parts, as the ophthalmics, the sphenopalatines, the maxillaries in the head, as also the semilunars in the abdomen. In the thorax there are none thus separate; though sometimes we see a small one at the base of the heart.

Besides the ganglions uniformly seen, there are often accidental ones, if we may so say; such are those that are sometimes found in the hypogastric plexus, in the solar even, at some distance from the semilunar, in the middle part of the neck, &c. On the other hand, some of those that are usually met with are oftentimes not found, as some of the lumbar, sacral, maxillary, &c.; so that it appears that there is really an essential difference between the ganglions under the relation of existence. The superior cervical, the semilunar, the ophthalmic, &c. are always found; they appear to be essentially necessary to the action of the organs to which they furnish nerves. Most of the others may be wanting on the contrary, and be supplied by those of the neighbouring ones, or by others formed not in the ordinary anatomical order.

All the ganglions are generally in a deep situation. Destitute of a bony covering analogous to that of the brain, they are not less powerfully protected against the action of external bodies. It is this deep position, that prevents us from making experiments upon almost all of them, from making those at least which require that the animal should live a certain time after they have been made. It is this which will undoubtedly keep up for a length of time the obscurity that hangs over the functions of these organs.

The form of the ganglions is extremely irregular. In general they are round; but sometimes they are long, as the superior cervical; sometimes the ganglion is a species of triangular body, with obtuse and round ends, as the ophthalmic; sometimes the form is semilunar, like that which has this name, &c. Generally these forms are very variable, as I have said; the most uniform is that of the superior cervical.

Embedded in a quantity of cellular texture, all the ganglions are separated by it from the neighbouring organs. Almost all of them are so disposed, that they experience but little motion from these organs, and cannot receive it from any of the vessels that enter them. Those situated along the vertebral column especially, present this phenomenon, very different from that which takes place at the brain, whose functions are essentially connected with the constant agitation that the blood imparts to it, and very different from that which we observe in the plexuses of nerves coming from these same ganglions.

II. _Organization._

The ganglions have generally in the adult a reddish colour very different from that of the nerves; sometimes they are greyish. When opened, they present a soft, spongy texture, resembling considerably at first view that of the pretended lymphatic glands.

This texture has nothing in common with the cerebral substance, nor with that which occupies the canal of the nervous coat. These two last should rather be ranked in the class of fluids, as I have said; their substance is a pulp, a real jelly. Thus they have not any of the properties of solids. They do not harden like horn; the kind of hardening, the result of the contact of alkohol, of the acids, and of caloric, is wholly different from the horny hardening. It is analogous to the hardening of the white of an egg. On the contrary, the texture of the ganglions hardens like horn in an evident manner, a phenomenon which is characteristic of all the solids, except the epidermis, the nails, and the hair, which make a separate class. Treated by the acids, the ganglions, after wrinkling, hardening like horn and hardening gradually, soften and become fluid.

Boiling produces a phenomenon nearly analogous; 1st. horny hardening and hardening at the instant the water boils; 2d. continuance of this state for half an hour; 3d. softening gradually brought on; when this last is complete, the effect of the boiling is finished. In this state, the ganglions are all different from the nerves submitted to the same experiment. I have observed also in veal, that they have a very different taste from that of the nerves, a method of research which should not be neglected in attempting to ascertain the difference of the nature of the organs. In fact, as we do not yet know the difference of the principles which enter into the composition of each, we should be satisfied with the difference of the qualities.

The alkalies act a little upon the ganglions, which they tend to dissolve, and which they do partly dissolve, if they are very caustic. But this solution is infinitely less prompt and less easy than that of the cerebral pulp by the same re-agents. The ganglions resist putrefaction as much and even more than the nerves; this forms also a very remarkable difference between them and the cerebral substance. In general, we cannot establish any kind of analogy between them.

