All anatomists have heretofore considered the nervous system in an uniform manner; but if we reflect a little upon the forms, the distribution, the texture, the properties and the uses of the different branches that compose it, it is easy to see that they should be referred to two general systems, essentially distinct from each other, the one having the brain and its dependancies for its principal centre, and the other, having the ganglions. The first belongs especially to animal life; it is on the one hand the agent, that transmits to the brain the external impressions that are to produce sensations; and on the other it serves as a conductor of the volitions of this organ, which are executed by the voluntary muscles to which it goes. The second, almost every where distributed to the organs of digestion, of circulation, of respiration, of the secretions, belongs more particularly to organic life, in which it performs a part much more obscure than that of the preceding one. Neither is strictly confined to the organs of either life. Thus the cerebral nerves send some branches to the glands, to the involuntary muscles, &c.; and the nervous system of the ganglions have ramifications in the voluntary muscles. It is from the general arrangement, without regard to particular exceptions, that the division of the two nervous systems is founded, between which I shall not draw a parallel here to show their difference, because the description of each will be sufficient to do this.
The nervous system of animal life is exactly symmetrical, like all the organs of that life. The brain and spinal marrow, which are the double origin of this system, have this character in a remarkable degree. Nerves precisely similar go from them; hence the name of pair, by which is designated the double, corresponding trunk, a name, that we should not be able to employ commonly in the system of ganglions. There are then really two nervous systems of animal life, the one right, the other left; the median line separates them. Their distinction is apparent not only from dissection, but from their diseases. At one time exactly one half of the body is deprived of motion, and the whole nervous system of that side remains passive, the other retaining its ordinary activity; at another, one side only has an unnatural energy and becomes the seat of convulsions, while the other remains calm. In both cases, sometimes the phenomenon is general; often it is limited to a greater or less number of lateral organs; but always there is an evident separation between the two nervous systems, the right and left. The kind of partial paralysis, of which I just spoke, and the principal character of which arises from the symmetry of the nervous system of animal life, is wholly different, as it regards this character, from that in which the lower parts of the body are deprived of motion in consequence of a fall upon the sacrum, or any other analogous cause.
The relations of size of the nervous system with the brain are in man and most quadrupeds, in an inverse proportion, as has been observed by Soemmering. In man the brain is much more voluminous than in the others, who have nerves larger than his. It is easy to prove this assertion, in all the animals that we commonly employ for our experiments; in fact, small dogs are used, on account of the size of their nerves in very delicate experiments upon sensibility. This difference is a striking proof of the superiority of man, as it respects the intellectual phenomena, which are all referable to the encephalic mass. On the other hand, many animals are superior to him as it respects motions and the four senses of taste, of smell, of hearing and seeing. Observe however that he surpasses them all in the perfection of the fifth sense, viz. that of touch. Why? Because this sense is entirely different from the others, is consequent to them, and corrects their errors. We touch, because we have seen, heard, tasted and smelt. This sense is voluntary; it supposes reflection in the animal that exercises it, the others do not. Light, sounds, &c. strike the respective organs without any effort of the animal; but he touches nothing without a preliminary act of the intellectual functions. It is not then astonishing, that the perfection of the organs of touch and the great development of the brain, should be in man, in the same proportion, and that in those animals, in whom the brain is more contracted, the touch should be more obtuse and the organs less perfect.
I shall consider these forms, 1st. in the origin; 2d. in the course; 3d. in the termination of the cerebral nerves.
The word origin should only be understood in relation to anatomical arrangement. In fact, the nerves are formed at the same time as the brain; they are rather organs of communication with this viscus, than elongations of it. If we take a view of the functions of one part of the nervous system, we shall see that the termination is at the brain, and the origin is upon the surface. Is it not said that the nerves go towards this or that part, that the arteries take this course, wind about, &c.? These are only metaphorical expressions, the least reflection will determine their meaning.
The nerves of animal life derive their origin from three principal portions of the encephalic mass; 1st. from the cerebrum; 2d. from the Tuber Annulare or Pons Varolii and its elongations; 3d. from the spinal marrow; the cerebellum gives origin to none. This circumstance, which, we ought not to lose sight of in the examination of the functions of each part of the brain, and which will perhaps hereafter elucidate these functions, is undoubtedly sufficient to make us appreciate the opinion of many physicians of the last age, which placed in the cerebellum the source of involuntary motions, and attributed the voluntary to the cerebrum.
The cerebrum furnishes but two nerves, the olfactory and optic; these are remarkable, 1st. in this, that their adhesion is very strong at their origin with the brain, and that by raising the pia mater, we cannot remove them; 2d. in this, that their softness is greater than that of most other nerves.
The tuber annulare and its elongations, as well those that go to the cerebrum and the cerebellum, as that which begins the spinal marrow, furnish the motores communes of the muscles of the eye, the pathetic, the origin of which, though posterior, is evidently derived from the tuber annulare, the trigemini, the motores externi of the eye, the facial, the auditory, the par vagum, the glosso-pharyngeal and the great hypo-glossal. All these nerves are distinguished by different characteristics. 1st. As the medullary substance is every where exterior to the eminences from which they arise, all appear manifestly to be continuous with this substance. 2d. Almost all begin by many filaments separated from each other; sometimes, as in the trigemini and par vagum, these are very numerous. The others arise, some by one filament and others by two. 3d. Except the auditory nerve, all have a greater consistence at their origin than these last. 4th. They adhere but little to the corresponding cerebral portion, so that they are almost always raised in detaching the pia mater; thus it requires great precaution, to prevent breaking the nerves from the brain when it is taken out of the skull. The adhesion of the pathetic, the motores communes and the facial, is particularly weak. We should almost say, from a slight examination, that there was only contiguity.
The spinal marrow gives origin to thirty or thirty-one pair of nerves, viz. eight cervical, twelve dorsal, five lumbar, five or six sacral, and to a nerve that enters the cranium and goes out of it under the name of spinal. The following are the characters of these nerves at their origin. 1st. They are continuous, like the preceding, with the medullary substance. 2d. They all arise by two cords, one anterior, the other posterior. These cords derive their origin from many filaments, placed above each other, most usually separate and always distinct. 3d. The adhesion is much stronger at the origin of these nerves than at that of the preceding, a circumstance that depends upon a cause that will be hereafter pointed out. 4th. The consistence of the spinal nerves is also very evident in their canals.
From what has been said, it is clear, that the nerves do not arise deep in the cerebral substance, at least in an apparent manner, but take their origin from its external surface. Many physiologists however, have admitted an origin more remote than can be proved by examination. They have believed that the nerves of one side arise from the opposite, and that each pair cross each other not only in the brain, but also in the spinal marrow. This opinion is founded upon a singular phenomenon, viz. this, that paralysis almost always takes place on that side which is opposite to the affected side of the brain, a phenomenon that is frequently noticed in diseases and proved also by experiments, as has been shown by Lorry. On the other hand, it is said that convulsions are seated in the side corresponding with the injured side of the brain; but this fact is more uncertain than that of paralysis, which is incontestable. I do not believe that with our present knowledge we can explain this last, and the anatomical opinion pointed out above, is contradicted at the first sight.
