The insanity of over-exertion of the brain : being the Morison lectures delivered before the Royal College of Physicians of Edinburgh, session 1894 / by J. Batty Tuke.

  • Tuke, J. Batty (John Batty), Sir, 1835-1913.
Date:
1894
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Licence: Public Domain Mark

Credit: The insanity of over-exertion of the brain : being the Morison lectures delivered before the Royal College of Physicians of Edinburgh, session 1894 / by J. Batty Tuke. Source: Wellcome Collection.

Provider: This material has been provided by the Gerstein Science Information Centre at the University of Toronto, through the Medical Heritage Library. The original may be consulted at the Gerstein Science Information Centre, University of Toronto.

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    to compare a silken thread to a hawser. There is no organ of the body possessing such immense intricacy of arrangement as a convolution of the brain ; the structure of the spinal cord is, in comparison, simplicity itself,—that of the cerebellum or of the retina commonplace. It is impossible to find terms or to cite comparisons to express the feeling produced by study of its delicacy and complexity. It is preserved from rough accident by its rigid bony envelope, which has till of late years been regarded as a practically closed sac. Were it so, it would prove a greater source of danger than of protection : a fit of coughing or of sneezing might under such circumstances prove fatal. If we assume that the average compressibility of brain matter is at all comparable with that of water, were it confined in a rigid chamber absolutely filled, the addition of a T|-§o Part to its volume would produce a pressure of one atmosphere, and an additional atmosphere would crush the organ into a shapeless mass. The statement of the physical fact enables us alPthe better to recognise that the coherence and continuity of this large and delicate organ depends on the maintenance of the normal ebb and flow of the cerebro-spinal fluid in which it is suspended. The constant variation of the quantity of this fluid is admirably illustrated by the experiments of Dean,1 which also enable us to get a clearer conception of its action in preserving the unity of the whole encephale. The cerebro-spinal fluid also receives from the lymphatic system the products of waste, and under abnormal conditions the products of diseased action. Any interference, therefore, with its flow must act detrimentally ; for, be it remem- bered, the brain obtains no vicarious assistance from other systems,—it must do its own work, and must rid itself of all effete matter. Although Falkenheim and Naunyn2 have shown that increase of blood pressure does not increase the amount of secretion of cerebro-spinal fluid, Dean observes that the cerebro-spinal fluid pressure increases considerably with increase of blood pressure ; and he naturally infers that the same occurs under such circumstances as excessive secretion or diminished absorp- tion of the fluid, or the pouring out of inflammatory exudation.3 1 Cerebro-spinal Pressure, W. C. Dean, Journal of Pathology, vol. i., No. I. 2 Archiv fur Exper. Pathol., 1887. 3 Loc. cit.