The texture of the ganglions appears in nowise fibrous; there is absolutely no linear, filamentous appearance, &c. upon simple inspection. Homogeneous, if we may so say, in its nature, it presents every where an uniform aspect when cut in slices. However the celebrated Scarpa has considered the ganglions as resulting from a kind of expansion of the nerves, into an infinite number of extremely delicate fibres, which interlace with each other, and which become very distinct by maceration. I have not repeated all his experiments, which appear to me extremely difficult. I refer then to his work, and to the plates it contains. I would observe only that there is certainly something else in the ganglions, besides a simple division of the nerve into extremely fine threads. In fact, mere inspection is sufficient to establish between them the greatest difference. There is as evident a demarcation between the ganglions and the nerves, as between those of the brain and the brain itself. 1st. Difference of colour, reddish or greyish tinge in some, white in others; 2d. difference of consistence, of external qualities, &c.; 3d. difference of properties. If the nerves coming from the spinal marrow make only an expansion, in their passage, in the ganglions, by delicate filaments, there would then be only a difference of form and not of nature; the properties would be the same. Why then are they so different as I shall prove hereafter? Why, as a nerve goes from a ganglion, does it not communicate more voluntary motions? 4th. Why has not nature placed ganglions in the nerves of the extremities as in those of the other parts? If there is only a division of the nerve into finer filaments, in the ganglion, why is there not a proportion between the filaments that enter on one side, and those that go out at the opposite? In fact, those that enter into the superior cervical above, if they only expanded their filaments in this ganglion, and united afterwards to form those that go off below, would be equal in respect to size to those that go from it; all the ganglions would exhibit this constant relation between the nerves of one side and those of the opposite; now, it is sufficient to examine them to be convinced that an inverse arrangement exists. 6th. The ganglions ought always to be in proportion to the size of the nerves which form them by spreading their fibres. Why then are the intercostal ganglions so small, and the trunks that unite them, or rather that give origin to them and which go from them afterwards as we see in the usual manner, so large? Why on the contrary, is the superior cervical ganglion so large, and its branches so small? 7th. How can be explained the frequent interruptions between the ganglions in man, which are constant in many animals, if there is a continuity between the nervous filaments that enter the ganglions above, and those that go from them below? 8th. How does it happen that the ganglions and their nerves do not follow an exact proportion as to development with the cerebral nerves, if these form them by expanding? 9th. Why has not pain the same character in each species of nerves?

I have no opinion as to the nature or the functions of the ganglions, because I have no fact to support me; but there is certainly something more in their texture, than a mere expansion of nervous filaments. Scarpa admits a peculiar matter which separates these filaments; but this substance ought to predominate considerably, as the ganglion surpasses in size the nerves which are thought to give origin to it. Now I have never seen this substance; I do not know what it is; all is solid when the ganglion is cut. I think then by admitting, even to a certain extent, the internal arrangement that this author has observed in the ganglions, we cannot describe these organs in the point of view in which he has presented them.

We know but little of the alterations that diseases produce in the texture of the ganglions. I have already many times examined in diseases of the heart, of the liver, of the stomach, the intestines, the ganglions that send nerves to these viscera; they have never appeared to me to have undergone any change. In cancers of the stomach in the very last stage, in which all the cellular texture is engorged, and in which all the lymphatic glands are considerably swelled, I have always found the semi-lunar ganglion untouched, except however in one case where it was enlarged and its density a little increased. At another time I found this same ganglion of the size of a small nut, with a cartilaginous substance in its centre, resembling the stone of it, in the body of a man brought to the Hôtel Dieu on account of periodical mania. Some authors have thought, and I suspect the same thing also, that the hysteric paroxysms, which begin by a contraction at the epigastric region, and in which the patient feels a ball mount up even to the throat, arise from some affections of the semi-lunar ganglions, from the solar plexus and the communications which go from ganglion to ganglion, even to the neck. However two bodies that I have opened lately, exhibited no alteration, though during life the subjects had been frequently attacked with these paroxysms; but they may arise evidently from the ganglions and the epigastric plexuses, without their being altered in their structure, as a number of cerebral affections leave after them no trace in the brain. This point deserves particular examination.

