Anal, p. 2/19 M... Reynolds. M

ON IRRITATION AND INSANITY.

A WORK,

1834.

WHEREIN THE RELATIONS OF THE PHYSICAL WITH THE MORAL CONDI-
TIONS OF MAN, ARE ESTABLISHED ON THE BASIS

OF PHYSIOLOGICAL MEDICINE.

BY F. J. V. BROUSSAIS,

THEVALIER OF THE LEGION OF HONOR, PRINCIPAL PHYSICIAN AND PRO-
FESSOR AT THE MILITARY HOSPITAL OF INSTRUCTION AT PARIS, AND

TITULAR MEMBER OF THE ROYAL ACADEMY OF MEDICINE, &c.

TRANSLATED

BY THOMAS COOPER, M. D.

PRESIDENT OF THE SOUTH CAROLINA COLLEGE, IN THE STATE OF SOUTH
CAROLINA; AND PROFESSOR OF CHEMISTRY, MINERALOGY, GEOLOGY,
AND POLITICAL ECONOMY IN THAT INSTITUTION.

TO WHICH ARE ADDED

TWO TRACTS ON MATERIALISM,

AND

AN OUTLINE OF THE ASSOCIATION OF IDEAS.

BY THOMAS COOPER, M. D.

COLUMBIA, S. C.

PRINTED BY S. J. M'MORRIS,

MARCH 1831.

PREFACE

OF THE TRANSLATOR.

E features of what has been termed Physiological Medicine in France, and of which Dr. Broussais, Professor of Medicine, at the Hospital of Val de Grace, is the chief propounder and supporter, are principally these.

The Body consists of certain organized parts, as the circulating and respiratory apparatus, the thoracic and abdominal viscera, the muscular apparatus, the secreting and excreting glands, the osseous structure, &c.

The membranous elements of which these are composed, are tissues. They are all of them subservient to the nervous apparatus, of which the Encephalon is the centre of communication.

The tissues of the animal body, appear to be composed chemically, of fibrine, of gelatin, and of albumen. The muscular parts are chiefly fibrine; the skin, the mucous membrane, &c. are chiefly gelatin; the nervous apparatus is albuminous. The phosphat and carbonat of lime composing the bones, do not seem to have like properties with the other tissues; but these chemical subsubstances in the living body have not been fully examined. All of them, except the bones perhaps, are contractile upon the application of certain substances called stimuli: upon this property (of contractility) depends the motion and action of the organized parts.

Life is the aggregate of those functions which the several organic parts of the body perform, on being stimulated into action, by the natural stimuli of caloric, light, air, atmospheric electricity, and food, in the usual and regular proportions and degree.

The organic actions excited by these natural stimuli in a healthy body, eonstitute the normal, regular, healthy functions of the

various parts so stimulated into action; the aggregate whereof, is included in the term Life. When the tissues from any cause, are more than usually irritable; or the stimuli applied, are in excess as to proportion, or from their unusual character, the natural stimulation of the tissues and organs, becomes increased or exalted into over-excitement or over-stimulation, technically called Irritation. Stimulation, therefore, is the term appropriated to what produces regular, usual, normal, healthy action; Irritation, to a morbid increase of stimulation; and, in the language of Rush, may be termed, morbid action. Irritation has various shades and degrees, extending from a very slight excess of stimulation, to inflammation, and consequent disorganization of the part affected, terminating in suppuration or in gangrene.

Irritation, producing abnormal, morbid action, may, according to the degree and continuance of the irritation, exist in a tissue or an organ, or a viscus, for a long time: the consequence will be functional derangement, without manifest organic lesion or destruction. After long continuance, this functional derangement may assume the character of habit, or may proceed gradually to sub-inflammation, inflammation, and disorganization,

Contractility, stimulation, irritation, are not entities distinct from the tissue itself, which is contractile and irritable, or which is stimulated or irritated: they are words without meaning, if the meaning do not strictly include the tissue stimulated or irritated: we know nothing of them, but in connection with the tissue itself, of which they are properties.

All the tissues are pervaded, more or less, by nervous fibre.

The nervous apparatus, consisting of the encephalon and its ramifications, and the spinal cord and its ramifications, may be considered as divided into two great portions-the one serving for voluntary, and the other for instinctive and automatic functions. The encephalic apparatus serves for the first, the spinal cord and its ramifications for the second set of functions.

Sensation, perception, feeling, consciousness, are words denoting that property or function of the encephalic nervous apparatus by which we have cognizance of objects extraneous to us, and also of the visceral affections and wants within us, transmitted to the encephalic centre by the internal visceral nerves. This property

or function of the encephalon is termed Sensibility.' It connects us with the material world extraneous to our bodies, and with the affections or modifications of our internal organs, destined to instinctive and automatic functions.

Hence we have two sources of sensation, viz. one, the impres sions made on the nerves of our senses by external objects; and another, the impressions made on our internal, visceral nerves, and thence transmitted to the nervous centre, the encephalon. The nervous apparatus of voluntarity, is stimulated to action by these transmissions of impressions from without, and affections from within us. The influence of the encephalic centre on the nervous system in various parts of the body, is called Innervation. The nerves that transmit to the brain information of the internal visceral affections, are not the same as those that transmit from the brain, the resulting voluntary motions.

All the tissues and organs of the body being instruments of, and subservient to the nervous apparatus of the encephalon, whenever any of these are morbidly irritated, or have suffered lesion, or any other abnormal (morbid) affection, the nerves of the part become irritated, and act sooner or later upon the encephalic, as well as on the neighboring nervous apparatus; the nervous system thus becomes gradually irritated, and assumes abnormal, morbid action, and what is called disease ensues.

Disease is a word only, not an entity or thing. Like other abstractions, it has been personified. But disease is strictly nothing else than the disordered action of some injured or irritated tissue, producing derangement of function; it has no meaning separate from the tissue actually affected: and the cure of disease, is the restoring the regular, healthy, normal action of the part, in lieu of the irregular, abnormal, morbid action which constitutes disease.*

Hence, no man is competent to pronounce on disease, who is not well acquainted with the regular, normal, healthy action of

*The leading principles of physiological therapeutics, are:

Sedatives including general, and topical bleeding by leeches and cupping: mucilaginous drinks: cold affusions: gentle laxatives and enemata. The general rule being, to avoid as much as possible, irritating by medicaments an internal surface already in a state of irritation.

Revulsives: as epispastics, sinapisms, and sinapial pediluvia, irritating unguents, cauteries, and issues.