It may be objected, that it is possible to eject a morbid element from the blood by other means than change of matter. It may, for example, be purged, or sweated, or salivated away. But this objection is more apparent than real; for physiology teaches us, that the processes of sweating, purging, salivation, and, indeed, of secretion generally, are only forms of change of matter; that is to say, the secretions are derived from decomposed, disintegrated, dissolved tissues, and, therefore, increased secretion is only increased change of matter, in which the destructive element predominates. Hence, as we see that recovery from disease is effected by the process termed change of matter, and, as we have proved, that change of matter is more actively performed in children than in adults, we can readily comprehend the fact, known to all persons of experience, that children not only recover from disease generally more quickly than those who have attained more advanced age, but that they survive many maladies which would prove fatal later in life.

Notwithstanding the facts immediately discussed, it is quite true that children are greatly more obnoxious to the attacks of disease, than adults; and this proposition is intelligible enough, when we consider the delicacy of the child's organism. The exquisite sensibility of the nervous system; the soft and semi-fluid condition of the tissues; the hurry of digestion, secretion, and assimilation; the quickness of the circulation-these, and many other circumstances, render the infantile constitution extremely susceptible of morbid

causes.

The child cannot endure variations of heat and cold, nor of dryness and moisture; it cannot digest coarse, improper, ill-prepared food; nor is it able to endure hardship of any kind like those, whom age has, as it were, roughened and fitted to do battle against the hostile influences which incessantly threaten human life. There is, moreover, in the very nature of the nutritive functions, a reason why children should be more liable than adults to inflammatory attacks. We have seen that the process of growth is, physiologically, only change of matter; now when this

process is exalted beyond a certain point, it becomes inflammation. But the change of matter is exceedingly energetic in childhood, and is, therefore, proportionably liable to pass into inflammation. With the limits of this work, it is not consistent to enter into a full explanation of the nature of inflammation; nor to show, in detail, that inflammation is a sort of growth; and that, in fact, wherever this latter process becomes too rapid and too intense, inflammation is the result. But it may be considered as established, that the liability of childhood to inflammatory disease, is a corollary of the rapid change of matter, or energetic growth which marks that period of life.

The nervous system is formed very early in uterine existence, and, as soon as it is completed, its functions begin to be manifested. The nerves, distributed over the different organs and tissues of the body, as the heart, stomach, skin, muscles, etc. are excited by the nutritive processes performed in and around those textures; and this excitation, communicated through the nerves to the brain, awakens the first glimmerings of mind. It is probable, that the first manifestation of mind is a state of simple consciousness, or sensation of pleasure or pain, of comfort or discomfort, according as the various vital functions are perfectly or imperfectly performed.

Immediately upon the birth of a child, its brain, which previously had been almost quiescent, is called into intense activity. The special senses bring into relation with the interior consciousness, the multiform phenomena of nature. By five distinct channels, five distinct sets of ideas are constantly flowing into the brain; and, in proportion as these ideas accumulate, and fill, as it were, the percipient chambers, fresh space must be created to receive the impressions that come after. Hence it follows, in the words of Dr. Charles West, that There is no organ in the body, with the exception of the pregnant womb, which undergoes such rapid development, as the brain in early childhood. It doubles its weight during the first two years of life, and reaches

6

nearly, if not quite, its maximum by the end of the seventh year. This same active state of the nutritive, or vegetative processes in the brain of the child, renders the organ liable to have diseases set up in it, by causes which would produce little or no injurious effect on the brain of the adult. This condition of rapid growth renders intelligible many of the mental phenomena of childhood, such as its mutability of ideas and ever-varying emotions.

In the second place,' says Dr. West, 'the brain of infancy is much more exposed to disorder than that of the adult, owing to the far wider variations of which the circulation of blood through this organ is susceptible, in early life than subsequently. Nor is the cause of this difficult to discover. The cranium of the adult is a complete bony case, and the firm substance of the brain affords a comparatively unyielding support to the vessels by which it is nourished. The variations, therefore, in the quantity of blood which it receives, must needs be circumscribed within far narrower limits than in the child, whose skull, which is principally formed of membrane, with a few scattered plates of cartilage and bone, opposes no such obstacle to the admission of an increased quantity of blood; while the soft brain keeps up a much slighter counterpressure on the vessels, than is exerted by the comparatively firm texture of the organ in the adult. If the circulation in the child be disturbed, whether from difficulty in the return of venous blood, as during a paroxysm of hooping-cough, or from increased arterial action, as at the onset of a fever, or during the acute inflammation of some important organ, the brain becomes congested, and convulsions often announce the severity of the consequent disturbance of its functions. The same causes, too, which expose the brain to be overfilled with blood, render it possible for it to be drained of its blood more completely than in the adult.'

