ORIGINAL COMMUNICATIONS.-SUMMERS.

151

When we view the vast amount of literature that floods our medical journals upon subjects now as familiar as household words, which but a short while ago were believed to be beyond the reach of demonstration, we are no longer surprised at anything and the day is not far distant, from the trend of recent pathological investigation when the molecular vibrations which are peculiar to every vital expression of the common force of nature will be as positively determined as are the established chemical phenomena of the organism. Why, it was not a very long time ago when the presence of a grape seed in the appendix vermiformis was considered as inevitably premonitive of death as the sound of the "death rattle" in the throat, which was wont to thrill our minds with unutterable awe. To-day the slightest inconvenience in the ileo-cœcal region is the signal for the "inch and a half" incision and "the week and a half confinement," and it may well be doubted if the next generation will be able to show an abdomen without the scar that marks an operation for appendicitis.

The influence of the nerve system upon the nutritive function of the organism is too well recognized to demand more than passing notice in this connection, but its relation to pathological conditions, until recently considered independent of neural influence, is as yet sub judice, and it is this that I propose to establish, as far as the limits of journalistic discussion will allow.

When we consider that all the phenomena of secretion upon which the functional activities of the organism depend, are determined by the molecular vibration of nerve elements, it is a necessary corollary that the dynamic expression of nerve force must leave its permanent impress upon the morphological characteristics of the elements themselves, which are active in such expression. There is not a thought, however evanescent it may be, that is flashed into existence by the molecular activity of the nerve cells which does not leave its permanent stamp upon the morphology of the cells through which it was expressed, and if this be true of the subtle phenomena of cerebration, how much more so must it be of those physiological and pathological processes which are brought into activity and sustained throughout their whole functional expression through the agency of nerve

force. Whenever a cell is thrown into functional activity there is always produced some material essence as the result of that activity which either enters into the structure of the cell, thus altering its morphological condition, or is thrown off as wastethe product of retrograde metamorphosis or disassimilation. If neither of these natural or physiological results of cellulation appear, then there is a third condition-a tertium quid-namely, the environment of the cell by this "formed material," as Beale defines it, thus interfering with its normal expression of function by arrest or alteration of influence. This is pathological, and it is this which I propose to demonstrate as lying at the foundation of those disorders which have, by a sweeping generalization, been treated of under a nomenclature that reached no further than the semiological conditions, with no reference to the ultimate analysis of the nisus formativus which determine them. I do not think that I speak rashly, and I believe the experience of nearly every close observer will sustain me, when I say that the great majority of disorders which we are called upon to treat have their origin in this investment of the nerve elements, by the products of retrograde metamorphosis thrown out in the normal functional activity of the cell, and which have remained in its interstitial structure arresting its action, or determining it in pathological lines, and I have remarked that most of our renowned and successful neurologists proceed intuitively in practice to bring about elimination in nearly all the conditions which they are called to treat even which they do not formally recognize the neuropathic environment as here expressed. Now many of these products of neural cellulation are directly toxic in their effect, and if not promptly eliminated from the organism will impair the integrity of the nerve cell, even to the extent of its destruction. In many cases it takes on plasmic development, and throws around the cell a web that interferes mechanically with its molecular vibration, and preventing the influx of nutritive material necessary to its structure and its function. In discussing the intoxication of the animal economy with its own products, Aitken has endeavored to bring them under two general classes, viz.: 1. Chemic and physiologic or bio-chemic, and 2. Clinical or pathologic.

This classification is too general to be of practical use.

ORIGINAL COMMUNICATIONS.-SUMMERS.