I will make but one observation upon this singular phenomenon, and that is, that it particularly concerns the nerves of motion, and hardly ever affects the nerves of sensation. In fact we know, that in wounds of the head, in consequence of apoplexy, &c. one eye, one ear, one side of the tongue, one nostril, do not become insensible, as the muscles of one side cease to move. We do not suddenly become paralytic on one side as it regards sensation, as we do as it respects motion in hemiplegia. Experiments cannot elucidate this, for it is impossible to perceive the alterations of sensibility as we do those of mobility. However, by compressing the brain of a dog, and thus rendering him paralytic on one side, and then shutting each eye separately and alternately, to see if he distinguished objects, and afterwards by presenting in turn to each nostril volatile ammonia, or other pungent substances, I have not seen, as it regarded the sensibility, an alteration corresponding with that which the mobility experienced. We often observe in man a discordance in the organs of sense. One ear hears better than the other, one eye sees further, &c.; hence false hearing, hence a species of strabismus, &c.; but the cause of these discordances appears to reside in the organ itself, and not to be connected with the brain.
Moreover, it does not appear that each hemisphere always corresponds necessarily with the nerves of motion of the opposite side. In fact, we often see on the right side effusions or injuries of the cerebral substance, without any alterations of motion on the left, and vice versa.
The following are the cerebral membranes that are found at the origin of the nerves; 1st. the dura mater forms for them a kind of canal in the fissure through which they go out, then it quits them entirely, and is partly lost in the cellular texture, and the remainder is reflected upon the edges of the opening and continued with the periosteum. The optic nerve is the only exception to this; it is accompanied in its whole course by a fibrous canal, which goes even to the sclerotic coat, which in this way, communicates with the dura mater. 2d. The tunica arachnoides surrounds every nerve at its origin with a fold formed oftentimes in the shape of a tunnel, the broadest part of which is at the origin. By carefully raising the brain, or by opening the dura mater of the spinal canal, we very easily discover this fold, which is continued to the osseous opening, through which the dura mater enters, it is then reflected upon the surface of this membrane corresponding with the brain, forming a sac between it and the nerve. Sometimes, as in the optic nerve and the motor externus, it penetrates the fibrous canal of the dura mater, and accompanies the nerve to the middle of the canal, which, consequently, is lined in part by the tunica arachnoides, and partly by the cellular texture. 3d. The pia mater is used in a manner that is difficult to understand, and which has not as yet been well explained. I shall speak of its continuity upon the nerves, in treating of their peculiar membrane.
The nerves go over a more or less considerable extent before going out of the cranium or the spinal canal. 1st. The two that arise from the cerebrum are much longer within than without. 2d. Among those of the tuber annulare and its dependancies, the pathetic nerves are the only ones that remain any length of time in the cranium before they go out of it, and that have a greater extent there than externally; all the others go out almost immediately. 3d. The nerves of the spine have a much greater extent when examined lower down. Above, they become directly external; below, they are six inches long in the canal, and consequently pass many foramina before they arrive at their own; hence it happens, as has been observed by Jadelot, that if we avail ourselves of the spinous processes, on account of their prominence, to judge of the origin of the nerves in the application of the moxa, it is necessary, in the neck, in order to act upon a point corresponding with the origin of any nerve in particular, to take nearly the spinous process of the vertebra that corresponds numerically with the pair that we have in view, whilst in the loins it is much above this vertebra that the application should be made.
The direction of nerves at their origin is also very variable. At the cerebrum and the tuber annulare, there is no general arrangement. But in the spinal nerves, this direction, almost perpendicular to the marrow above the cervical region, always becomes more and more oblique down to the end of the lumbar region. These three things, viz. the length in the canal, the size and oblique direction of the spinal nerves, successively increase from above downwards in a gradual manner, with some exceptions as to size.
Each pair of nerves, in going from the cerebrum, the tuber annulare or its dependancies, and the spinal marrow, diverges in the two trunks which form the pair. The olfactories alone converge, and the spinal run nearly parallel.
The nerves exhibit different arrangements at their exit from the osseous cavities that contain their origin.
1st. The two nerves of the cerebrum, go without communicating with any other, to their respective destination. 2d. Those of the tuber annulare and its dependancies begin to have communications, which are much more evident when examined inferiorly. Thus the par vagum and the great hypo-glossal nerves, send in going from their respective foramina, numerous filaments to the neighbouring organs, whilst above, the motores communes, the pathetici and even the trigemini shew this arrangement less evidently; the auditory nerve does not communicate with any other. 3d. The communications of the nerves of the spine are more evident at their exit, especially in their anterior portion. The deep cervical plexus, the brachial, lumbar, and sciatic, arise from these communications, which are not so visible in the intercostal nerves.
These kinds of plexuses have a particular arrangement. They are formed in the following manner; each nerve, at its exit from the foramen, sends a branch above and below, and also receives one; so that the cords that succeed those that go from the foramina, arise from two or three of these. These second cords, in dividing, send branches above and below, receive them and form third cords; so that in the brachial plexus, for example, when the nerves cease to communicate thus, and are divided into separate trunks, that each may go to its destination, it would be impossible to say correctly from which pairs they arise. It would require a very tedious dissection to ascertain precisely from what pairs come the median, the cubital, &c.
It is this consideration that has induced me not to describe the nerves of the spine as it is usually done, that is, as going from such or such pairs. I describe at first in each region the plexus that the nerves form there in going out of the spine; thus, I expose before the cervical nerves, the deep cervical plexus, before the brachial the brachial plexus, and before the lumbar and sacral the plexuses of the same name. The general arrangement, the form, the relations of these plexuses being known, I pass to the description of the nerves that go from them before, behind, without, within, &c. without regard to the pairs of nerves that come through the foramina. This method has appeared to me, moreover, to be extremely convenient for students. Nothing, for example, is more complicated than the description of the cervical nerves, by referring them to the pairs that first furnished them. But understand well at first the deep plexus, arising from the anastomoses of these pairs at their exit; afterwards class the nerves, 1st. into internal, which go to the great sympathetic; 2d. into external, which are distributed upon the acromion and the triangular space, bounded in front by the sterno-mastoideus and behind by the trapezius; 3d. into anterior, which, winding upon the sterno-mastoideus, form there with the branches of the facial a kind of superficial plexus; 4th. into posterior, which go either to the occiput, or to the posterior muscles of the neck; 5th. into those that go inferiorly, as the diaphragmatic, as those that communicate with the nervous branches of the hypo-glossal, &c. &c. In this way, you will easily retain all the nervous distributions, because you will have one point to which your memory will refer them all, and not to as many centres as there are pairs.
