30 NOVEMBER 1844, Page 14

SIR GEORGE LEFEVRE'S APOLOGY FOR THE NERVES.

THE scope of Sir GEORGE LEFEVRE'S view is to be found in his motto from Dr. MACCULLOCH—" Without a nervous system there is no animal, there can be none ; without a circulating one there are myriads." The Apology for the Nerves is not, therefore, a quite accurate indication of the book ; for the object of the author is to advocate their predominating influence in disease, in opposition to those authorities who attribute the sole or greater importance to the blood. The nervous system, he says, "does not make up the sum of life, but we do believe it to be the most important fink in the vital chain."

In advocating this opinion, the author exhibits his subject in two phases. He first takes a general survey of human physiology, not only in its more obvious branches—as circulation, nutrition, secretion, the senses—and endeavours to show by reasoning and examples the domination of nervous influence or energy, but he also considers its singular powers as shown in sympathy, and its (supposed) effects in mesmerism and dreams. In the second phase of his argument he passes in review the greater part of the diseases which flesh is heir to, not only embracing those disorders which are generally ad- mitted to be nervous, but others that seem directly dependent on the blood—as scurvy; the object, as in the former section, being to show that nervous influence in some way or other is a real though a remote cause of disease. Thus Sir GEORGE states, that during the late Russian expedition to Khiva, the troops were healthy during the advance, but when the retreat commenced scorbutic disease appeared among them ; and he quotes Arisore's voyage to show, that "whatever discouraged the people, or any time damped their hopes, never failed to add new vigour to the distemper." The fact of depressing influences aggravating disease, or even seeming to produce it, is indeed well known, and not likely to be disputed by anybody whose opinion is of much value, any more than the loss of nervous energy in many or all disorders : but this leaves the point in question much where it was. The dispute is not about facts but causes—does the loss of energy produce the disease ? or does the disease produce the loss of energy ? Even in the case of sickness produced in armies and navies, it may be said that the depressing influences merely permit the disease to develop itself, but do not cause it ; and this view would appear to be strengthened by the distemper varying according to the circumstances and nation of the force : sometimes fever appears, sometimes scurvy, sometimes dysentery ; and so forth. It is a curious but a moot point, to what extent hope, or a stimulus of any kind, will throw off disease, or merely postpone it. Dr. M‘Wintrast struggled through the Niger fever as long as his duties stimulated him, but succumbed when the expedition arrived at Fernando Po: and many other cases might be quoted where stimulus of any kind sustains the individual for a certain time but the disorder appears afterwards. Hence, though we fully admit the wonderful powers of the nervous influence sud- denly exerted,—almost making, as Sir GEORGE LEFEVRE shows, the deaf to hear, and the lame to walk,—and though we agree with the author that many chronic intermittent diseases (" good-and-bad- day patients") appear to be temporarily overcome by anything which does not allow the person time to think about himself—yet two difficulties interpose to render these facts of any avail. In the first place, neither the patient himself nor any one else can produce these stimuli at will ; and if it were possible, the stimuli must be continually varied, or their repetition would soon fail of effect. In the second place, it may be doubted whether such remedies, if possible, would not be worse than the disease—whether the consti- tution would not sink under a succession of such surprises.

In these remarks we rather wish to intimate the difficulty of the subject than to ascribe an error of opinion to the author. So far as opinion, or rather as belief goes, we agree with Sir GEORGE LEFETHE rather than with those who take an opposite view of the subject. Tested not by preconceived opinion but by actual accom- plishment, his Apology for the Nerves may be held to put the predominating influence of the nervous system over the functions of the body in their normal state in a new point of view, and to indi- cate the probability that they exercise the most important effects in inducing general disorder ; though we do not see that there is any ground for holding that they originate specific diseases, snore than the blood, or than any particular organs. But the sub- ject is one of great difficulty, unsolvable with our present lights, and perhaps not solvable by our present faculties. Take a common cold, for example, which every one says is caused by checked per- spiration : does the nervous influence fail before the perspiration can be checked ? or is it lowered by the diminished action of the skin ? Why should the cold "fly" to various parts,—head, chest, or "all over " ? It may be said it attacks the weakest part ; but why does it pass from a cold into influenza, fever, and many other diseases ?