It does not appear that the texture of the ganglions is surrounded by a peculiar membrane. The cellular texture is only condensed in their neighbourhood; it then becomes very consistent, and much contracted around them. It there has the nature of the sub-mucous, the sub-arterial textures, &c.; it never contains fat. There is then truly around the ganglions, as around the arteries, under the mucous surfaces, &c. the two kinds of cellular texture of which we have spoken in treating of the organization of this texture, and which differ so essentially from each other in their nature, and even in their properties. It is the second kind, which is analogous to the sub-arterial texture, &c. which forms the peculiar membrane admitted by some authors.

By examining attentively the interior of the ganglions, we see that there is but very little cellular texture there. I have found this texture constantly destitute of fat; thus the alkalies do not form a saponaceous deposit upon them, as upon the cerebral nerves when plunged in their solution. I have examined many ganglions in this way, on account of the opinion of Scarpa, who believes that these organs are penetrated with this fluid, at least in fat people.

The ganglions receive many blood vessels. These penetrate them from all sides, run first in a kind of cellular covering that surrounds them, then entering their texture, ramify and are lost there in numerous anastomoses, and in continuation with the exhalants that carry nutritive matter. Fine injections show a great quantity of vessels in these little organs. Nutrition supposes exhalants and absorbents there.

III. _Properties._

It is difficult to analyze the properties of texture in the ganglions. As to vital properties, they cannot grow, live and be nourished without organic sensibility, and without insensible contractility of the same kind. Animal and sensible organic contractility do not exist there evidently. As to animal sensibility I have observed the following circumstance. As in opening the abdomen of an animal, of a dog, for example, he lives very well for some time, and remains even calm after the first moments of suffering; I have waited for this calm that succeeds the agitation arising from the incision of the abdominal parietes, then laid the semi-lunar ganglion bare, and irritated it powerfully; the animal is not agitated, whilst when I excite a cerebral lumbar nerve, for comparison, he cries out, raises himself up and struggles. In general it appears that the sensibility of the ganglions is infinitely less evident than that of many other organs. Certainly the skin, the mucous system, the medullary, the nervous of animal life, &c. surpass it in this respect.

Our ignorance as to the diseases that have their seat in the ganglions, the distance of those organs from external excitement, prevent our having any data as to their sympathies. I think it very probable, however, that these sympathies take a real part in hysteria, in certain kinds of epilepsy, the paroxysms of which begin, like those of hysteria, by a painful sensation at the epigastric region, in that multitude of affections called nervous, and which the vulgar confound under the name of vapours. One of the most important objects of research in the neuroses, is to determine those that have their particular seat in the nervous cerebral system and those which affect more particularly the system of the ganglions. Place on one side, palsy, hemiplegia, convulsions of infants, tetanus, catalepsy, apoplexy, the greatest part of epilepsies, all the numerous accidents that arise from engorgements, from compressions of the brain from wounds of the head, nervous affections of the sight, hearing, taste, smell, &c. and all the diseases the source of which is evidently in the head; on the other place hysteria, hypochondriasis, melancholia and all that numerous class of affections in which the abdomen and the thorax, the first especially, seem to be the spot in which the evil is seated; you will see that there is an essential difference and that the symptoms have entirely a different character. I do not say that the last kind of nervous diseases affect exclusively the ganglions; for too much obscurity hangs over these affections to pronounce any thing positive as to their seat, or their nature. Undoubtedly even the secretory, circulating, pulmonary organs, &c. can be then particularly affected in their peculiar texture and independently of the nerves they receive; but certainly it is an interesting subject of research, and there is too great a difference in the phenomena of the two orders of affections, not to present differences in their primitive seat. It is difficult to conceive that the system of the ganglions has not a great part in the last order.