It is not only at their exit that the spinal nerves thus communicate. The different cords of which each nerve is formed have precisely the same arrangement, as may be easily seen in the great trunks, as in the median, the cubital, the radial and especially the sciatic. By separating the different cords of these nerves, we see that they are not only in apposition longitudinally, but that they send numerous filaments to each other. These communications do not resemble those of the arteries, in which there is always continuity between the communicating branches. Here there is only contiguity, and each of the cords forming the nervous trunk is, as we shall see, composed of filaments; now it is these filaments that frequently go from the cord to which they belong to a neighbouring one; so that after a short distance, the cords that began the nerve are not composed of the same filaments as those that finish it; the whole becomes mingled together in the course of the nerve. Thus the cords of the branches of the brachial plexus, at its origin, are not arranged like those of the branches that terminate it. For there is this difference between the very evident plexuses formed by the nerves themselves and those that are less evident formed during their course in their interior even, viz. that in the first, it is the cords that go off and form the interlacing, and in the second it is the filaments. I once amused myself in tracing the filaments of the sciatic for a short distance; now those which composed above the external cords, were found for the most part below in the cords of the centre.
This remark proves that there are not nervous cords destined to sensation and others to motion, and that if the same nerves do not serve the double use, the difference is in the filaments, and not in the cords.
In the interior of the vertebral canal, in which the nervous cords are much insulated, for the want of cellular texture, the filaments that compose them do not thus communicate with each other; there is not, as without, a plexus in the interior of the nerve. This is remarked particularly at the extremity of the canal, where the nerves run a long course, as I have before said.
The communication of the nerves at their exit from their osseous cavities is so general, that under this point of view it may be said that they form on every side a kind of organ every where continuous, an organ to which the optic, the olfactory, and the auditory nerves only are strangers.
Besides, these kinds of communications, which are all made by juxta-position, do not appear to have much influence upon the functions of the nerves. Each of their cords, though belonging in its course to many different trunks, can perform its functions in an insulated manner; so can each filament, though concurring in its course to form many cords of the same nerve.
I would observe with regard to this, that it is necessary to distinguish accurately these communications from anastomoses, in which two nervous filaments coming in an opposite direction, are confounded and identified with each other, which is seen between those of the facial, the sub-orbitary, the mental, &c.
After having thus communicated at their exit, the nerves separate from each other and go towards the different organs. They form at first considerable trunks, which pass through the great cellular interstices and go over a greater or less extent. The form of these trunks is sometimes flattened as in the sciatic; but it is most commonly rounded; but the form does not affect nervous action, for the nerves that are naturally round, when flattened by a tumour, perform their functions as usual. In general, whenever it does not interfere with her design, nature chooses the round form for the organs of animals. I would observe also, that this form requires a system generally diffused, and destined to fill up the spaces that necessarily exist between round organs; this system is the cellular. It would be infinitely less necessary, if the form of our organs was square, because there would be less space between them.
The nervous trunks are of different length. Those of the extremities hold the first rank in this respect, because the extremities being very distant from the origin of the nerves, these trunks must of course go over a certain extent before distributing their filaments. In the trunk and the head, on the other hand, as the organs are presented immediately to the nerves that enter them, the division into branches is immediate, and the trunks are very short.
The nervous trunks are sometimes accompanied by a corresponding arterial and venous trunk, as the brachial, crural trunks, &c.; at other times, as the sciatics, and those of the par vagum, they go separate.
As the trunks advance, they furnish here and there different branches; these give out smaller ones, which send off those that are still smaller, from which arise the last divisions. All these different divisions take place at very different angles. The acute angle is the most common. It is not a real origin, but merely a separation of many cords united, that forms the branches, of one or two of these for the smaller ones, of one cord only for the still smaller, and of separate filaments for the last divisions. Thus this separation is made more or less high, in different subjects. The place where it happens is never exactly determined.
According to these divisions, the filaments which compose the cords of each nerve and these cords themselves, are of different lengths; the shortest separate first, then the middling; in fine, the longest filaments of all go the whole extent of the nerve, and only terminate where it ends. The brachial and crural nerves exhibit this arrangement in a remarkable manner.
The nervous branches are almost all accompanied by an artery and a vein, especially in the extremities; for in the trunk, there are exceptions to this rule; in the neck, for example, the arteries often cross the nerves at an angle, instead of accompanying them in their course. In the head, many arterial branches are found thus separated from the nervous. This circumstance is sufficient to make us attach less importance than some authors have done, to this juxta-position of the nervous and sanguineous systems. Moreover, if this juxta-position was so essential, it would be seen with regard to the smaller branches; but this never happens.
I call that the termination, where each filament ends and not that only where the whole trunk of the nerves terminates; so that the sciatic terminates at the thigh, at the leg and at the foot, and not merely at the extremity of this last. In fine, after what has been said already and from what will be said further, the union of filaments into cords and that of cords into trunks, is an arrangement disconnected with their functions, and each filament should be examined separately. The filaments of nerves have three different terminations. They are continued, 1st. with other filaments of the same system; 2d. with the filaments of the system of the ganglions; hence arise anastomoses. 3d. They are lost in the organs.
I have already observed, that true anastomoses should be distinguished, from the junction of a cord that passes to a nerve more or less remote from that to which it belongs, and which simply places itself by the side of its filaments, so that it contributes with them to the nervous cords. Thus there is no anastomosis in a plexus, in the union of the chord of the tympanum with the lingual nerve, &c. So that though the filaments of the different cords of a nerve pass frequently from one to the other, so as to give to the nerve a net-work-like texture, and not as anatomists say, a simple thread-like texture, still it cannot be said that the cords of the same nerve anastomose with each other; there is only juxta-position. On the other hand, the communication of the great hypo-glossal with the cervical pairs, forms a true anastomosis, because there is a continuity, and not merely contiguity of nervous filaments.
If those physicians, who have considered the anastomosis as the exclusive causes of all sympathy, had reflected how few they are in comparison with what they appear at first view, they would have been, by this simple reflection, led to a different opinion. In fact, it is very evident, that though a filament is joined to a trunk, it has no more relation to the filaments of that trunk, than these have among themselves; that is to say, that there is nothing in common but the cellular covering. The arterial and venous anastomoses are infinitely more numerous than the nervous. I believe that they can perform a part in neuralgia, in some sympathies even, a part foreign to the simple communications of the filaments.
