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choly instance of the power of the imagi-nation to kill the body, even when its fan-tastic terrors cannot overcome the intellectof the unfortunate person who suffers underthem. The patient in the present case sankunder his malady; and the circumstances ofhis singular disorder remaining concealed,he did not, by his death and last illness,lose any of the well-merited reputation forprudence and sagacity which had attendedhim during the whole course of his life."*Notwithstanding the continued illusion in

this case, there was no insanity; the hypo-chondriac had no belief in the reality of thespectral form which haunted him : if suchhad been the case, his disorder would nolonger have been hypochondriasis, but trueinsanity. Thus, in the case of the baker ofFerrara, recorded by DoNATUS, who believedthat ne was made of butter, and on that ac-count would not approach the oven lest heshould melt, the disease was no longer hypo-chondriasm, but true insanity. These illu-sions depend both on corporeal and mentalcauses : when they proceed from the formerthe health of the brain remains entire, thepatient is a reasonable man in all other re-spects ; when from the latter, the brain isalways disordered either by the unequal ex-ercise of it, or hereditary predisposition.Thence the difficulty in distinguishing be-tween hypochondriasis and insanity, whenhallucinations are present, for they occur inboth, is undoubtedly great; but in one respectdiffer,—the hypochondriac does not believein their reality, and they are in him onlytransient, whereas in the insane they arenot only permanent and fixed, but there isalso a rooted conviction of their reality, animplicit belief in the delusion.But, notwithstanding this test, many cases

have been recorded as instances of hypo-chondriasm which should, apparently, havestood as cases of insanity ; as a proof ofwhich I shall mention a case related byMARCUS DONATUS, of one VICENTINUS, whoimagined that he was of such an enormoussize that he could not go through the doorof his apartment. He was led forciblythrough it, and believed that, in the passage,the flesh was torn from his bones, and thathis limbs were broken off. In a few dayshe died of this impression, accusing thosewho had conducted him of being his mur-derers. Now, in this instance the erroneousidea of his size might be regarded as hypo-chondriacal; but it is dilficult to conceivethat the conviction of the effects of forcinghim through the passage could have been sodeeply rooted in a sane mind. Notwitli-standing the apparent amalgamation of hypo-chondriasis and insanity, attention to thecircumstances which I have pointed outwill generally enable you to discriminatebetween hypochondriasm and insanity.

’ Scott’s Demonology, Letter J., p. 28.

LECTURESON THE

PHYSIOLOGY OF THE NERVOUS

SYSTEM,DELIVERED IN 1836, IN THE COLLEGE OF FRANCE.

BY M. MAGENDIE.

LECTURE XV.Resumé of previous Statements and Experi-

ments. The Vidian Nerve, a retrogradeBranch of the Fifth. The Treatment ofFacial Diseases. Special Sensibility of theNerves of the Head. The Optic and Olfac-tory Nerves entirely destitute of generalSensibility, Which Nerve, the Fifth or theFirst, presides over the special Sensibilityof the Organ of Smell ? Experiments on aFrog and a Dog. Qualified Conclusion infavour of the Fifth. Animals which possessno Olfactory Nerve.GENTLEMEN :---In my last lecture I took a

rapid view of the different branches of thefifth pair of nerves, and examined the in-fluence which the latter exercises over thevarious parts of the face, and some of the" organs of sense," properly so called. You

saw how one of these branches, and that aconsiderable one too, was distributed to themasseter, the buccinator, and the pterygoidmuscles ; another to the pa.Ipebra3, conjunc-tivas, and forehead; while the principal por-tion of the nerve, having furnished somefilaments to the nares and all the teeth, islost in the integuments covering the anteriorregion of the face, about the cheeks andchin. I entered into these anatomical de-tails merely for the purpose of showing youhow the extensive distribution and commu-nications of this nerve enabled it to exercisea very wide-spread influence over the sen-sibility of the face. I also drew your atten-tion to an anatomical fact which is worthyof your attention in more than one point ofview, viz., the numerous anastomoses whichexist between the filaments of the fifth nervewith those of the seventh, and the possibi-lity of more attentive examination discover-ing the more intimate relations of these twonerves. I also spoke to you of the nervewhich is supposed to preside over the senseof smell; and an experiment which I per-formed before you demonstrated, in a veryclear and positive manner, that this nervealso may be irritated, and even destroyed,without the animal’s exhibiting the leastmanifestation of sensibility.Here is the rabbit on which we performed

the experiment alluded to at our last meet-ing. When I touch the inside of the nostrilthe sensibility seems to have undergone nomodification of any kind. You would ima-gine that both the first and fifthherves werein a state of perfect integrity, but this is not

