The Transactions of the Provincial Medical and Surgical Association. Vol. XIII. 456 1. Retrospective Address upon the Progress of Practical Medicine. By 2. Retrospect of Anatomy and Physiology for 1843-4. By Dr. Budd 462 3. The Inflammatory Affections of the Retina. By Dr. Hocken 464 IX. I. The Cyclopædia of Anatomy and Physiology.-Articles, Nerve, Nervous II. The Physiological Anatomy and Physiology of Man. By Dr. TODD and III. Traité Complet de l'Anatomie, Physiologie et Pathologie du Systeme Ner- .. IV. On the Nervous and Circulating Systems in Myriapoda and Macrourous V. Physiologische Untersuchungen ueber die Bewegungen des Gehirns und VII. Lehrbuch der Physiologie des Menschen. Von Dr. G. VALENTIN.. VIII. Recherches Experimentales sur les Fonctions du Nerf Spinal. Par 473 A View of the Formation, Discipline, and Economy of Armies. By the late I. A Practical Treatise on Midwifery, &c. By Professor MOREAU. Translated II. The Principles and Practice of Obstetric Medicine and Surgery, &c. By III. De la Puberté et de l'Age Critique chez la Femme, &c. Par M. A. Bibliographical Notices, &c. 2. The Cold-Water Cure, its Use and Misuse examined. By Herbert Mayo, M.D. 546 3. Contributions to the Medical History and Treatment of Sexual Diseases. By .. 6. Is Railway Travelling conducive to Apoplexy. By J. C. Badeley, M.D... .. 552 7. Registration of the Causes of Death 8. Extracts from the Quarterly Medical and Surgical Journal for the North- 12. New Analysis of the Sounds of the Heart. By M, Rouanet 13. M. Parchappe on the Sounds of the Heart.. 14. On Cataract, and its appropriate Treatment. By Charles G. Guthrie THE MEDICO-CHIRURGICAL REVIEW. JULY, 1845. I. THE CYCLOPÆDIA of ANATOMY AND PHYSIOLOGY. Parts 25 and 26. 1844. Articles :-Nerve, Dr. Todd; Nervous System, (Comparative Anatomy), by J. Anderson, Esq. Nervous Centres, Dr. Todd. II. THE PHYSIOLOGICAL ANATOMY AND PHYSIOLOGY OF MAN. By R. B. Todd, M.D., F.R.S., and William Bowman, F.R.S. Part II. 1845. III. ON THE NERVOUS AND CIRCULATING SYSTEMS IN MYRIAPODA AND MACROUROUS ARACHNIDA. By G. Newport, F.R.S. Philosophical Transactions. 1843. IV. UEBER DEN VERLAUF DER NERVENFASERN IM RÜCKEN- V. LEHRBUCH DER PHYSIOL. DES MENSCHEN. Band. II. VI. RECHER. EXPERIM. SUR LES FONCTIONS DU NERF SPINAL. Par C. Bernard. Archiv. Gen. de Med. 1844. Ir must be confessed that, although within the last few years there has been no lack of labourers in the field of neurology, the actual progress has not been commensurate with all the toil and trouble that has been bestowed upon the subject. In some of the more recent contributions indeed, and herein our friends of the German school have been the principal offenders, the tendency has been to retrograde. We certainly did not anticipate, and least of all in England, that a time would arrive when it would be necessary to vindicate the great principle announced by Bell, that principle upon which all accurate knowledge of the nervous system must ever repose, the individuality, namely, and uninterrupted continuity of the primary nervous filaments. Doubts have, however, been thrown upon this fundamental truth; and principally, as it would appear, on the faith of certain dissections and experiments of Stilling, from which it is inferred that the elementary fibres interlace and are fused one with ano NEW SERIES, NO. 111.-II. B ther in the spinal cord, in the several nervous plexuses, and in other parts of the system; that, in fact, the disposition of the nervous system "is precisely analogous to what is seen in the venous and lymphatic systems.' We believe this to be an entire fallacy, and unhesitatingly express our conviction, resting on repeated and careful examination, that no anatomist has ever seen, in any of the parts just mentioned, a true anastomosis in the sense of that existing in the vascular system. The only places where the primary nervous tubules do actually communicate is in their peripheral extremities, where, both in the muscles and in the tactile papillæ of the skin, they unite and form loops. It has also been asserted by Valentin, that a similar disposition prevails in the central ends, implanted in the grey matter of the brain, but, as we shall subsequently state, this must at present be held to be doubtful. It is so essential to the physiology and pathology of the nervous system to establish the real relations of its component parts, that we conceive the best introduction to the subject before us, will consist of a brief reference to the disposition of the nervous tubules. And, in the first place, it may not be superfluous to remark that the functions of the blood-channels and nerves are so totally different, that it is surprising any comparison between them should have been attempted. It is the office of the blood-vessels not merely to carry the nutritive fluids to all parts of the body, but specially, by overcoming the repeated obstacles which impede the circulation, to secure, in the extreme divisions or capillaries, that uniform current which alone is compatible with healthy nutrition. Now, how is this to be accomplished?clearly