We can generally refer anastomoses to three classes. 1st. Two branches belonging to different nerves, go on together, as in the example cited above of the great hypo-glossal, and as also the branches of the facial with those of the sub-orbitary, the occipital with the frontal, &c. 2d. The branches of the same nerve can unite together, as those of the three portions of the trigemini. 3d. Sometimes the two nerves of the same pair, or those of two different pairs, but coming from the two halves of the nervous system, unite at the median line; some examples of this may be seen in the superficial nerves of the neck, in those of the chin, &c. This union does not take place upon the abdomen, where the median line, entirely aponeurotic, has no nervous branch in its texture. It is perhaps by these anastomoses that take place at the median line, that we may explain, how certain motions can still continue in a part affected with paralysis. This sort of anastomosis is in general very rare. In the extremities it is evident, that they cannot exist; in the trunk, they are hardly ever seen behind, and not frequently before. If every pair of nerves gave examples of them, it is clear that hemiplegia would rarely take place, because the sound side of the brain or spinal marrow would through them have an influence upon the nerves of the affected side.
This termination has a great analogy with the preceding, since there are two nerves, which meeting at their extremity, are blended in such a manner, that we cannot tell where one begins, or the other ends. I shall treat of this in the following system.
The exposition of the following systems will show us the varieties that exist as it respects the nerves. 1st. In some there are many of them, as in the mucous, dermoid and muscular systems of animal and organic life. 2d. In others we find fewer of them, as in the cellular, glandular systems, &c. 3d. Some require a more attentive examination than has heretofore been made of their nerves, which are little known, as the serous, the medullary, a portion of the fibrous, &c. 4th. In fine, many, as the cartilaginous, the fibro-cartilaginous, the pilous, the epidermoid, the tendons of the fibrous, &c. are evidently destitute of nerves.
We are ignorant of the situation of each nervous filament at its termination; is it deprived of its covering, and does the pulp only penetrate the interior of the fibres? In the optic nerve this last arrangement is evident. The covering of the nerve is continued only to the entrance of the eye, and the pulp is expanded to form the retina. A similar expansion seems to take place in the olfactory and the auditory. But nothing is known concerning any of the others.
Every nerve is formed, as I have said, of a greater or less number of cords lying in apposition to each other. These cords arise from filaments likewise in apposition and united together, like the cords by cellular texture. I have already mentioned how both are interlaced in the interior of the nerve, so as to form a kind of plexus, which differs from the true plexus only in this, that the branches applied to each other, do not allow us at first view to see their intermixing.
The general character of the nervous cords varies considerably. 1st. Their size is not always the same. Those of the sciatic and the crural are smaller than those of the brachial nerves, except those of the median. 2d. Some nerves, as the par vagum, are formed of one cord only, divided by many furrows. Sometimes the filaments form around it a net-work, a very delicate kind of plexus. 3d. In the same nerve, there is sometimes united large and small cords; in many they are all equal, as in the sciatic. 4th. The optic nerve, though furrowed in its whole extent, from the commissure to the eye, does not appear to have in its interior that interlacing, that the others evidently exhibit. 5th. In the posterior part of this nerve, and in the trunk of the olfactory, the cords are not distinct. 5th. Most of their nerves at their origin are separate in their filaments; the trigemini on the contrary, exhibit a common pulpous portion, in which all their's seem to be implanted, &c.
It follows from all these considerations and many others for which we are indebted especially to Reil, that the internal arrangement of the nerves varies singularly, that each presents almost a different texture, that under this point of view they do not resemble the arteries and veins, which are every where the same, whatever be their size, their course, &c. These varieties however, do not affect the intimate structure, and our business is to describe this intimate structure even to the last fibres that we can separate. Reil appears to me to have thrown great light upon this subject. I have repeated exactly his experiments; they have given results very analogous to his. Some only have appeared to me so difficult, that I have not even undertaken them. I have added to his researches many new facts as will be easily seen by comparing his work with this article, in which will only be found that which rests on accurate observation; I have omitted all the theoretical ideas that Reil has added to the facts which he offers.
We distinguish two things in every nervous filament, 1st. an external membrane in form of a canal, in which is contained the medulla; 2d. the nervous medulla itself; I shall now treat of each separately.
This membrane forms for each nervous filament a true canal which contains in its interior the medulla; as the veins and arteries contain the blood, with this difference, that this medulla is stagnant, while the blood circulates.
The origin of the nervous coat is very evident at the spinal marrow. It is continued with the dense and compact membrane which covers its white substance, and which is called the pia mater, though it does not resemble the membrane of that name which surrounds the cerebral circumvolutions. To see this origin well, this spinal membrane should be cut longitudinally before or behind. The medulla then appears whitish, soft and easily raised up. If it is raised and scraped with a scalpel or any other instrument, the immediate covering of the spinal marrow is thus separated from either side, especially if precaution be taken to wash it. It might be had in the form of a sac, by cutting out a piece of the medulla of a certain extent and then pressing out the medullary substance at the two ends. In this double experiment, the nerves remain attached to the membrane separated from its medullary substance, because their nervous coat is continued with it. It is exactly as if a number of small arterial filaments went from the aorta; the parietes of this artery would be to those of these filaments, what the pia mater of the spinal marrow is to the coat of the nerves which go from it. Only the nerves are white, because their medulla fills them; whereas the canal to which they belong is transparent, because it is deprived of its own medulla. I do not pretend however, that there is a perfect identity between these two membranes, since we do not exactly know the nature of either; I refer only to their anatomical arrangement.
As to the origin of the nerves contained in the cranium, those coming from the tuber-annulare and its dependancies, that is to say, the elongations that it receives from the cerebrum and cerebellum, have an arrangement analogous to that of the nerves of the spine. However, the difference of thickness and density of the pia mater establishes differences. In fact the pia mater which covers these parts is different from that which serves as a canal to the spinal marrow; it is much softer, less adherent, is torn with more ease, and appears to be analogous to that which covers the cortical substance of the brain. The coat of the nerves of the tuber annulare, which is manifestly continued from this portion of the pia mater, exhibits partly this character. At the place of their union, it is more soft than in the canal, hence the extreme facility with which, as I have observed, the origin of these nerves is broken. Moreover, the continuity with the pia mater is proved by the facility of raising the nerves by raising this membrane; almost always both are attached together.
As to the nerves of the cerebrum, the olfactory, loosely covered by the pia mater, does not appear to have a coat of its own. The optic is evidently destitute of it from its origin to its junction with that of the opposite side. Then it begins to be covered with it; and canals are formed by it, filled with medullary substance, and which continue even to the retina. Besides, this nerve differs singularly from the others, 1st. because it has a kind of general nervous coat; 2d. because its medullary substance is more abundant and more easily obtained, its canals being larger; 3d. because these canals, pressed against each other, give it the appearance in the interior of a continued body; but by cutting it longitudinally, it is easy to see that the medullary substance is separated there by partitions. The auditory nerve has also a very peculiar texture.
