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apparently destroyed. Here is a point that is worth considering for many reasons. I have said in a former place, that upon a suspension, or an arrest of the process of brain wreckage, occurring in the progress of paralytic dementia, there takes place a readjustment of the mind with its surroundings. The process of brain destruction being stayed, hallucinations and delusions of persecution cease, and thereupon the mind, using its physical basis of activity, relieved as it is of these distressing complications, begins to act in a better manner, although in a sphere narrower than normal.
But the mere relief from progressing disease is not the only factor entering into the causes which enable the mind to resume in good part functions which seemed to be irretrievably lost. It is well known that the brain is so constructed that its parts, within certain limits, may be brought to act vicariously for each other. It is unnecessary to dwell very long on this point. A single illustration of the principle will suffice; for the books are full of instances illustrative of the doctrine. Dr. C. H. Hughes (Alienist and Neurologist, July, 1880, p. 319). says he had a patient with "cerebal softening quite general in the left hemisphere. The aphasia actually improved towards the close of life. The post mortem revealed a healthy third frontal convolution on the right side, while the corresponding left side was completely disorganized.
The man learned to say a great many words, that at first he could not say; so that it was undoubtedly an instance of education of the vicarious function of the opposite speech center.” The extensive association of the sense of sight with various parts of the brain would indicate that the sense of vision could easily find vicarious means of expression, even were the more evident centers of the sense of sight injured or destroyed. But in truth, it by no means depends wholly upon the double constitution of brain structure to secure a vicarious exhibition of mind or sensation. In regard to this department of mental pathology, however, much indeed remains to be explained.
It must be accepted as a fact, that in various ways and through various associations, there are a great many portions of the brain which may be brought to exhibit in a vicarious manner function that of right belong to other portions of the nervous centers. Upon this general hypothesis it may be claimed, with every appearance of propriety, that more or less vicarious function may be aroused in some portions of the brain, which will represent the injured basis of the moral nature. It is true, that in the indiscriminate destruction of nerve tissue due to some forms of chronic alcoholism, it would be impossible to surmise precisely where it would be most reasonable to look for relief; and this vicarious co-ordinating and moral function must be sought in the spontaneous
operations of nature, rather than in the powers of medicine. But that some sense of moral responsibility may be induced vicariously in a mind whose moral basis is injured or destroyed by alcohol, must, it seems to me, be recognized if possible.
It is important that the expression of our meaning should be clear on this head. While the brain and nervous centers are in a condition of progressing and advancing structural disease, while hallucinations and delusions of persecution prevail, the mind is insane and should not be esteemed to be morally accountable. But upon the hypothesis that the disease is arrested before the brain tissues are hopelessly injured—delusions and hallucinations having ceased to trouble—then it may
be pected that nature will designate and provide such centers of nerve energy as will assume to some extent those functions of the centers of moral activity which have suffered in the wreck of disease. There is a very important conclusion arising out of this, namely, that in cases of arrested brain disease, with injury and deterioration of the moral sense, there is still good reason to hold the mind to some extent morally accountable for its acts.
In the second place, a point of general conclusion of parámount importance in the consideration of the subject of alcohol is afforded by anästhesia. The two great powers displayed by alcohol over the physical constitution--including the ideational and moral elements-is, first, that one producing an increment of the general connective tissue ; and second, that other one which induces a state of anæsthesia. The former has been sufficiently noted. Great and important as it is, it is not by any means so frequently brought under observation as the latter. Indeed, while the cases of well-marked interstitial hyperplasia are rather infrequent, especially in the brain, the presence of anæsthesia from the use of alcohol is perhaps noticeable in every instance where it has been received into the system.
On several occasions I have already spoken of anæsthesia when the subject became linked with important collateral considerations, but some of the more special effects of alcoholic anæsthesia upon the mind and constitution have been reserved for separate observation and analysis. It should be remembered that while the acute mania of intoxication is the usual inducement to drunkenness, pure intoxication is invariably attended by that happy oblivion to troubles which is due to anæsthesia, and it is highly probable that the anesthetic effects of alcohol are quite as seductive as its stimulating properties. At all events, it is a fact that alcohol is habitually consumed by a very great number of men in a degree far short of manifest intemperance. Indeed, drunkenness is to such men a disagreeable as well as a disgraceful condition, and they partake of alco
holic drinks with the simple object of calming some neurotic irritability of nerve, and enjoying in a sensible measure the lethal effects of anæsthesia. It is, therefore, from the steady but often moderate drinkers that the injuries inflicted through anästhesia, both directly and by heredity, upon the human constitution are chiefly derived ; and it now remains, while considering the powers and effects of alcoho!, to trace as best we may the operations of habitual anæsthesia, and point out their final consummation in the destruction of the moral and the establishment of the criminal nature.
Of course, it is understood that sundry agencies capable of inducing anæsthesia, or, at least, greatly reducing the acuteness of the nervous sensibilities, are in very frequent use. The irksome and galling irritations, both physical and mental, of civilized life, are prone to induce an insupportable erethism of nerve, with a morbid continuity of thought and imagination, that demand rest, lest insanity or other nervous calamity should follow. To obviate such distress and danger, therefore, other substances besides alcohol are often instinctively employed ; and they are seized upon and welcomed as true and trusted friends. Of such are opium and chloral, and I think it will admit of no doubt that the almost universal employment of tobacco for its soothing properties has the same practical basis. Of course these and other anæsthetic and quieting substances, habitually taken, work their share of evil in common with alcohol; and whatever may be said in this inquiry respecting the outcome of the habitual anæsthesia induced by alcohol that can be also applied to the effects of opium or tobacco, it is understood will receive such application by the intelligent reader. Our present discussion is distinctively of alcohol, and I will speak in express terms of its powers only.
