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VAGOTONIA - A Clinical Study in Vegetative Neurology
VAGOTONIA - A Clinical Study in Vegetative Neurology
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Scanned, proofed and corrected from the original edition for your reading pleasure. (Worth every penny!)
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INTRODUCTION
It is often unsatisfactory for the physician, when investigating a disease dependent upon long standing disturbance of internal organs, to find that he must be content to make a diagnosis of '' Neurosis.'' The symptomatology and the impossibility of establishing any anatomical basis for the disease always remain the most conspicuous points in formulating the diagnosis of a neurosis of an internal organ. It is true that one would be inclined to correlate these disturbances with nerve abnormalities were it possible to form any clear picture of the significance of the nerves either in the normal progress of the functions of organs or in pathological conditions, but when one considers how difficult under such circumstances it is to give a clear definition of the conception of "a nervous disease of an internal organ" one can only recall the truth of the saying that where knowledge is lacking a clue will appear at the right time. If an attempt be made to substitute a precise conception for obscure ideas, special care must be taken to construct such a concept upon a foundation of facts.
Instead of simply making use of the general expression "nervous," which so frequently is nothing more than the expression of a soothing statement, either to the patient or to the physician, we must attempt, where we can, to separate definite disease pictures from an etiological point of view. Just as we may analyse with precision the diseases of the cerebrospinal nerves, in the light of anatomical and physiological knowledge, so, when diagnosing diseases of the nerves which supply internal organs, we must attempt to direct our thoughts along anatomical and physiological channels. Above all, if one really wishes to make further progress, it is necessary to review the physiological facts with thoroughness. It is through an exact knowledge of physiology that one may justly introduce pathology and apply it to the analysis of disease.
***
an excerpt from the beginning of the following chapter:
THE VEGETATIVE NERVOUS SYSTEM AND ITS RELATION TO DRUGS
In contrast to the "Animal" (sensori-motor) nervous system which serves the senses and the muscles controlled by the will, we include under the term "Vegetative" nervous system all those nerve fibers which go to organs having smooth muscles, such as the intestines, blood vessels, gland ducts and skin, as well as the nerve structures which exert a secretory influence upon glands. Besides these organs, there are to be included certain cross-striated muscles: as the heart, the beginning and end of the alimentary canal, and the muscles of the genital apparatus. With the exception of the heart, all of these muscles are functionally very similar to smooth muscles.
The vegetative nervous system cannot be readily distinguished anatomically from the sensori-motor nervous system, because their nuclei lie close to one another both in the brain and spinal cord, and because their fibers have many anastomoses with each other. The principal difference lies in the peripheral make-up of the two systems. The nerves of the sensori-motor system have but one neurone between the nerve centers and the cross-striated muscles, whereas the nerves which go from the spinal axis to involuntary organs of vegetative nature have ganglion cells interposed in their course. Since both afferent and efferent fibers are interrupted, the path from the central nervous system to its organ may be divided into pre-ganglionic and postganglionic segments. The ganglionic interruptions vary in their location. In some cases they are in the sympathetic cord, in some on the path from this cord to the periphery, as, for example, in the celiac ganglion; in some at the periphery itself, as in the case of the heart and intestines. Langley divides these ganglia, on topographic grounds, into ganglia of the first, second and third order.
The uniformity of the anatomic arrangement of the vegetative system foreshadows a uniform pharmacologic reaction, and it is this pharmacologic uniformity which has made possible the separation of the vegetative from the sensori-motor nervous system. If vegetative nerves are stimulated peripheral to their origin in the central gray of the cord, definite manifestations are obtained. These may be eliminated at once if nicotine is painted upon the ganglion between the site of stimulation and the periphery. The functional manifestations of the activity of the sensori-motor nerves are on the contrary unaffected by nicotine.
The vegetative nervous system may be divided anatomically as well as functionally. The system of fibers which arises from the middle and lower part of the thoracic cord and from the upper part of the lumbar cord forms an anatomical entity...