From what has been said, it is evident that the pia mater has greater analogy with the coat of the nerves, than any of the other membranes; it may be said to be almost the same in the spinal canal. Observe, in fine, that this membrane, which has never yet been well described, evidently presents three great modifications, according as it is examined; 1st. upon the grey substance that surrounds the whole of the cerebrum and cerebellum, where it ¡s reddish, extremely vascular, loose, slightly resisting, and very easily raised; 2d. upon the white substance that covers anteriorly and posteriorly the tuber annulare and the four great elongations that it receives from the cerebrum and the cerebellum, where it is less red and where it begins to become more firm, more adherent, and less easily torn; 3d. upon the whole spinal marrow and upon the corpora pyramidalia and olivaria. It is thickened and condensed at the furrow that separates these eminences from the tuber annulare, then, increasing in thickness below, becoming whitish, resisting, &c. it has an appearance entirely different from what it had in the cranium. It might be said to be a membrane wholly different. It has four times the thickness of the tunica arachnoides.
In most of the subjects that I have examined it is much stretched, and compresses, if it may be so said, the medullary substance for which it serves as a canal; so that when a small opening is made in it the medullary substance immediately comes out. But I presume that it is looser during life. Besides, this state of compression is much less sensible towards the superior part than towards the middle and inferior, on account of the difference of thickness. I would remark, that the density of the pia mater of the spine is necessary to prevent injuries of the medullary substance, which is very soft at one part, and which at another is smaller than the diameter of the canal; so that it can be shaken there; an arrangement wholly different from that of the brain, which completely fills the cranium.
Arising in the manner we have pointed out, the coat of the nerves passes with them through the cavity of the cranium and that of the spine. It is very distinct in these cavities, because it is not surrounded there with cellular texture, but only with the arachnoides, which may be raised with great ease; instead of using the different preparations that Reil mentions for the purpose of separating the coat of the nerves from the cellular texture, it is infinitely more convenient to examine this membrane upon the last nerves of the spine, which are, as we have seen, remarkably long.
Without the osseous cavities, the nervous coat embedded in the cellular substance, adheres to it strongly, but appears evidently to be of the same nature as in the interior. We are ignorant what its nature is, whether it is the same as that of the pia mater, of the medulla, of the tuber annulare and its dependancies. It appears to have great affinity with the cellular texture. It is transparent and consequently free from the colour of the nerves; hence why, when they have been deprived, by alkalies, of their pulp, they lose a great part of their whiteness.
The coat of the nerves is one of the parts of the animal economy which are hardened with the greatest ease, especially at the instant the nerves are immersed in an acid slightly concentrated, particularly the nitric and sulphuric. I have not observed in any other texture this phenomenon in so remarkable a manner; the nerve is suddenly diminished in size and twisted in different directions; now we shall see that the medullary substance is in no way concerned in this phenomenon. The action of boiling water produces an analogous effect; by it the nerve is wrinkled, contracted and hardened; then, after the ebullition has continued for a certain time, it gradually becomes soft, and its whitish colour is changed to a sort of yellowish tint, very different from that of boiled tendon or aponeurosis. The action of the acids continued for some time, produces an effect analogous to that of ebullition. To the sudden hardening like horn which the nerve undergoes, soon succeeds a softness so great that at the end of a short time it is easily moved under the finger, and afterwards becomes partly dissolved.
The alkalies do not produce the horny hardening in the nervous coat any more than in any other texture of the living economy; neither do they dissolve it. Hence, undoubtedly, why Reil, having macerated for some time a portion of nerve in soap-boilers lie, was able to separate accurately the nervous coat from its medullary substance.
The action of water upon the nervous coat produces a phenomenon that is exhibited by few others of the animal textures. Far from softening it immediately and then reducing it to pulp, it seems in the beginning to increase its consistence. A nerve soaked in water becomes there harder and more resisting, and this state, at the ordinary temperature of cellars, continues for a month and a half, and even two months. It is only at the end of this time and frequently longer, that the texture of the nervous coat is gradually softened, and broken, and finally ends by being diffused like other macerated textures. I have not repeated this experiment in a very warm temperature, which has always succeeded in that of winter and spring.
The coat of the nervous filaments has a very great resistance, because it is, in proportion to the medullary substance that it contains, infinitely thicker than the membranous canal of the spinal marrow. It is thus that the proportion between the thickness of the vascular parietes and the fluids they contain, is much less in the great trunks than in the small branches; the fluid considerably exceeds the solid in the first, there is at least an equality in the second. Thus a very small nerve would support a much greater weight than the spinal marrow. I believe that among the textures which are arranged in filaments or in elongated tubes, this and the arterial, next to the fibrous, afford the greatest resistance; they surpass the venous, the muscular, the serous, &c.
This substance occupies the interior of the nervous canal, in the same way as the substance of the spinal marrow fills the canal formed by the pia mater. This medullary substance is whitish, as that of the brain and spinal marrow; it gives the nerve its colour. It is in much greater proportion in the optic nerve than in any other; it is found exclusively in that part of it posterior to the junction of the two, as well as in the olfactory. It is so abundant in the auditory that it seems to form a great part of it. In general, I think at the origin in the osseous cavities, it predominates over the nervous coat, but in the course of the nerve, the nervous coat is the greatest. Hence the greater degree of resistance of the nerves in the second, compared to what they have in the first.
This substance appears to be continuous with the medulla of the brain, the tuber annulare and its dependancies, and the spinal marrow. I think, no one can deny this continuity with the origin of the optic and olfactory nerves, in which more of this medullary substance is found than in the other nerves. In the auditory, also, it is very apparent; in the spinal marrow, by scraping this white substance from the internal surface of the pia mater, so as to leave the nerves adhering to this membrane, we see evidently at the place where these nerves go off, that there is an elongation penetrating their nervous coat.
What is the nature of the medullary substance of the nerves? I have endeavoured to institute a comparison between it and the cerebral substance; there is considerable analogy under some points of view and some difference under others.
1st. Submitted to drying in the open air, in small slices to prevent putrefaction, the white substance of the brain becomes yellow, and acquires considerable consistence. The nerve dried becomes yellow also, hardens and contracts. These changes are undoubtedly owing in part to its coat. The proof of this is that if we dry the covering that the pia mater furnishes to the spinal marrow, a covering that has great analogy to the nervous coat, the new qualities it acquires are very analogous to those of the dried nerves. But this does not prevent the medullary substance of the nerve from contributing also to the yellow colour by the evaporation of its watery part. I will make, in regard to this, a remark that I think interesting; it is this, that water has an influence upon the whiteness of a number of textures which become yellow or greyish by its subtraction, and are whitened again by its addition. Thus we have the power of making yellow, by drying, all the fibrous organs, the skin, &c. and of restoring them afterwards to their primitive colour. Thus also the serous surfaces, the cellular texture, &c. that have become greyish from drying, regain their whiteness when immersed in water, if they have not been long dried. The epidermis of the sole of the foot and the palm of the hand turns from grey to white, when it has been immersed for some time in water.