153

Most of the experiments upon which his classification was based were upon dead animal tissues when processes of putrefactive decomposition had set in, and Selmi, of Bologna has designated the products elaborated from proteid substances as "ptomaines.' But, as Dr. Clifford in his admirable paper read before the Oral Section of the American Medical Association at its last meeting, has wisely suggested, there are distinct alkaloids developed in living tissue by the very act of "living." Gautier has endeavored to separate these, and has distinguished them from the "ptomaines" of dead tissue by the general term of "leucomaines," and he goes on to speak of certain azotized uncrystallized substances "as yet undetermined," which he calls "extractive matters" about which nothing has been definitely known. It is just here that I take issue with the learned investigator, and propose to define some of them which gather about the nerve tissue in the act of cellulation. I have succeeded in separating at least one of these products of retrograde metamorphosis which is constant and which produces a decided and well-defined toxic effect upon the elaboration of nerve force. To this I have given the name of neuro-sclerotin, although I have little doubt from its similarity of reaction to neuro-keratine that it is really this substance in a nascent state, and therefore more active and positiye in its effect upon the neuroblast. When we consider how much neurotic cellular substance there is in the brain and spinal cord as well as the ganglia of the sympathetic that acts by diffusion without any investment it is not difficult to account for the marked changes which are produced in the organism by the interposition of any agent mechanical or chemical which disturbs this direct diffusion, either by shutting it off from its trophic distribution or by concentrating it into adventitious channels. So dependent are the nutritive functions upon this direct trophic diffusion, if it may be so called, that anything which will obstruct or divert it must neccessarily disturb the functional activities of all the organs over which it has control. It is now scarcely to be questioned that neuroglia, formerly considered a kind of adenoid tissue is a distinct material derived from the neural epiblast and yields neuro-keratin. This substance is readily convertible into a plasma which will invest the cell poles and convert a diffused nerve current into a concentrated influence, which, if the

ment.

investiture remains permanent will go so far as to superinduce upon the cords leading out from the poles a direct excitation, and unless controlled by external agencies will induce vascular engorgement. It seems reasonable to suppose that such a process as this goes on in those states brought about by the habitual use of narcotics, and it is only by the reabsorption of this investiture that a proper distribution of the generated nerve force can be again established, and until this is done the physiolgical processes dependent upon nerve-supply can only be accomplished when the centers are acted upon by the agent which has originally established this condition. To be more specific, I am thoroughly convinced that this neuro-keratin produces a slerotic condition which will totally obstruct the trophic influence unless an artincial stimulus is applied of sufficient power to act through the investiture, and it is this which accounts for these terrible conditions which are manifested upon the withdrawal of the specific drug which has produced this alternation of cell environFrom this it may be seen than with all his charlatanry that great apostle of the dipsomania humbug may have stumbled upon something that by removing this investiture permitted the normal distribution of nerve force into its proper channels without the aid of external stimulus, for it is a significant fact well recognized by all who have studied the therapy of gold that it is in these sclerotic conditions that its effect is most pronounced. These adventitious investitures of nerve substance where in the normal state there exists no lemma are capable of bringing about just such conditions as those we see developed by the habitual use of narcotic drugs, and there is relief until by some therapeutic agent this artificial investiture is absorbed and carried away, leaving the gray matter free for the diffusion of its generated force. The function of automatism is the one most seriously interfered with by the habit of using narcotics, and it is by the formation of this plasmic investiture of neuro-keratine that this is brought about, the nerve centers being then dependent upon afferent stimuli and incapable of sending out efferent impulses of various kinds. The metabolism of the nerve center is rendered of no effect so that the anabolism or building up of the explosive substance is not followed by katabolism or its discharge and the center fails to send out its

no

Fresh Raw Beef, Predigested and Sterilized, is
the basis of

Armour's Nutrient Wine

Of

of Beef Peptone.

Armours

Food is the foundation of life, assimilation of food the condition of existence.

A distinguished writer says: "Nearly 80 per cent. of the patients

NUTRIENT WINE who apply for relief, suffer from or

ganic diseases, or functional disorders due directly or indirectly to mal-assimilation of food. The impaired condition of the nutritive powers will account for most of the misery and suffering which the modern physician is calied upon to remove and alleviate."

ARMOUR'S

STANDARD PEPSIN

AND

supplies deficient digestive power. ARMOUR'S PANCREATIN SODA TABLETS supply the means of peptonizing milk and other foods.

ARMOUR'S NUTRIENT WINE OF BEEF PEPTONE supplies predigested nourishment in an immediately assimilable form.

Prepared at The Armour Laboratory, Chicago.