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THE MEDICAL ECLECTIC,

DEVOTED TO

Reformed Medicine,

GENERAL SCIENCE AND LITERATURE.

Editors:

ROBERT S. NEWTON, M. D., LL. D.,

Professor of the Theory and Practice of Medicine in the Eclectic Medical College, of New York. ROBERT S. NEWTON, JR., M. D., L. R. C. S.,

Professor of Surgery and Ophthalmology in the Eclectic Medical College, of New York. Published every month, by THE ECLECTIC MEDICAL COLLEGE, of the City of New York.

VOL. VII.

JULY, 1880.

No. 7.

ORIGINAL COMMUNICATIONS.

INTERACTION OF PHYSICAL AND VITAL ENERGIES. BY GEO. H. TAYLOR, M. D., NEW YORK.

The remarkable efficacy of transmitted energy in restoring defective and irregular nervous power has its foundation in the nature and relations of the different classes of vital energy to each other.

This will be understood on reviewing the physiological processes whereby the different forms of vital power, especially those of the muscles and the nerves, are evolved.

The development of dynamic, or muscular energy, involves nutritive support of the muscular tissue, as the condition for its further development; or the incorporation of supplies of outside material, which include that which is destined to appear as energy. The vital molecule, in parting with energy, is reduced to common dead matter, which in health is instantly removed and replaced by

like material, similarly endowed; and thus the physical and dynamic power of muscles are maintained.

The energies of the nervous system are maintained by a similar process, being that of constant importation from outside sources. The nervous system represents a variety of forms of power; as sensation, emotion, reflex action, intellection, and those combinations and modifications of them which constitute the will. The gray matter of the nerve centres are the vital organs which have the power to eliminate nervous energy, as the muscles do the dynamic variety.

As all vital parts and tissues are practically bathed in a solution of food and oxygen constantly renewed (the blood and its circulation), it is plain that the support for vital action is ever present, and ready to yield to acting organs that which is demanded by them to sustain each special form of action, whether it be that of muscular or nervous energy. Such support, in any case, is conditioned upon use, and upon nothing else. It is quite impossible to force nutrition upon unwilling organs. Physicians often attempt this method, but the consequences, in the long run, are often dis

astrous.

The instruments of energy-the vital tissues of muscles and nerves-draw upon the common fund, the blood, only in proportion to use, and extract from this fund the special combinations of elements that are adapted to serve the demand.

Immense injury arises from the endeavor to extort nervous and muscular energy by medicaments, and by other means than is provided by nature, in the natural use of the instruments of power. In no other way is their capability for use reinforced and maintained.

The blood contributes of its multiform components to whatever tissue presents its demand by action, that which through the organizing process is capable of sustaining such action. Every functional act is a local demand on the whole resources of the system. The organ is local; the supply is general and mobile. The parts of the vital system are so connected and so responsive to local nutritive calls, that they unite in urging the general supplies forward to the point of need. The blood evidently comprises ample resources to sustain alike the muscular and nervous ener

gies, and these are yielded to the support of either, in the ratio of the demand produced by use.

Healthy persons, therefore, find no difficulty in supporting either class of functions from the same food. This shows that ordinary food contains ample diversity for all needs; if for those in good health, therefore for the ill, whose requirements are the same in quality, but greatly diminished in quantity, by reason of inactivity of function. Hence, it appears, that special aliments for the support of weakened powers are of slight utility; the plan does not recognize that the essential difficulty is not in aliment as such, but in its imperfect application to use.

The physiological process.of deriving vital energy from aliment is a double process. Muscular energy is naturally evoked by the incitation of nervous energy. The senses, the emotions, the intellect, and that resultant of the combination of these designated as the will,. are the usual and natural provocation to muscular action. Thismode of action of the two varieties of power, involve nutritive changes in the respective instruments located at the utmost dis tance from each other. The two classes of function, while acting nearly simultaneously, are, in fact, the natural counterpoise of each other at least, as regards the distribution of nutritive support,. derivable from the blood.

This law is essential; otherwise there can be no surety of a proper distribution of the blood, laden with energy bearing material. It is in the contravention of this law that we shall find a profound cause of derangement in the product of energy yielded by the system, and of the organs which give rise to it. This law is, in fact, the key to the etiology of widely prevailing forms of nervous disease, and equally a guide to prophylaxis and cure.