That which induces me to think that the difference of the phenomena that the general order of neuroses presents us, arises particularly from the difference of the cerebral nerves and of those of the ganglions, is that their phenomena in a state of health are very different. Hallé has observed very well that the pains that are experienced in the parts in which the nerves coming from the ganglions are distributed, have a peculiar character, and that they do not resemble those that are felt in the parts where the cerebral nerves are sent. Thus the painful sensation that is experienced at the loins in affections of the womb, by vinous injection made into the tunica vaginalis, &c. a sensation that appears to me to arise from the sympathetic influence exercised by the organ affected upon the lumbar ganglions, the pains of the intestines, the burnings at the epigastric region, &c. &c. do not resemble pains of the external parts; they are deep, and go to the heart, as we often say. We know that there are colics essentially nervous, which are certainly independent of every local affection of the serous, mucous, and muscular systems of the intestines. These colics are evidently seated in the nerves of the semi-lunar ganglions, which are spread along the whole course of the abdominal arteries. They are real neuralgias of the nervous system of organic life; now these neuralgias have absolutely nothing in common with the tic douloureux, sciatica, and other neuralgias of the nervous system of animal life. The symptoms, the progress, the duration, &c. every thing is different in these two kinds of affections.

What I have just said upon the injuries of sensation, applies also to those of motion. No kind of comparison can be made between the convulsions of the muscles that receive the nerves of animal life, and the spasmodic and irregular motions which arise in all the muscles that receive nerves from the ganglions. Nothing resembles tetanus in the heart, the intestines, the bladder, &c.

All these considerations establish striking differences between the cerebral nerves and those of the ganglions; differences upon which I can only present approximations, as we have no data as to the functions of the last.

IV. _Development._

The ganglions differ essentially from the brain in the early periods in their development, which is proportionably much less advanced than that of the brain. They are only on a level with all the other organs, whilst this is infinitely superior to them in this respect, as we have seen. By comparing the superior cervical, semilunar ganglions, &c. in the fœtus, and in the adult, it is easy to make this remark. The ganglions receive also less vessels in proportion than the brain. They do not follow the proportion of increase of the organs to which they send nerves. Thus those that furnish the genital organs, which are nearly nothing during the first years of general nutrition, are as large in proportion as those which go to the liver, the stomach, the intestines, which are characterized by an early increase. These nerves follow in this respect the same law as the ganglions, though the most are found upon the arteries, which are more or less developed according to the organs they penetrate.

The nervous system of organic life being less early in its development than that of animal life, should be subject in infancy to fewer affections; and this is what is observed. Convulsions, and most of the neuroses of the second, are, as we have seen, a peculiar appendage upon infancy. On the other hand, the particular order of nervous affections of which we have spoken, and in which it appears that the first takes the principal part, is generally less frequent at this period. All nervous diseases, whose peculiar seat seems to be at the epigastric region, in which there is so great an abundance of nerves coming from the ganglions, appear to be foreign to this age.

Another difference that distinguishes the ganglions from the brain as it respects development, is this, that in the fœtus, they are not, like it, of extreme softness. Their hardness is little inferior to what they afterwards possess in adult age.

In proportion as we advance from infancy, the organic nervous system begins to become predominant. It is towards the thirtieth or fortieth year that it appears at its maximum of action; it diminishes as we approach old age; it decays in part at this epoch. The nerves become greyish; the ganglions are hard, resisting and smaller. The neuroses that appear to belong to them are infinitely more rare. Moreover, the obscurity that rests upon the functions of this system, does not allow me to point out definitely the alterations they experience in the different ages.