2d. The cerebral substance and that of the spinal medulla easily become putrid when submitted to the combined action of water and air; they become of a greenish colour and have acid sufficient to redden blue paper. Of all animal substances, I think they exhibit this phenomenon the soonest. The nervous medullary substance, on the contrary, resists putrefaction much longer. The nerves are among the slowest of all the parts of the animal economy to become putrid. During life they are often found untouched in a gangrenous limb, in the middle of an abscess, &c. In a dead body which is putrid, they preserve their whiteness and consistence, while the other parts are black and soft. I have observed that the water in which the nervous system has been macerated has but little odour, but that that in which the brain has been macerated is fœtid. These phenomena clearly would not take place if the medullary substance of the nerve became as easily putrid as that of the brain. It is manifest, however, that it is especially to the nervous coat, that the nerves owe this sort of incorruptibility; for I have observed, that the optic nerve, in which the medullary substance predominates, and the olfactory and auditory, which are abundantly furnished with it, become putrid sooner than the others. I have remarked also uniformly, that whilst the white substance of the spinal marrow becomes putrid, its covering remains untouched.
3d. The medullary substance of the nerves, as well as that of the brain and spinal marrow, does not seem to be susceptible of any kind of horny hardening. This is very evident when we immerse the two last in boiling water, in a concentrated acid, &c. We may be convinced as to the first, by submitting to the same experiment the soft nerves that have their nervous coat pretty distinct. To this also must be referred the following phenomenon; when the anterior part of the optic nerve is put into boiling water, the nervous coat becomes wrinkled, its canals shrink, and the medullary substance not contracting in proportion, is forced towards the extremities, which become consequently enlarged. As this substance is in less proportion in the other nerves, this phenomenon is less apparent in them; it takes place, however, and this explains the small round tubercle that is seen at each end of boiled nervous filaments; it is the medullary substance that produces these enlargements. This phenomenon is very evident in the spinal marrow, which, being immersed in boiling water, suffers the compressed substance to escape, either at the extremities, or at any openings that may be made in its covering. Thus in boiling a head, the dura mater detached from the cranium contracts powerfully in hardening like horn, compresses the cerebral substance which does not contract like it, and sometimes breaks it, so that it escapes into the space that the boiling has produced between the dura mater and the cranium.
4th. When the cerebral substance is agitated in water, it becomes suspended in it in the form of an emulsion, as has been observed by Fourcroy, then it is precipitated to the bottom of the vessel. A similar emulsion is made by the olfactory nerves, the posterior part of the optics, &c. When the anterior part of these, in which the nervous coat is very evident, has been soaked some time in water, and commonly even without this, a large quantity of whitish substance can be pressed out of them, which is evidently analogous to the medulla of the brain, and which colours the water that receives it. From the other nerves in which the medullary substance is much less abundant, it can often be forced out by pressure, from the cut ends of the filaments, especially if they have been previously macerated in an alkaline solution.
5th. Boiling hardens the brain, and gives it a greyish and dingy appearance, very similar to what is seen in ataxic fevers. The same phenomenon takes place in the soft nerves. In the others, the nervous coat is in too great a proportion to the medullary substance to allow us to see what happens to this last. It is to this property of coagulating by heat, which the brain has, that must be referred the flaky precipitate that is obtained in a heated cerebral emulsion.
6th. All the acids that are much concentrated harden the brain very evidently, the instant it is immersed in them. The sulphuric afterwards softens it, and finally reduces it to pulp, if it is not diluted. The nitric makes it yellow only, in hardening it. The muriatic has the least action upon it. The effect of acids upon the soft nerves is very analogous to this. In those in which the coat is very distinct, the horny hardening of which this coat is the seat, conceals all the sudden phenomena relative to the medullary substance. When the coat is softened and dissolved, this substance has appeared to me to be diminished in consistence and altered by the acids, whereas that of the brain keeps always the same degree of hardness, if the acid be not too much concentrated.
We all know that alkohol hardens the brain. This hardening, the effect of acids, of boiling, and of alkohol, is a phenomenon that the anatomist can avail himself of to give the parts he dissects a firmness, that will enable him to examine them better. It approximates this substance to the albuminous fluids. I say that it approximates it, for there are still great differences between them, of which, I think, we know but little.
7th. The alkalies have an effect upon the cerebral substance precisely opposite to that of the acids. They make it fluid, and even dissolve it completely after a short time. I have observed, with regard to this, that the grey substance is much quicker altered by them than the white, which is softened, disappears in part, but still leaves a considerable portion that is not dissolved. From whatever part we take these two substances to submit them to the action of the alkalies, the result is the same. The alkalies act also evidently upon the medullary substance of the nerves. This action, as I have said, has been of great assistance to Reil in his experiments.
8th. Thouret and Fourcroy have discovered, that the brain, after being buried, lessens considerably in size, and changes to a brittle substance, capable of softening under the finger, miscible in water, exhaling a disagreeable odour, having the properties of ammoniacal soap, and resembling very closely spermaceti in its nature. Do the nerves undergo a similar alteration in their medullary substance? We know nothing at present by which we can determine this question.
9th. The muriate of soda, when sprinkled upon slices of the brain and the pulpy nerves, increases their consistence.
10th. The digestive juices generally alter with ease the medullary substance of the brain. I think, however, that they would have a much more powerful action upon it in a natural than a boiled state; for all the re-agents are in general more powerful in the first of these states. We know that most carnivorous animals esteem the cerebral substance delicious food. Those that feed upon birds, the parietes of whose craniums are easily broken, almost always eat the brain first. The weasel, the polecat, &c. furnish examples of this. Man considers the brain as one of the most dainty parts of the animal. The nerves are much less easily digested; but this depends wholly upon their coat, which does not yield so readily to boiling as the other parts. For example, the tendons, which are as hard or harder than the nerves in a natural state, become much softer by boiling. We can distinguish in boiled meat each of these parts. The first, in its gelatinous state, is more pleasant and digestible.