In children, the nervous system is tender, and susceptible of impressions which take little or no hold upon older persons. Consequently sensation is acute,

and a child experiences pain from a collision which his parents would scarcely feel. A slight tumble on the floor, will set an infant vigorously crying, and a slap on the back is to him severe punishment.

That sense, whose instrument is probably the ganglionic nerves, and which the Germans denominate Self-feeling, or Canoesthesis, is exceedingly active in early life. By Self-feeling, or Cancesthesis, we mean those sensations which are constantly flowing into the brain from every part of the body-sensations by which we know our own members and other constituent parts to be our own. I feel that the fingers which guide my pen along this paper, belong to me, and not to another. Now the sensations by which I know this and similar facts, constitute the cænæsthesis. There is perhaps no part of the economy which does not contribute to this sense, that is to say, make known, through the instrumentality of nervous fibrils, to the sentient principle that it also participates in that composite unity called self. It is true that these cænæsthetic impressions are, many of them, exceedingly obscure, and in good health, they are apt to be overlooked entirely; still they exist, and may generally be perceived, if the attention be excited. Thus, let a person direct his thought to any part of his system, and he will soon be conscious of certain sensations, which announce to him its existence, but which, previously, he had failed to notice. Let any person think of his knee, his chin, or his abdomen, and he will understand what is meant. By continued exertion of thought, even the sensations which emanate from the internal organs, may sometimes be brought into the consciousness; and a man may feel his heart, kidney, liver, or any other organ. Some have these feelings more intensely than others: thus the late Dr. Andrew Combe had a distinct perception of the two sides of his heart; but this was a morbid exaltation of the sense. The cænæsthesis in a child is exceedingly acute. He is therefore, of necessity, much occupied with himself, and discovers within the limits of his own little organism, greater varieties of pleasure

and pain, and a fuller existence, than many an adult, whose senses have at their disposal the great globe itself, can enjoy.

'Glücklicher Säugling! dir ist ein unendlicher Raum noch die Wiege,

Werde Mann, und dir wird eng die unendliche Welt.'

But cænæsthetic sensation, when it is very acute, becomes pain; hence children are more subject to pains and aches than grown-up persons. They are also liable to be painfully affected by apparently very slight and inadequate causes. When a little disorder of the alimentary canal occurs, it is thought very strange that an infant should cry and be fractious about such a trifle, and wise people say, that to spare the rod is to spoil the child; and that a little salutary correction would teach it selfcommand, and prove of infinite service. We forget, however, all this while, that we are measuring the sensations of a child by the sensations of men-a manifest absurdity! What should we think of a man who should place his own big hat upon the head of his child, and thrust the little feet into Wellington boots, and the puny arms into the sleeves of a swallow-tailed coat? Yet this proceeding would be not one whit lest ridiculous, than the common error of calculating the feelings of four or fourteen from those of forty years.

The acuteness of the senses is one element which contributes greatly to that power of discrimination which is so remarkable in a child. His impressions and ideas are all sharply cut-all distinct and complete; hence he remembers, and recognises clearly without effort or hesitation. The activity of the sensorium, or that portion of the mental organ which receives sensuous impressions the central terminus, to which all the nerves carry their several messages-is also very intense. Hence the imagination (not the creative, or poetic imagination or fancy, but the passive imagination, or mental impressionability) is very vivacious. I remember very well that, in early youth, I could at any time close my eyes, and summon before my mental vision any object that I de

sired to see. Sleeping with my brothers, I frequently amused myself and them, before slumber interrupted our discourses, by describing the gay scenes which spread themselves before me, obedient to a wish. As I proceeded with the description, the same pageantries figured before their eyes; and no objective spectacle could surpass in distinctness of outline and colouring these spectral illusions. At the present time, I am totally devoid of this power.