V. _Remarks upon the vertebral ganglions._

In all that I have said thus far upon the ganglions, I have not noticed those which correspond with the foramina through which the nerves pass, and which some call simple ganglions. We know that at the instant each nerve goes from each of these foramina, it exhibits an evident enlargement, reddish, pulpy, analogous in its appearance to most of the ganglions. I confess, that I know not how to class these organs. We cannot deny that they have the greatest analogy in structure to the others. They are approximated in another respect, which is this, that the nerves, in going from them, form almost immediately plexuses that we have designated under the names of cervical, brachial, lumbar, and sacral, in the same way as the solar, cardiac, mesenteric plexuses, &c. are formed by the nerves of organic life, at the moment they go from their respective ganglions. However, these last nerves are conductors of very different properties. Irritate in a living animal the superior cervical ganglion, the inferior even, which is more difficult, though it may be come at, the muscles to which they send nerves will remain unmoved; the same phenomenon takes place by exciting the nerves themselves. On the contrary, every irritation of a filament coming from the vertebral ganglions, produces immediately convulsions in the corresponding muscles. The sensibility is entirely different in the two species of nerves. Besides, there is no analogy between the manner in which the nerves go in all directions from the vertebral ganglions, and that in which the other ganglions furnish theirs. In the expectation that further experiments may elucidate the subject, let us content ourselves with pointing out what is the result of accurate observation.

ARTICLE SECOND.

OF THE NERVES OF ORGANIC LIFE.

I. _Origin._

Each ganglion is, as we have seen, a centre from which go in different directions, various branches, the whole of which form a kind of little separate nervous system. The manner of the origin of these branches has but very little relation with that of the branches of the brain and of the spinal marrow. The following are some differences that distinguish it.

1st. The adhesion is much stronger; the nerve breaks any where else rather than at its origin; the opposite of this takes place in the preceding system. 2d. It does not appear that the substance of the ganglion is continued in the nerve to form the medullary substance of it, since the organization of the one and the other is very different. Sometimes, however, the ganglion is continued for a short distance in the form of a cord. This happens especially in the superior cervical, in the lumbar, the semi-lunar, &c. Then the form only is different; but it is easy at the first view to distinguish where the ganglion ends and the nerve begins. 3d. This beginning is made in a sudden manner; it is like a muscle implanted in a tendon. The best manner of seeing this arrangement to advantage is to cut longitudinally the superior cervical ganglion and the cord it sends to the inferior; the change of nature of the one and the other is then very apparent; or, if we consider the ganglion as a division of the numerous filaments of the nervous cords, we distinguish very well the sudden change that these filaments experience in passing from the cord to the nerve. 4th. The dense cellular covering that surrounds the ganglion is continued upon the nervous origin, and gives it an increase of consistence at that place. This must be carefully raised before we come to the nerve. We see then each distinct filament arising from the ganglion. After it has gone from it, sometimes it remains separate; this takes place at the semi-lunar, the lumbar, the opthalmic, whose elongations are of great delicacy. Sometimes many of these filaments unite together and form a cord as between the two cervical, as at the great and small splanchnic nerves, &c.

I have not been able by maceration, ebullition, or the action of the acids to destroy the adhesion of the nerve with the ganglion, as we destroy that of the muscle with the tendon, of this with the bone, &c.

II. _Course, Termination, Plexuses._

The nerves after going from the ganglions, are distributed in many different ways which we shall now examine.

1st. There are always some which go immediately to communicate with the system of animal life. The ophthalmic ganglion sends branches to the motores communes, and to the nasal nerve. The spheno-palatine communicates with the superior maxillary nerve; the superior cervical with all the nerves that surround it, viz. above with the motor externus, within with the great hypoglossal, the par vagum, the glosso-pharyngeal, the spinal, &c.; behind with the first cervical pairs. All the ganglions situated above each other along the vertebral column, send communications through each pair of foramina that correspond with them. The par vagum communicates with the semi-lunar, &c. It is not then any separate ganglion of the nerves of animal life; hence the common expression that designates each ganglion as arising from this or that pair, or being found in its course, is very inaccurate. Thus the opthalmic is by no means in the course of the common motor nerve. The one and the other send each a branch, which unites; or rather there is a branch of communication between the ganglion and the cerebral nerve. In general all these branches of communication with the system of animal life, are short, whitish, and of the same nature, or at least of the same appearance as the nerves of this last. They do not form any plexus in their course, rarely furnish branches, and appear to have no other use than that of establishing anastomoses between the two systems.