***
INTRODUCTION
It is often unsatisfactory for the physician, when investigating a disease dependent upon long standing disturbance of internal organs, to find that he must be content to make a diagnosis of '' Neurosis.'' The symptomatology and the impossibility of establishing any anatomical basis for the disease always remain the most conspicuous points in formulating the diagnosis of a neurosis of an internal organ. It is true that one would be inclined to correlate these disturbances with nerve abnormalities were it possible to form any clear picture of the significance of the nerves either in the normal progress of the functions of organs or in pathological conditions, but when one considers how difficult under such circumstances it is to give a clear definition of the conception of "a nervous disease of an internal organ" one can only recall the truth of the saying that where knowledge is lacking a clue will appear at the right time. If an attempt be made to substitute a precise conception for obscure ideas, special care must be taken to construct such a concept upon a foundation of facts.
Instead of simply making use of the general expression "nervous," which so frequently is nothing more than the expression of a soothing statement, either to the patient or to the physician, we must attempt, where we can, to separate definite disease pictures from an etiological point of view. Just as we may analyse with precision the diseases of the cerebrospinal nerves, in the light of anatomical and physiological knowledge, so, when diagnosing diseases of the nerves which supply internal organs, we must attempt to direct our thoughts along anatomical and physiological channels. Above all, if one really wishes to make further progress, it is necessary to review the physiological facts with thoroughness. It is through an exact knowledge of physiology that one may justly introduce pathology and apply it to the analysis of disease.
***
an excerpt from the beginning of the following chapter:
THE VEGETATIVE NERVOUS SYSTEM AND ITS RELATION TO DRUGS
In contrast to the "Animal" (sensori-motor) nervous system which serves the senses and the muscles controlled by the will, we include under the term "Vegetative" nervous system all those nerve fibers which go to organs having smooth muscles, such as the intestines, blood vessels, gland ducts and skin, as well as the nerve structures which exert a secretory influence upon glands. Besides these organs, there are to be included certain cross-striated muscles: as the heart, the beginning and end of the alimentary canal, and the muscles of the genital apparatus. With the exception of the heart, all of these muscles are functionally very similar to smooth muscles.
The vegetative nervous system cannot be readily distinguished anatomically from the sensori-motor nervous system, because their nuclei lie close to one another both in the brain and spinal cord, and because their fibers have many anastomoses with each other. The principal difference lies in the peripheral make-up of the two systems. The nerves of the sensori-motor system have but one neurone between the nerve centers and the cross-striated muscles, whereas the nerves which go from the spinal axis to involuntary organs of vegetative nature have ganglion cells interposed in their course. Since both afferent and efferent fibers are interrupted, the path from the central nervous system to its organ may be divided into pre-ganglionic and postganglionic segments. The ganglionic interruptions vary in their location. In some cases they are in the sympathetic cord, in some on the path from this cord to the periphery, as, for example, in the celiac ganglion; in some at the periphery itself, as in the case of the heart and intestines. Langley divides these ganglia, on topographic grounds, into ganglia of the first, second and third order.
The uniformity of the anatomic arrangement of the vegetative system foreshadows a uniform pharmacologic reaction, and it is this pharmacologic uniformity which has made possible the separation of the vegetative from the sensori-motor nervous system. If vegetative nerves are stimulated peripheral to their origin in the central gray of the cord, definite manifestations are obtained. These may be eliminated at once if nicotine is painted upon the ganglion between the site of stimulation and the periphery. The functional manifestations of the activity of the sensori-motor nerves are on the contrary unaffected by nicotine.
The vegetative nervous system may be divided anatomically as well as functionally. The system of fibers which arises from the middle and lower part of the thoracic cord and from the upper part of the lumbar cord forms an anatomical entity...
Product Details
| BN ID: | 2940012976628 |
|---|---|
| Publisher: | OGB |
| Publication date: | 06/15/2011 |
| Series: | Nervous and Mental Disease Monograph Series , #20 |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| File size: | 346 KB |
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