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the case; I am pleased at the experiment when we know accurately the point of thehaving been so successful, for it is one in nervous system which is diseased, in para-which we are apt to fail. lysis, for example, we apply galvanic orHence, in examining whether the anato- other stimuli to the nervous branches which

mical dispositions of the fifth pair of nerves suffer, and thus act in the most eflicaciouscorresponded or not with the physiological manner possible.phenomena of the nerve, we found a very Having said thus much touching sensi-close connection between them both. There bility in general, let us turn our attention tois scarcely a point of the face which does special sensibility, or to that species so pecn-not receive a filament from some of the liar to the organs of sense. A natural coursebranches of the fifth pair of nerves, and you would be that of examining sensibility in allall know how extremely sensible is this the nerves of the human body, and thenportion of the body ; for, as we showed, the ascend to those of the senses; but as yetfilaments of that nerve communicate sensi- we have merely spoken of the nerves of thebility. head : these latter are amongst the mostThe distribution of the fifth nerve is not interesting; we shall, therefore, confine our

confined to sending its filaments forwards inquiry, at present, to the special sensibilityto the integumentary covering of the face; of the nerves of the head.it also sends retrogrude branches, as, for There are certain portions of the cephalicexample, the vidian nerve, which enters nervous system which enjoy no degree what-the petrous portion of the temporal bone, ever of general sensibility; the optic andand there takes the name of chorda tympani. olfactory nerves, destined, as their namesThis, Gentlemen, is a very curious anato- indicate, for two of the special senses, aremical fact; but, unfortunately, it is not al- completely destitute of general feeling. Thisways that we can discover a connection be- fact, which we have repeatedly demonstratedtween anatomical distribution of the nerves on the living animal, is one that is perfectlyand their physiological phenomena, though, new. The physiologists of the last century,undoubtedly, such connection invariably who built their systems on conjectures andexists. not on experiments, could never have de-

Finally, we entered on an examination of vined, or even given credence to, the factthe question, Whether anatomy could fur. of which you yourselves were witnesses,nish us with any explanation of the manner when last we met. The phenomena of spe.in which one nerve influences the functional cial sensibility have been subjected to theaction of another nerve ; and we demon- test of experimennt, as well as those belong-strated, as clearly as the nature of the sub- ing to general sensibility; and the peculiarject would permit, that it is not by simple disposition of the organs with which theyanastomosis, or communication of filaments, are connected has been carefully studied bythat the seventh nerve receives its sensibi- the most distinguished anatomists. Thelity from the fifth. Some doubt, however, labours of the latter have not been entirelystill hangs over this point of physiology ; lost ; they show us the connexion and har-to determine it, rigorously, we should ex- mony existing between the distribution ofamine and experiment on the anastomoses those nerves, in their organic apparatus,andof these nerves in the living body, and it is the functions they are destined to fulfil,unnecessary for me to say how very difficult Thus, for example, with respect to the sensethis would be. Such is the state of the of smell, we find in the nostrils and nasalscience, as it exists at the present day: im- fossae a disposition of parts which is similar,perfect, it is true, but progressing. in general plan, to what we observe in the

The physiological facts just mentioned are lungs, viz., an arrangement which is des-a foundation on which many practical views fined to augment the sentient surface, with-in medicine must be built. The " facial out any incommodious increase of bulk, asnerves" (including under this term all the in the lungs we have an immeuse spacevarious branches which are distributed over exposed to the action of air in a, compara-the face) must evidently play an important ratively, very small compass. A disposi-part in many of the diseases which manifest tion of this kind is evidently well calculatedthemselves in this region of the body, and to receive a large mass of air charged within many of them the lesion is strictly con- odoriferous particles, and so far an ana-

fined to the nervous system. In this latter tomical knowledge of the organ of smell il-case, the facts we have established render lustrates its physiological qualities; butyour practice sure, whereas, formerly, the this alone would never enable us to pro-physician was compelled to practice at nounce on the nature of the sensibilityhazard. Henceforward you will know when which resides in the mucous tissue of theto address your remedies to the seventh pair nares, or to decide whether its special sensi-of nerves, and when you should act exclu- bility be connected with one nerve rathersively on the fifth pair. It is also evident than another,-depend on the first pair, forthat an accurate knowledge of the anasto- example, rather than on the fifth.moses of these two nerves may be highly If, as anatomists, we examine the branchesuseful in a therapeutical point of view, for of the fifth pair of nerves which are distri-