11th. The cerebral medullary substance is very different in the brain, the tuber annulare and its elongations, and the spinal marrow. If we examine it attentively, in all these we must perceive the difference in colour, consistence, hardness, humidity, and, without doubt also in its very nature, though our knowledge is not yet sufficiently advanced to decide with certainty upon this last point. Has the nervous medullary substance analogous differences? I believe that it is similar in the same nerve, but that it varies in different nerves according to their uses. In fact, when the internal arrangement of the cords and the filaments which constitute the nerve, differs so much, when there are varieties in the nervous coat also, why should the medullary substance be every where of the same nature? Certainly the colour and consistence of that of the olfactory are different from that which is forced out from the anterior part of the optic. That of the auditory does not resemble that of the trigemini, &c. We have seen that each of the organs of sense has its peculiar sensibility, which places it exclusively in relation with particular bodies in nature, that of the eye with light, that of the ear with sounds, &c. I think that these differences of sensibility depend upon the difference of organs; but I am persuaded that the organization of the nerves has much influence, and that the optic nerve would be unfit to transmit tastes, the auditory to propagate impressions made by light, &c. If we examine attentively, we shall see an essential difference of structure between the nerve of the eye, of the nostrils, the ear, and that of the taste, which approximates, in thickness, the nerves of motion. As to the nerves of touch, they do not require a peculiar texture; for I shall prove hereafter that a particular kind of animal sensibility is not necessary for this sense, but that this general property is sufficient for it, since its accuracy depends especially upon the mechanical form of the hand. As to the nerves that go to the voluntary muscles, as these muscles are every where analogous and perform similar functions, I think their medullary substance is the same. But in the par vagum, whose destination is so different, why do not the varieties of internal organization coincide with that of the texture which we observe in dissecting this nerve? We may say the same of many nerves that go to parts whose sensibility presents an entirely different modification.
This then is a comparison between the cerebral pulp and the medullary substance of the nerves, which may throw some light upon their difference and their analogy. I have not availed myself of all the details of the chemical experiments that have heretofore been made upon the brain; I have only given the principal phenomena of the action of different re-agents, phenomena, all of which I have repeatedly proved.
The medullary substance of the nerves is not arranged in filaments. It appears to be analogous to the white substance of the spinal marrow which is a real jelly, stagnant in the canal of the pia mater, which serves as a reservoir for it. Besides, examination proves this assertion in the optic, auditory, olfactory nerves, &c. In general I think, that this substance, as well as the cerebral, would be ranked, if they were deprived of the vessels that run through them, rather among the fluids than the solids, or they would form a medium of connexion between the two.
The nerves are entirely destitute of this texture in the interior of the cranium, and the spine; but out of these they have a great quantity of it. A large external layer, first covers and then connects them with the neighbouring parts. This layer is looser than that which surrounds the arteries. Fat often accumulates in it; sometimes, though rarely it is the seat of dropsical effusions.
From this common layer go off different elongations which communicate with the cellular texture of the neighbouring organs, and form a medium of union between the nerve and these organs. Within, there are other elongations that go between the nervous cords, and separate them from each other, and form for them kind of canals. When a nerve has been macerated some time in diluted nitric acid, the cords become separated from their sheath, which is to them what the layer of which we have spoken is to the whole nerve. These cellular canals often contain also fat in the great nerves, in the sciatic there is always some of it. Hence it is that when we dry these organs, there is almost always as I have observed, a fatty exhalation upon their surface; and that, when they are immersed in any alkaline solution, they have evidently an unctuous and truly saponaceous deposit.
Finally new elongations going from the cellular canals that surround the cords, cover the nervous filaments with canals still smaller. Here, there is never any fat or serum, and the cellular texture has in part that peculiar nature which characterizes the sub-arterial, the sub-nervous texture, &c.; perhaps even the nervous coat is nothing but this texture considerably condensed. Besides, the cellular texture so connects the one to the other, the cords of the nerves, and the filaments of these cords, that no motion can take place there.
Each nerve receives its vessels from the surrounding trunks, which send to it branches which penetrate from all sides to the interior. The optic is an exception to this rule; the membrane that surrounds it prevents the vessels from entering it laterally. An artery passes through it in the course of its axis and sends out different branches.
In the other nerves, the arteries run first in the cellular texture between the cords, and are of a size there more or less considerable, according to the nervous trunks. Sometimes this size increases considerably. For example, in popliteal aneurism, the artery of the sciatic nerve has been seen with a caliber more than three times its natural size.
The arteries running between the cords, send off a number of little branches that go into all the interstices of the filaments. In fine, from these arise the little capillary arteries which are spread upon the coat of the nerve, cross it and are continued with the exhalants of the medullary substance. We readily see this vascular arrangement in the spinal marrow. Numerous ramifications are spread first upon the dense and firm pia mater, which there takes the place of the nervous coat; they then penetrate the medullary substance, and are lost in continuation with the exhalants.
The veins follow in the nerves a course analogous to the arteries; however, in carefully dissecting many great nervous trunks, I have been convinced that their branches do not go out of the nerves at the place where the arteries enter. This arrangement is analogous to that of the brain, where the arteries enter below and the veins go out above.
Many authors, particularly Reil, have overrated the quantity of blood that goes to the nerves, because, in order to ascertain it, they have made use of fine injections which have entered the capillary system, which does not commonly contain red blood. I am convinced by dissecting the nerves of living animals, the only means of having an accurate idea of what takes place in a natural state, how uncertain this method is here as every where else.
The blood that goes to the nerves, like that which is sent to the brain, is a stimulant that supports their action. When this stimulant is increased the nervous excitability increases, as Reil was convinced by rubbing the nerves of a frog, so as to redden them by the quantity of blood that was brought there. Does this fluid, when carried in great quantity to the nervous system, sometimes interrupt its functions, as happens to the brain in sanguineous apoplexy? I have not had an opportunity yet of making this observation in a very decided manner in the great number of bodies that I have opened. Only the nerves are a little more reddish in some cases than others. Do these cases coincide with certain determinate diseases? I have not any knowledge upon this point. As to the pretended compression of the origin of the nerves, by the blood that is carried to the brain and spinal marrow, whoever has examined the relations of the nerves with the vessels of the base of the cranium, will see that such a compression is not probable. Besides, most of the holes through which the little arteries penetrate into the interior even of this viscus, have a caliber greater than that of the arteries; so that how full soever they may be, they cannot press upon their parietes. I can only conceive of a compression at the origin of the nerves, from effusions at the base of the cranium.
We cannot discover these vessels in the nerves; but nutrition supposes their existence there. It appears that this function is performed in the following manner; the exhalants receive from the arteries, with which they are continuous, the medullary substance which they deposit in the canal of the nervous coat, which is, if I may so express myself the reservoir of this substance, that is afterwards taken up by the absorbents.
Many think that the nervous coat is the secretory organ of this medullary substance, which oozes out of its parietes, to lie in its cavity. I do not believe it, 1st. because the olfactory nerve would not then be able to support itself, any more than the posterior portion of the optic. 2d. The cerebral membranes are not concerned with the secretion of the pulp of the brain, they only permit the vessels to pass, which enter this organ to deposit it there. 3d. There is the same arrangement at the spinal marrow, the pia mater of which has so great an analogy with the nervous coat. The vessels cross this membrane, then losing themselves, as I have said, in the medullary substance constantly renew it; so that if it was possible to remove this substance without touching the vessels, these would hang loose by their extremities in the canal of the pia mater. Thus, in some very soft fungi, the vessels cross here and there the substance that they deposit in their interstices, and would produce a vegetation like net-work, if we could remove this substance and leave them untouched. 4th. In the optic nerve the vessels evidently are not confined to the nervous coat; they penetrate also the canals it forms, and deposit there the medullary substance.