The approach to and development of nervous disease proceeds something in this wise: Exercise of the nervous function in some one or more of its departments is prolonged. Constitution,. habit, circumstances, control this. The continued evolution of nervous energy compels, to a corresponding degree, the adjustment of the physiological mechanism to support the energies being so. liberally and unremittingly set free, by conveying the blood in increased amount to the region of action. But, corresponding: muscular action being wanting, it is plain. that the condition abso

lutely essential for redistribution of the circulating fluid, in this way concentrated, is inoperative. The consequence is, the local vessels of the brain and spinal cord become surcharged, dilated, stagnant. Hyperæmia is the inevitable consequence. From this there is no prospect or hope of permanent relief, except by the operation of the natural law, making a counterpoise of the muscles by muscular action. In this downward progress the first stage is apt to cause temporary local nervous excitation (neuralgia), soon followed by diminished power of sensation or motion, or both. This may be succeeded by well known pathological changes of substance of different orders, which, however, are not so much the real disease, as its last products.

These residual effects of aberration of function are less amenable to physiological removal than are the normal tissues, but do not necessarily require remedies additional to physiological action. 'But this physiological action must be intensified, by introducing exterior energy through mechanical methods.

Defective counterpoise causes the pathological state only in case of the nerves. Excess of muscular action can only diminish nervous manifestation. That intellectual strength, emotional power, and even sensation are distinctly diminished, by prolonged excess of muscular action, is matter of common observation. Injury occurs only when the muscles, failing for want of rest, are further stimulated by still greater nervous exertion by the will, when temporary nervous exhaustion occurs, which is restored by judicious

rest.

We e may now present some of the various kinds of evidence of the correctness of the fact, that the principal instruments of nervous energy are seriously injured, often destroyed, by prolonged deficient muscular counterpoise.

Physiological Evidences.-These have mainly been presented in the fact of the facility with which the sources of energy may normally be diverted from one portion of the system to another, and from one tissue to another, and so be made to assume at will the form of dynamic or of nervous energy, according as it is evolved by the muscles or the nerve centres.

Pathological Evidences.-Certain morbid irritations of the spinal centres produce muscular spasm. The violent muscular contraction

and liberation of energy calls for nutritive support, producing thereby such counterpoise as to diminish the morbid nerve-excitation, and the spasm, temporarily, at least, removes its own cause.. Epilepsy is an extreme illustration of this principle. The whole muscular system is thrown into violent contortions. The revulsive effect of extreme muscular activity reduces the local nerve irritation (which may consist of temporary local hyperæmia), and the system very soon returns to its normal equipoise. Hysteria presents similar marked illustrations of the principle, as does also instances of local spasmodic action of the muscles.

Therapeutic Evidences.-It is within the writer's experience and knowledge that each of the above forms of spasmodic action is radically caused by means of energetic muscular action, or rather, by such action imparted to the muscular system. For, according to the hypothesis as well as the facts of experience, it is necessary that nerve centres should not act; that the motion should be not only very energetic, but entirely passive.

Evidences from the Consequences of Pain. It is well known to physicians, that in prolonged sciatica the affected limb is soon found to be diminished in size; the difference of circumference between the affected and the sound limb often amounts to one or two inches at the thigh. So, too, the muscles of any other painful part will diminish. The reason for this is evidently because of the diminished muscular nutrition produced by the excitement, and consequent increased demand for the support of the morbid energy of the nerve centres. The muscles are starved by pain-pain being doubtless a form of energy, and a product of increased nerve nutrition. It is often observed that even a painful rheumatic member soon diminishes in size, affording evidence of morbid diversion of the energy bearing nutritive support. On the other hand, excited muscular action, or continuous spasm, sometimes occurring in partial paralysis, causes increase in size of the affected muscles, showing conclusively which form of morbid excitation demanded the larger amount of support.

Evidences from the Effects of Drugs.-The class of drugs included under the head narcotics, or quiet and sleep producing remedies, have the ultimate effect of increasing, relatively, at least, the functions of the cerebro-spinal centres. It is not necessary to

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