Whatever may be the opinion respecting the nature of mind abstractly, it is a fact that its manifestations through its so-called faculties are, in the human association, dependent upon the operation of physical
The faculty of perception, for instance, cannot be brought into normal activity and become manifest, except through the intervention of sensation. If there is no sensation, there can be no perception, and no consequent mental projection. If anaesthesia is simply incomplete with respect to the element of sensibility, perceptions are necessarily incomplete also, and they cannot result in well defined and positive mental operations and mental convictions. If anaesthesia is modified with regard to the quality, or kind of sensibility, and the given sensations are not in conformity with the normal sensibilities of the nervous parts and structures which they represent, the perceptions must partake of the modifications of such sensations, and they will be misleading as to actual facts. The subsequent mental acts will be out of accord with the normal
surroundings, as will also the judgment and the final choice in action or belief. Finally, if sensations are partial ; if, in other words, anaesthesia is confined to parts of the structure only, while other parts retain sensibility, then perceptions are incomplete, relatively with the outward fitness of things. We have the familiar examples of partial, or locally confined sensibility, in the phenomena of dreams, somnambulism, delerium, and all the forms of impaired and deteriorated consciousness. Some of the modifications of consciousness operating in abnormal planes have been described in another connection of our subject, and the evils thence liable to arise, were indicated.
Anaesthesia in some degree of intensity, greater or less, is a general if not universal accompaniment of intoxication. The anaesthesia of alcohol is not, as a rule, complete. Still, instances of entire insensibility to pain, and that, too, without unconsciousness, while under the influence of alcohol, have been observed. Dr. Mason Journal of Inebriety, Oc
( tober, 1882, pp. 215-216), reports such a case. The patient, a lady, suffering from cancer, refused to take ordinary anaesthetics preparatory to an operation. "It was decided to try the anaesthetic effects of alcohol. The administration was begun about two hours previous to the operation, The quantity used was six ounces of brandy, given diluted in divided doses, every twenty minutes. The superficial portions of the breast were removed by the scissors, and the deeper portions by means of the electro-cautery knife, the deeper and surrounding tissues being deeply cauterized ; the patient was wholly unconscious of pain during the operation, and under perfect control and self-possessed, answering questions that were asked her." This was a case under the treatment of Dr. W. H. Bates, of Brooklyn. The time consumed in operating was over an hour. Dr. Seguin and others have recorded examples where the absence of common sensibility was confined to particular portions of the body only-as, for instance, below the knees, in the forearms, and in various circumscribed portions of the bodily surface.
It is not necessary to dwell longer upon this branch of our subject. It is certain that the anaesthesia of alcohol may partake of any one of the modifications of the anaesthetic state. That is, it may be complete, or incomplete, as to intensity; partial as to localization; and modified as to quality. Of course this implies all the disabilities to perception that have been noted as belonging to these conditions. And an important inflowing mental disability is that which, in consequence of modified or partial anaesthesia, makes possible, and indeed probably, various forms of delusion and hallucination.
There are several avenues through which the moral nature is debased by the anaesthetic properties of alcohol :
(a) It is apparent that a mind hedged in by serious lesions of nerve sensibility must operate at a great disadvantage. It is obvious that it is forced to persue its course of action, so hampered by the radical inferiority and poverty of its instrumentalities, that the operations are upon a plane beneath that pertaining to its natural and healthy power. Perceptions arising under such circumstances are of necessity defective, and all the mental activity and conclusion associated with them must partake of kindred characteristics. It follows, if reason and will are confined and deflected, if the inhibitory and ideational centers are not working in harmony and health, that the co-ordination of mental qualities thus evolved cannot bring forward the best and clearest principles and feelings of manliness, honor and morality. The very fact that the mental elements which await the co-ordinating function of the nerves of Meynert, are in their own nature imperfect, indistinct, illusive, injures the standard quality of that final average of the whole, which it is the province of the association fibres to determine and establish. The ultimate consequence is that the quality of assertive personality, of the ego of responsibility, in fine, the quality of distinctive moral principles must be inferior and deficient.
(6) But the influence of evil to the moral nature derived from the positive power of alcohol to deprave the physical structure of the brain is displayed in yet another direction. Nothing can be more probable than that the power and perfection of the co-ordinating structures within the brain must themselves undergo injury and deterioration at the hands of alcoholic anæsthesia. It is absurd to imagine that the mischief wrought by alcohol is confined to certain portions of the brain, exclusively. It would be an easy task to show that anesthesia is not limited to the mere tactile sensibilities, but that it extends to organic sensibility also. “It affects not only the integumentary, but the deeper tissues of the body as well," is the remark of competent authority. The inference is plain. Let the sensibilities otherwise be what they may; let the reasoning faculties in ordinary be in the best possible condition; still, with the centers of co-ordination repressed, and the expression of their special sensibilities hindered and obtunded, the moral attributes developed and displayed through their operation must exhibit the characteristics of instability, weakness and imbecility,
(c) Again, alcohol, in the injuries it inflicts upon the nervous organization, interferes with another and very important factor in morality. We have seen elsewhere that motive is the spring of all sound mental activity, good and bad ; that it is a principle of the moral nature, and it depends for its finest and highest qualities upon the integrity of the physical structure and of the functional operations of the brain. For, in