by providing free inter-communications between all the parts of the vascular system, and more particularly between its smaller divisions. Thus, as to the function of the blood-vessels, it matters not how the blood reaches its destination, provided it does but get there. But in the case of the nervous system all is reversed; here the whole action of innervation requires in theory what is shown by observation, a disposition of the nervous threads, which will enable them to act as isolated conductors, so as to transmit unmingled the mandates of the will centrifugally to special muscles, and centripetally the impressions made on the organs of sense to the brain. In consequence of the unsatisfactory results of many of Stilling's researches, we have again cautiously examined the disposition of the primitive tubes in the spinal cord, with the express object of ascertaining if, in any part of the white substance, an anastomosis could be detected. All our examinations have shown that the fibres invariably observe an isolated course. When viewed with a sufficiently high power, an objective of one-sixth of an inch focus for example, the beaded particles are beautifully and distinctly seen in a perfectly recent specimen, and, mixed with them, branches of minute blood-vessels and capillaries; these latter canals, it is necessary to state, present appearances so deceptive, that to an unpractised eye, and especially when low powers are used, as was done by Stilling, they may very readily be mistaken for nervous tubes, and herein we believe will be found the source of the errors above noticed. The capillary vessels are seen branching and uniting, but they present physical • British and Foreign Medical Review, 1844, p. 146. marks, and especially nuclei, in their walls, which are quite distinctive : indeed we were never more impressed with the certainty and elucidation which microscopic examination confers on the great questions of physiology, than by thus seeing under the eye the true characteristics of the vascular and nervous systems. 1 The conclusion at which we have ourselves arrived, as the result of direct inspection, is confirmed by the best observers. Thus Valentin, in his Physiology just completed, after pointing out and demonstrating the physiological necessity of isolated conductors in the peripheral portion of the nervous system, both as relates to sensation and motion, says, " We conclude, as a general anatomical proposition, that all ramifications, anastomoses, and interlacements of the nerves, are in reality only apparent, and therefore that no true divisions nor communications similar to those of the blood-vessels exist, but merely a corresponding entrance or exit of unbranched, uninterrupted primitive fibrils; a disposition which enables us easily to comprehend the laws of nervous conduction.”—(Lehrbuch der Physiol. Zweiten Band., p. 589.) In the same sense Dr. Todd, in his excellent article upon the nervous system (Cyclop. of Anat. and Phys., Part 25, p. 593), thus expresses himself: "the nerve-tubes lie side by side, parallel, and sometimes have a wavy course within the general sheath. The relation of the nerve-tubes to each other is simply that of juxta-position. All observers, from Fontana down to those of the present day, agree in denying the existence of any inosculation or anastomosis between the fibres in vertebrate animals; and it seems almost certain that this complete isolation of the nerve-tubes is not limited to those se of the nerves, properly so-called, but may be observed in the nervous centres also." A similar opinion is expressed by the same gentleman in the recent number of the Physiological Anatomy. Although there is no real anastomosis, all the nerves, with the exceptions probably of the olfactory, optic, and perhaps of the acoustic, mutually interchange fibres, sentient nerves receiving motor fibrils, and muscular nerves receiving sentient twigs, by which their actions are modified in a most important manner. In the hichons, there i expressed what we are convinced is the law s the course is the nerve-tubes; and we only further remark that, if anatomists yield this fundamental fact in obedience to some recent, and in many respects defective, researches, they must at same time be prepared to abandon that which is the key to all Bell's splendid discoveries, and to return to the chaos of confusion, uncertainty, and contradiction from which this, the highest, branch of physiological science was rescued by our illustrious countryman. the sh [I In considering the works and papers before us, we shall commence with the ABS T know دلی STRUCTURE OF THE GRAY AND FIBROUS SUBSTANCES.Although organic chemistry is not sufficiently advanced to throw much light on the nervous system, it is interesting to that, according to L'Heritié, the quantity of phosphorus found in t the nervous matter varies considerably at different periods of life, and that it is very small proportionally in idiotcy. The following table of his comparative analyses, is taken from the Physiological Anatomy of Dr. Todd and Mr. Bowman. B |