As regards execution in a medical point of view, the Apology for the Nerves exhibits the practical physician, whom long expe- rience has rendered more doubtful of the power of active practice, than the tyro, who is all for art ; and more observant of the efforts and operations of nature, which it is the physician's business to assist. This feeling, whilst it adds to the value of the work, may perhaps detract somewhat from the completeness of its theory. Sir GEORGE admits the inexplicable character of many operations of nature. Your quack or system-monger, bent upon making out a case, never allows that he is ignorant, or that any thing is inexplicable.

In a literary sense the book is of a very popular character, unless where the professional nature of the matter deprives the general reader of any interest in the subject. The style is clear, vigorous, and animated, with something of the easy pleasantness 'which characterizes the man of the world. This renders the book very readable : but perhaps it is not altogether exempt from the trait we noted in the author's anonymous Life of a Travelling Physician- s tendency to write for effect, or at least to make the manner predo- minate over the matter, as if the writer w ere relying too much upon his art. This may have arisen from habit, as a mode of writ- ing once formed is not easily shaken off ; or it may be that we are more sensitive on this point from seeing so much of writing, and that what is a fault in our eyes may be a merit with others. There is no doubt that it gives force and impressiveness to description ; as in the sketches of natural functions.

ImPORTANCE OP THE NERVOUS POWER.

In a state of health and tone we recognize its powers in the perfection of the five sense; : the smallest derangement of its minutest organization is accom- panied by imperfect communion with the external world in any of these five modes of relationship. The division of a little chord, finer than the most deli- cate lutestring, shall prevent the eye from seeing, the ear from hearing, the tongue from giving utterance; nor shall there he aroma in the rose, nor smooth- ness to the finger's touch—all shall be dead without; and then the inmost soul shall wither, pine away, and die. Its importance over the vital and animal functions equally prepooderates. The division of two small chord* shall suspend respiration; and circulation is so dependent upon the duties this function, that it soon ceases afterwards. In the processes of digeation, assimilation, and secretion, there is equal evidence of its prior claim to con- sideration. It is not so easy to test it in these latter operations by mechanical lesion as in the former ; but pathology affords us the same conclusive evidence ; and another power, of which at present we have but imperfect notions, but which offers us much that resembles the nervous, makes that evidence still stronger. Thus the nerves, which preside over digestion, may be subjected to test; and when, by division of these, this function is suspended, it may be re- newed by the snbstitution of the electric fluid.

Some of the facts in the following account of the effects of heat and cold support our view that the nervous system would not bear the frequent efforts necessary to overcome chronic or habitual dis- ease.

HEAT ANC coLD.

We find the body capable of resisting a temperature sufficient to decompose dead matter. Animals, as well as man, have been exposed to a degree of heat exceeding that of boiling water, and without injury ; when at the same time • thermometer placed under the tongue has indicated an elevation of a few degrees only above the natural standard. This power of resistance is but of short duration, for the nervous influence is exhausted by so extraordinary a demand. Chemical agents come into play, and matter is resolved into lifeless form.

As regards cold, the same law prevails, the limits are the same. However great the power may be of resisting it, as soon as the nervous energy is ex- hausted, the system is subject to injury.

I have witnessed the effects of cold too long endured upon the little postil- lions who are barbarously exposed to it in the winter season at St. Petersburg. The lads bear it for a time, as they sit on their horses, clapping their hands, and singing to keep up their courage ; but this fails them by degrees, aud finally, benumbed, they fall from their saddles in a state of torpor which nothing but rolling them in the snow will overcome. There is seldom a fete given at St. Petersburg in the extreme cold weather that occurrences of this sort are not recorded. In very cold nights the sentries are frequently frozen to death, if not relieved at short intervals.