Every thing appears then to prove, that the nervous coat is no more the secretory organ of the nervous substance, than the pia mater is of the cerebral substances or that of the spinal marrow. It may have uses of which we are ignorant; but the principal certainly is that of a covering; it is the passive part of the nerve, the medulla being the part essentially active.
From this way of describing the production of the nervous medullary substance, it is evident that it does not proceed from the brain, but that it is formed in each nerve by the means of the neighbouring vessels. Hence why the inferior portion of a cut nerve does not decay; why a ligature that interrupts the cerebral communications, does not prevent the nervous nutrition; why in most paralyses in which the nervous system ceases to correspond with this organ, it is supported as usual.
From these and other considerations, Reil considers the nerves as having an entirely insulated existence, as being bodies by themselves, communicating only on one side with the brain, on the other with the different parts. This assertion is true as it respects nutrition, but as it regards the functions it is in part false; for the nerves are evidently only conductors; it is from the brain that goes the impulse, and there too is the sensation. In animals with white blood, and even in those with red and cold blood, these functions concentrated in the brain, in man and the neighbouring species, are, it is true more generally spread throughout the nervous system, hence it is without doubt, that we can remove the brain, the heart and the lungs in reptiles without immediately destroying life; it is on this account, that I have remarked in my Researches upon Death, that we should never avail ourselves of experiments upon animals with red and cold blood, to draw conclusions concerning those with red and warm blood. But in these and in man especially, it is undeniable, 1st. that the brain is the centre of animal life, which ceases when the action of this viscus is destroyed, as is proved by apoplexy, asphyxia, &c.; 2d. that it has also immediately dependant upon it organic life, though in an indirect way, that is by presiding over the mechanical functions of respiration, which by ceasing, stop the chemical, then the circulation, then the secretions, &c. so that the continuance of the two lives, and a serious injury of the brain, are two things wholly incompatible. Authors who have written upon life, the nervous system, &c. have usually considered them in too general a manner. The relations of the functions are absolutely different in animals with cold blood and in those with warm; that which is true for one, is not so for the other.
Does the nervous coat receive small nervous branches? Do these small branches penetrate the nerves, as the small arteries spread on the coats of the large ones? Anatomical examination does not render this probable.
Few systems exhibit these properties more obscurely than this. If we draw a nerve, in an opposite direction, in a living animal, it is extended with difficulty, makes great resistance, and acquires a length but little more than what is natural to it; this appears to depend particularly on the nervous coat. The medullary substance would yield much more. We know how much that of the brain is stretched in the dropsy of the ventricles. If a great trunk is distended by a subjacent tumour, as in popliteal aneurism, by a swelling in the axilla, &c. it is flattened down like a ribbon; its filaments are separated and lay at the side of each other, and it is consequently much widened. Thus distended, these filaments can yet sometimes transmit sensation and motion, at other times these two functions are annihilated there.
In general, a sudden distension interrupts them much more certainly than that which comes on slowly. Hence why the luxation of the head of the humerus often occasions paralysis, whilst it rarely happens from very large chronic tumours in the axilla. Spontaneous luxations of the vertebræ, which always come on slowly, are rarely accompanied by paralysis, an accident which is always the result of those that happen from external violence. It is thus in the brain, osseous tumours, large fungi which increase slowly, disturb its functions but little, while the least depression of a bone of the cranium, that succeeds a fracture, entirely deranges them. In hydrocephalus, also, a great collection of serum has oftentimes but little effect upon sensation, which is nearly destroyed, when a little more of this fluid than common is exhaled in the ventricles, as happens in some kinds of apoplexy.
When a large cavity, like the abdomen, is distended, the nerves that are there yield partly because their curves disappear, and partly because they are really elongated; there is also a greater separation of them.
The contractility of texture is still less evident than the extensibility. A nerve cut transversely, does not retract at the two ends, which remain opposite to each other, like those of a tendon. In amputation, the end of the nerve remains longer than those of the muscles, the skin, &c. This is sometimes the cause of a painful pressure from some part of the dressing.
These are less evident in the nerves, than would be thought at first, from the opinions of a great many physicians, who have made these organs perform almost the whole part in diseases.
The nerves must be considered, in regard to sensibility, in two points of view. 1st. We should examine that which is inherent in them. 2d. It is necessary to consider the part which they take in that of all the other organs.
This property is, of all others, the most strongly marked in the nerves. Exposed and irritated, they cause great pain. By tying, pricking, cauterizing, or exciting in any way a nervous filament, we uniformly obtain that result so well known in practical surgery, and by those who make experiments upon living animals.
This property would seem at first to establish a very great difference between the medullary substance of the nerves and that of the brain, especially towards the convexity of this organ; for we can almost with impunity irritate this after having removed the cortical substance. It is only deep in the brain that the animal sensibility becomes strongly marked, and even there it is not so much so as in the nerves. Observe, however, that in the experiments upon the cerebral pulp you destroy the organ itself that perceives, that, without which it could not have animal sensibility, and whose derangement would consequently have an inevitable influence upon this property; whereas the seat of perception being untouched when we irritate a nerve, the pain is more sensibly felt. It is, in fact, principally in the medullary substance of each nervous filament, that animal sensibility resides. The nervous coat possesses a much less degree of it. Hence why simple contact, without pressure, occasions but little pain; hence, also, why a nerve can almost with impunity be immersed in a purulent, ichorous fluid, or even in the sanies of cancer; hence why the contact of the air occasions but little pain when the nerves are merely laid bare, as I have had frequent occasion to see in animals; why, in a variety of cases, different tumours, in whose atmosphere the nerves are situated, have no influence upon them. The membrane of each filament is truly in every case a kind of covering that protects its medullary substance, in which the sensibility particularly resides. As to the cellular texture which enters into the composition of nerves, it has, as elsewhere, no connexion with this property. Hence why we can, as I have often done upon a living animal, separate from each other, with the point of a very delicate scalpel, the different filaments of a nerve of some size, of the sciatic, for example, when they have first been laid bare, without giving the animal much pain. In these experiments, it is easy to be convinced of the kind of insensibility of the covering of each nervous filament. It is necessary to pierce it and arrive at the medullary substance in order to produce pain.
In experiments, the animal sensibility of the nerve seems to be gradually exhausted, and finally ceases. I convinced myself of this upon the eighth pair of nerves, in making my experiments upon the injection of black blood into the brain. At the moment the nerve is raised and drawn to detach it from the carotid with which it is connected, the animal cries out and is much agitated; but after the same thing is repeated two or three times, he no longer gives any signs of pain. If we cease to excite the nerve for an hour or two, the sensibility returns with great energy, when it is drawn again. These experiments furnish a result very analogous to that of experiments relative to the animal contractility of muscles, experiments that are known to all physiologists.