Address to the American Neurological Association / by S. Wier [i.e. Weir] Mitchell.

  • Mitchell, S. Weir (Silas Weir), 1829-1914.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Address to the American Neurological Association / by S. Wier [i.e. Weir] Mitchell. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    19/20 (page 401)
    The mere act of closing one hand can scarce affect materially the blood flow, but try it with an ear over the heart and you will hear how notably it accentuates the heart sounds, as one of my assistants. Dr. John K. Mitchell, long ago pointed out.^^ All these facts deeply concern us and are not merely ingenui- ties and puzzles. Many other phenomena of disease may be rea- sonably explained by this conception of the far-reaching influence of overflows of energy. Grave central nerve lesions appear in some cases to render over excitable neighboring or related centers not directly implicated. Then the ordinary constancy of normal restraining inhibitions fails, and effort to use the injured center results in the excess of effluent energy so disturbing these remote ganglia as to give rise to ungovernable movements of healthy parts, such as we see in the motion of the sound hand in response to vain effort to move the palsied hand. There are other like phenomena with which you are all familiar. With one more illustration I leave this subject. When, in a case of violent facial neuralgia, to talk, to laugh, to chew evokes maddening pain, are we not in the presence of an example of reinforcement from overflow of related motor centers affecting a sensory ganglion excitably ready to call forth the phenomenon of pain? The phonomenon of overflow from sen- sation centres upon centres exquisitely sensitized by the torture of causalgia from nerve wounds I described long ago. Every positive sensation, sound, vibration, music, as of a band, added to the sum of torture. I wrote of this in language perhaps too imaginative that this terrible hyperesthesia was like a state of sensory tetanus.^® You may differ with me as to some of my conclusions—I may differ with myself soon or late—but I trust that in this too long claim upon your attention I have not left you without thoughts of interest. Much that would have lengthened my ad- dress I have relegated to notes. I thank you for the kindness which has made me your presi- dent and for the patience and attention with which you have listened to much that may have been familiar, but which I have vainly tried to put in briefer form. “ This fact and others open the question of the reinforcement of all normal movements, voluntary and involuntary, by reinforcements due to other and remote volitional acts. It was one in which we failed to obtain competent answers. The gymnasiums should be able to settle at least a part of this complex problem. Injuries to Nerves, page :8i.