As long as nervous excitement can be kept up, the resistance of cold is very great. General Piroffsky informed me, that in the expedition to Khiva, not- withstanding the intenseness of the cold, the soldiers marched along singing, with the breasts of their coats open, but only as long as they were flushed with the hopes of success. Where there is nothing to excite, and where exposure to cold takes place under the common routine of parade, its depressing effects are lamentably felt by those long exposed to it. In the time of the Grand Duke Constantine, a regiment of horse was marched from Strelna to St. Petersburg, a distance of twelve miles and upwards. He marched at their head at a foot pace all the way. He had well wadded himself; and smeared his face over with oil. It was the gratification of a whim to expose the soldiers to a great degree of cold. They arrived at the square before the palace, and were dismissed to their barracks. The following day one-third of the regiment was in the hos- pital, attacked by nervous fever, of which many died. There was no stimulus of necessity in this case ; but the moral feeling aggravated the physical suffering.

OPTicAL DELUSIONS AND GHOSTS.

It is when the brain and nervous system have been shattered by moral Causes, or by the sequela of physical ones, that the most curious phenomena occur as regards the visual powers. The author of the Diary of a Late Phy- sician has published a ludicrous paper of the spectre dog, which followed the man wherever be might he: he could not shake him off, either in his walks, or in his bedroom, or in the stage-coach ; the dog was always there. I know not whether this story be founded on fact or not, but a case very similar occurred in a gentleman, who related it to me. lu great distress of mind, he had taken a quantity of laudanum with the intent to poison himself. It did not accona- phsh what he intended, but was productive of most distressing nervous affec- tions. Among others, as soon as he was in bed at night, he saw a dog lying at the foot of his bed upon the floor, lie got out of bed to verify it—the dog vanished; when he returned to his couch, there was the dog again. The most singular item in the history was, that his mind could not rectify the error; the visual impressions overcame the rational powers. He would leave his bed two or three times in the same night to be shanied by a phantom ; and this lasted for full six weeks. At a subsequent period, and previously to his death, which was a melancholy one, he was haunted night after night by a chess-board with men upon it.

That ghosts and apparitions have appeared to people, cannot be doubted. Carlyle has alluded to the history of Luther and the blue-bottle fly, and re- ferred it naturally to that imperfect state of the sensorial powers when debili- tated by physical exhaustion or moral causes. It is not true that there are ghosts in substantial forms, paradoxically expressing it ; but they are visible to the mind's eye. It is nowhere recorded that two people ever saw a ghost at the same time and in company. It might so happen, that of two men walking down a lane at night, one should fancy he saw a ghost, and point it out to the other, whose fear might persuade him that he saw something; but no two Men at the same time, and in each other's company, ever saw the same spectral form before their eyes.

TASTE .

I knew a gentleman engaged in commercial concerns, whose mouth was out of taste for many months. Ile consulted several medical men, with no relief ; and as he was otherwise in good health, his friends laughed at him, but that made him no better. His nervous system was during this time much in- fluenced by the state of his affairs; for the sudden death of his predecessor had left him a deal to wind up, and he was very anxious to establish himself in the business. In this state he was obliged to go to England ; where, having found everything to his satisfaction, his taste came round again.

There is a certain relation between taste and smell, and the simultaneous mixture of the two adds to the pleasure or disgust of certain liquids. The aroma of the flue wines is twice tasted by the gourmet, who applies the glass to his nose before be drinks the contents. The child is told to hold his nose tight before he swallows his senna tea.

The volume is not wholly devoted to the nervous system, but contains some temperate remarks on Homceopathy,—whose results Sir GEORGE attributes to regimen and faith ; as well as an account of the German system of practice in some disorders, as contrasted with the English. There is also an appendix, in which some points only touched upon in the body of the book are elaborated in a more medical manner than was consistent with the plan of the text.