2d. Each ganglion sends above and below branches to the two ganglions that are contiguous to it. We have seen that the opthalmic and the spheno-palatine are exceptions to this rule. Sometimes also, as I have said, there are interruptions in other regions. Notwithstanding this, these general communications make us regard the ganglions as being connected every where, and able to receive from each other the different affections of which they can be primitively the separate seat. These branches of communication are straight as in the preceding, sometimes very fine, as between the lumbar and sacral ganglions, at other times larger, as that which is between the two cervical, superior and inferior, in some cases very large, as the great splanchnic, which is a real trunk of communication between the intercostals and the semi-lunar. The nerves that we are now considering, the last especially, have like the preceding, an arrangement exactly analogous to the cerebral nerves; they are formed of whitish cords, which are the result of filaments. The eye discovers no difference between them.

3d. Many filaments coming from ganglions, go to certain cerebral muscles, as to the diaphragm, some of those of the neck, &c.; others go to neighbouring organs only.

4th. The greatest number going from the ganglions in separate filaments, interlace in the form of a plexus with those of the contiguous ganglions, in the neighbourhood of, or upon the great vessels. The most remarkable plexus is the solar, composed by the innumerable branches that come from the semi-lunar; then we see the hypogastric, the cardiac, &c. The greater number of these plexuses are not exclusively formed by the nerves of organic life; those of the animal give some to them also, as the par vagum furnishes an example for the solar and the cardiac, as the sacral nerves afford another for the hypogastric, &c. However the nerves of organic life always predominate in these plexuses. There is only the pulmonary in which the par vagum particularly predominates, whilst the nerves coming from the inferior cervical ganglion are, if we may so say, but accessory.

The primitive plexuses resulting from the interlacing of the organic nerves at their exit from the ganglions, form a mass of irregular nerves, buried in the cellular texture, accommodated to the forms of the neighbouring organs, and wholly different from those of animal life, as of the brachial, the lumbar, &c.

In fact, the filaments at every instant, not only place themselves as in the preceding ones, at the side of each other, at every change of position; but their extremities continue; they interlace with each other, change at every point the direction, form networks, and mix so together, that it is not possible to distinguish any thing except a thousand nerves, that we might say grew up under the cloth with which we wiped the place where the plexus was found.

These organs are remarkable for their reddish or greyish colour, for their softness, for their indistinctness, &c.; it is often difficult to distinguish them from cellular texture. The best manner of making them evident is to let the subject macerate for a day or two open in the water; they whiten then sensibly, do not soften, and appear even to increase in consistence, like the cerebral nerves in a similar case. Besides their delicacy is such, that it is impossible to submit them to any kind of reagents. Only I have observed that they possess in an eminent degree the property of horny hardening, and that they do not yield in this respect to the cerebral. This delicacy depends upon this, that all the filaments are separate from each other, instead of being like the preceding, collected into cords; it is this also that makes these nerves so numerous. If all the filaments of the brachial plexus were separated like those of the solar, they would present the same appearance and the same number in their interlacing.

Do the primitive plexuses formed by the ganglions perform a part in the nervous functions? are they centres to which are referred important phenomena? What has not been said upon this subject, concerning the solar plexus? But nothing, I believe, of all that has been advanced is founded upon accurate observation.

The plexuses of organic life are soon separated into different divisions, which go to different parts, to those especially of this life. These divisions arise from an infinite number of little filaments which go constantly separate, though placed near each other, and which never unite into cords like the preceding. They accompany almost all the arteries; thus the renal, the hepatic, the splenic, the coronary stomachic, the mesenterics, the hypogastric, the carotid and its distributions, &c. are surrounded with filaments coming from ganglions. These filaments go in two ways. 1st. Some accompany the artery without being connected with it; considerable cellular texture separates them; they go in its course without intermixing in a sensible manner with it. 2d. The others form for it, if we may so say, a new coat, exterior to the others, which adhere to it intimately, and which interlace so together, that they might be taken for a network surrounding the artery.