In one of his essays Mr. Macaulay observes that 'of all people, children are the most imaginative. They abandon themselves, without reserve, to every illusion. Every image which is strongly presented to their mental eye, produces on them the effect of reality. No man, whatever his sensibility_may be, is ever affected by Hamlet, or Lear, as a little girl is affected by the story of poor Red Riding Hood. She knows that it is all false; that wolves cannot speak; that there are no wolves in England. Yet, in spite of her knowledge, she believes; she weeps; she trembles; she dares not go into a dark room, lest she should feel the teeth of the monster at her throat.

It is this activity of the imagination which makes the phenomena of clairvoyance more common among the young than among adults. The ancient magicians, when they wished to summon the spirits of the absent or departed, frequently caused children to gaze into a peculiarly constructed mirror, desiring them to observe if they saw such and such a person. This process was usually sufficient to bring before the view of the gazer the person indicated. It is known that, at the present time, when any anxious traveller desires to be informed concerning scenes he has left, or events occurring at a distance, boys are employed by the magicians of the east, for the purpose of divination. A little ink is poured in the palm of the boy's hand, and he is desired to look into this and describe the objects that appear. In a short time it happens that the child begins to see visions, and to dream dreams; and according to the report of

and cutaneous diseases, which arise from irritation, either sympathetic or idiopathic, in the cuticular branches of these nerves, and modified in these instances by depraved habit, and 'constitutional taint.' Among these, the first that attracts our attention is scrofula.

With regard to this malady, it is not very difficult to conceive that when, by hereditary descent, every nerve is depraved in its functions-the powers of life considerably below par-when, in consequence, the heart and vascular system are deficient in their action, and the important functions of the body imperfectly performed; when there is bad assimilation of food, a deficient quantity or vitiated quality of bile; when the glands of the mesentery are affected, and do not efficiently convey the chyle (such as it is) into the constitution; when the oxygenation of the blood itself is but very imperfectly accomplished, and nerve force consequently very sparingly developed; when, through the debility of the nerves supplying the kidneys, skin, bowels, and other excretive organs, injurious elements are retained in the blood for the nourishment of the whole frame, which ought to have been ejected by these organs; and when even the nerves and great nervous centres are nourished and maintained only by such sanguineous fluid as this, it is not difficult to conceive that, independently of any original morbid condition of the blood, sources of irritation, such as enlarged glands, tumours, tubercles, abscesses, etc. may be developed, and diseases of brain, muscle, sinew, membrane, or even bone, frequently discovered in such like constitutions.

From the precocious nature of scrofulous children, the general characters of this morbid affection, and the frequency of association of mental diseases with those of a scrofulous character, we should be inclined to place this disease under the class of exhaustive nerve irritation, with depraved nutrition. An eminent physician, however, of great knowledge and experience in the treatment of insanity, has stated to us his belief, that more than one-half of those who are subject to mental derangement are of a scrofulous constitution, having

some manifest indication of its existence in their persons.

It is stated by Dr. Cumming, in the Cyclopædia of Medicine, vol. 3 (p. 712), that after the age of two years, until puberty, tubercles are of frequent occurrence in the encephalon (brain) and spinal cord, and are very often enclosed in cysts. It is' (says he) singularly deserving of notice that tubercles have been repeatedly found in the nervous centres, where no symptom during life had induced any suspicions of their existence.'

If we include scrofula among the list of primary nerve affections, as induced by virus or morbid tuberculous deposit, acting upon the centres of life, and disposing them to morbid and depraved action, we may, by the same rule, include also equally all others which are transmissible by hereditary descent, as cancer, syphilis, scorbutus, lepra, and melanosis, etc.

But on whatever account these diseases might be arranged, either here or elsewhere, the general observations made we maintain, evince that they depend for their introduction and development upon the condition of the nervous system.

LOCAL DISEASES.

This class of Dr. Cullen comprehends affections which are ordinarily admitted to arise from derangement of the nerves, as diseases of the senses, depraved appetites and depraved motions. It also embraces increased and suppressed discharges, which originate in the ganglionic system, and tumours which are developed by specific irritation of these nervous centres. Included also in this class are the several varieties of tumours, as aneurism, dilated veins, etc., mechanical displacements, and solutions of continuity, etc. etc. all which, being purely surgical cases, and not, strictly speaking, diseases, are exceptions (as are many surgical injuries) to the law of the nervous origin

of disease.

[After some discussion, the thanks of the Society were given to Dr. Goodman for his laborious and interesting paper, and the meeting terminated.]