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tributed to the interior of the nasal fossre, This, it seems to me, is the only method ofand the ultimate filaments of the first pair, deciding the question in a rigorous manner.we shall in vain seek to discover any rela- If we argue from the facts which patho-tion or analogy between their physical dis- logical anatomy presents us with, the ques-positions and the sense of smell, or the func- tion is already decided in favour of thetion attributed to one of them. Anatomy, fifth pair, for numerous pathological phe-then, leaves us in the dark, and we must nomena demonstrate that the special seusi-

address ourselves elsewhere for an answer bility of the organ of smell may be lost,to the question, which of these two nerves while its general sensibility remains intact;presides over the special sensibility of the but, on the contrary, that it is impossible toorgan of smell? Let us commence our ex- destroy the general sensibility without, atamination of this question as if physiology the same time, modifying the special morewere in its infancy, and as if we had ac- or less profoundly, unless we admit, indeed,quired no idea or knowledge whatever upon the untenable opinion that each differentthe point in question. And first, if we ex- odour acts on the olfactory apparatus in aamine what history says touching the mat- manner which is essentially different frommatter in debate, we must go back to the that in which the rest operate. An immenseauthors of the preceding century. number of experiments has proved to usSCHNEIDER was the first anatomist who that burning, pricking, irritation with strong

positively established that the " mamillary vapours, &c., produce no effect whatever onprocesses" of the ancient writers (olfactory the mucous membrane of the nares in thebulbs_) descending through the foramina of living animal after the fifth pair of nervesthe cribriform plate of the oethmoid bone, has been divided. The olfactory nerve

were disturbed by numerous filaments over exists in most classes of animals, but it isthe mucous membrane of the nasal fossse ; developed in the reptile tribe to a very re-hence he concluded that these were the olfac- markable degree ; hence it would be de-tory nerves. The same question occupied the sirable to peform a series of experiments on

attention of the great Italian anatomist, and this nerve in reptiles; but these animals,gave rise to the beautiful work of SCARPA generally speaking, do not answer well foron the organ of smell. But here, again, I experiments of any kind; besides, the ex-must put the question-" Are these anato- treme degree of sensibility which many ofmicaldiscoveries, however brillant, sufficient them possess might very readily lead theto reveal the functions of the nerve whose observer into error. [Here the professordisposition was thus minutely established?" passed under the nose of a frog the stoppleCertainly not. The anatomical structure, of a flask which contained’some ammonia,or disposition, of a nerve, presents no ana- and the animal immediately gave signs oflogy or relation whatever to the function acute feeling.] You see (said M. Magendie)of that nerve, at least none that we can dis- what has happened ; however, we must trycover ; this is allowed on all hands. At the the experiment. I now destroy with thetime in which SCHNEIDER wrote it is not scalpel the bulbs of the olfactory nerves,surprizing that he should have concluded and leave no connection whatever betweenwhat was the functional action of a nerve the anterior portion of those nerves and thefrom its anatomical disposition, for at that cerebral hemispheres; in doing this I amperiod of the science theories were received forced to destroy a good deal of the brain ;without scruple, and men took little or no this has been the cause of our experimentspains to obtain direct or experimental proof failing. You observe the convulsive move-of what they advanced. N ow-a-days, how- ments with which the little animal, who be-ever, circumstances are changed; the empire fore lay so quiet, has been just seized; it isof facts gains daily more and more influence: because I injured a portion of the opticand should experimental physiology demon- thalami.strate the contrary of what has been so long Let us try and be more careful in ourtaught and believed with respect to the second. Here is another frog : I have de-functions of the olfactory nerve, we must stroyed, in the most complete manner, theneeds sacrifice our ancient prejudices to connection between the olfactory nerves andtruth, the brain, without, as in the last case, injur-You have seen that we can distinguish, in ing any important part of the cerebral he-

the living body, the special sensibility of mispheres; I now pass the ammonia underthe nasal fossaefrom their general sensibility; the animal’s nostrils, and you all see how ityou also had an opportunity of convincing exhibits’just as much symptoms of sensi-yourselves that if the first pair of nerves be bility as it did before the destruction of thereally the special nerve of smell, at least it olfactory nerves. The experiment you haveexercises no influence over the sensibility just witnessed, Gentlemen, would be deci-of the nares. However, it remains to be sive were it not for one circumstance whichseen (but,unfortunately, the experiment is a takes away a good deal from its value. Thevery difficult and complex one) whether the integumentary covering of the frog is highlysense of smell would survive after the fifth sensible, and hence the result obtained bypair of nerves was completely destroyed. applying ammonia to its nostrils, as well as

844

the results of various other experiments,may, very possibly, belong to the generalsensibility of the’skin, and not to the specialsensibility of the nerves, as an organ ofsmell. Comparative anatomy, from whosestudy we derive so many interesting andvaluable facts,teaches us s that certain animal s,the cetaceae, for example, do not possess anolfactory nerve ; yet persons who have hadan opportunity of observing those animalsassure us that they enjoy the sense of smell.It would be highly interesting to determinewhether the sense of smelling in theseanimals is furnished by the fifth pair, a con-jecture the more probable that nearly thewhole of this nerve is distributed to thenasal fossae.But to continue our experiments. Here is

a young dog in which I have laid bare theanterior portion of the lobes of the brain ; Inow divide across the bulbs of the olfactorynerves, and separate them entirely from thebrain ; but I beg you to remember that, be-fore commencing the experiment, I passedsome ammonia under the dog’s nose, and theanimal was perfectly sensible to the odour.Now, if the sensibility to the same odour

persists after the destruction of the olfactorynerve, you will be compelled to allow thatthe olfactory nerve is not indispensable tothe sense of smell ; if, on the contrary, allperception of odour ceases, you may con-clude with certainty that it is really the

agent which presides over the sense in ques-tion.

, The experiment which we have just per-formed gives rise to another consideration,of which we have already made mention,viz., whether the fifth pair of nerves, in addi-tion to its general sensibility, does not possessthe faculty of giving to the first pair thepower of special perception of the objectsof smell. It would be curious enough todetermine, by experiment, how far a nerveof general sensibility can communicate spe-cial sensibility to another. However, let uscontinue our experiment.The olfactory nerves have been completely

divided ; we shall, therefore, sew up thewound in the head, to avoid the develop-ment of irritation in the brain ; and havingnow done this, will proceed to determinehow far the sense of smelling exists. Iplace, as you see, some ammonia under thenose of the dog, and the animal gives themost unequivocal signs of sensibility. Theexperiment, however, would be much morecomplete if the animal gave not only symp-toms of general sensibility, but some proofof his being able to discern odours; for ex-ample, if he could distinguish a bit of meatfrom a morsel of cheese. [Here the Profes-sor placed a morsel of cheese under thedog’s nose, at some little distance. Theanimal made no attempt at eating it, how-ever ; he passed his nose over the cheese.]Even still (said M. Magendie) I do not con-

sider the experiment as completely conclu.sive. If the animal continue to live andeat we shall endeavour, at our next meeting,to determine more precisely the nature ofhis sensations.We can only arrive at precise notions on

sensibility by means of two experiments,very distinct from one another; the firstconsists in destroying the fifth pair of nerves,and then observing how far the sensibilityof the special nerves is influenced ; the otherconsists in destroying the special nerves,and observing sensibility as it resides in thefifth, isolated from all others. ,

As to the pathological facts which cometo our aid in the solution of this question,we possess several, very valuable. I haveseen a lesion of the fifth pair completelydestroy the sense of smell, and of sensibilityin general. In other cases, on the contrary,where the lesion has occupied the olfactorynerve, the sense of smell has continued.However, arguments which are drawn frompathological phenomena are not of the bestkind.

ONE YEAR’S

MIDWIFERY CLINIC AT PRAGUE.

THE first Number of Stifft’s and Raimann’sAnnual, vol. xx., contains’a Report, by Pro-

fessor JUNGMANN, on the Midwifery Clinicat Prague, for the year 1835, from whichwe select the following particulars:—The number of patients received during

the year amounted to 1,153. The number ofwomen delivered amounted to 1,111. The" annual constitution" was highly inflam-matory, evincing itself by the number andvariety of inflammatory affections underwhich the pregnant women suffered; suchaffections, for instance, as rheumatic, gas-tric, and typhoid fevers. Puerperalfever, or,rather, its premonitory symptoms, mani-fested itself in a great number of cases,from eight to two days before delivery,and then ran a most rapid and fatalcourse. Of the 1,111 deliveries, 1,093 weresingle. Eighteen patients gave birth totwins.

Presentations.—The positions of the headmaybe arranged as follows :-Vertex-presen-tations, 1,043.-Side of the head, 35.—Face-presentations, 6.—Presentation of the

buttocks, 17.-Knee, 1.—Feet, 16.—Shoul-ders, 7.-Transverse presentatios of thetrunk,4.

Labour termiuated naturally in 1,072 cases.It was terminated by turning the head in 1.- By turning the feet, in 15.—By extrac-tion by the feet, in 4.—With the forceps, inhead presentations, in 29 ; in breech pre-sentations, in 8.—The placenta was sepa-rated with the hands in 16.