Address. left his rural home, the village preacher and the academy teachers to sit at the feet of college SOME FACTS AND FANCIES ABOUT MIND AND professors, his expectation was keen and his BODY.* faith ascendant. His acute interest in the prob- lems of nature drew him to and chem- BY CHARLES A. DREW, M.D., BRIDGEWATER, MASS., physiology Medical Director State Asylum for Insane Criminals. istry, while a natural bent and sympathy for led him into the ranks of Mr. President and Fellows of the Massa- humanity medicine. " In as a chusetts Medical Society: is not the pride of his knowledge college senior Electricity there lurked a sense of not a form of more than water is a form disappointment, energy, any because he had rather of energy. Water may be a vehicle of energy slighted opportunities, because of a that behind the when at a level or in motion; so may elec- dawning suspicion high veil of were laws and realities the cannot be manufactured, as phenomena tricity. Electricity ultimate nature of which he never heat can; it can be moved from to might know. only place As he his medical ex- place, like water; and its energy must be in the began studies, smoldering was fanned to a rose form of motion or of strain. Electricity under pectation glow, hope high ' gross and the of strain constitutes charge' ; in loco- again; anatomy physiology electricity were but in anat- motion constitutes a current and magnetism; organs interesting, microscopic in vibration constitutes What omy and cell biology, especially as applied to electricity light. those cells of the nervous itself is we do not but it central system, lay electricity know, may, hidden the veritable elements of the soul. If perhaps, be a form or aspect of matter. So the riddles of life were not it was held to have for years the of Clerk- solved, taught thirty disciples be due to of the or to Maxwell. Now we may go one step further and imperfections microscope but this was more than say matter is composed of electricity and nothing faulty technique; forty else." years ago. The science of physiological psychol- The I have read from the of ogy was then young and overconfident. It quotation you pen with to its Sir Oliver as it in pointed pride the revelations of in- Lodge, appeared Harper's ductive and in the for August, 1904, must serve me as experimental methods, and, Magazine assurance of its its older introduction and text, from which I reserve the lusty youth, laughed to scorn. to wander as do some I rival, metaphysical psychology, Maud- right wide, theologians. thesis " and " would refer a sley's on Body Mind had not then you for complete elucidation of the " " of been written, but Herbert Spencer's First Electronic Theory Matter," which I shall " in to — Principles was being widely read, and Charles only touch its relation my theme, to Sir " " Oliver thesis, in the— Scien- Darwin's Origin of Species had been pub- Lodge's unabridged several influence of mas- tific American Supplements, Nos. 1428 to 1434, lished years. The this inclusive, and to " Modern Theory of Physical terpiece of a master mind was even then shaking the foundations of many cherished beliefs con- Phenomena," by Augustus Rigbi, as translated earth and heaven. by Augustus Trowbridge, and published by the cerning things of Doubt and Macmillan in 1904. apprehension were the first reactions for many Company conservative minds. Gleesome As my subject deals largely with theories, I aggressiveness " marked the attitude of others who may quote you in partial that the- thought they justification saw in the of evolution the of ory originally fashions science out of facts, and theory beginning is the the end of man's faith and hope in the soul's indispensable precondition of every im- " immortality. The brain secretes thought and portant scientific advancement." " consciousness as the liver secretes and Without further introduction or to " bile, attempt Without no disarm you, I submit my story. phosphorus thought," were pithy which served as a in Some a a epigrams rallying cry the years ago personal friend, physician rebellion of the nineteenth the of the best and one of the senior members century against type, in a of this talked to me of some older philosophy favor of strictly material Society, daydreams of of his manhood. At a certain he interpretation the phenomena of conscious early age sup- mental life. posed there must be men living wise enough to explain all the mysteries of life and mind. The It would not be quite true to say that these of mind seemed included in those of catch phrases have no potency to-day, but the phenomena fallacies have been times life, but conscious life, or self-consciousness, they embody many an a uncovered. seemed additional and super- " problem, With and added mystery. He could not then see how phosphorus you light your candle, these could be solved the laws of with phosphorus you discover Neptune and write problems by the Fifth how and molecular physics; and after many years of Symphony ; charmingly simple with mind convincing," wrote John Fiske1, with thinly study, keenly alert and open to the " evidence from chemical and physiological labo- veiled irony. And yet was anything save a ratories, the mystery to him continues supremely bit of rhetoric really gained by singling out but as a as in phosphorus among the chemical constituents of interesting, much mystery the days " of his brain tissue rather than nitrogen or carbon? early boyhood. " The have often com- As a boy, he looked for some great preacher or phosphorus philosophers to he pared thought to a secretion," writes William philosopher explain these mysteries. As ' ' ' James.2 The brain secretes as the *The Annual Discourse delivered before The Massachusetts thought " Medical Society, June 14, 1905. kidneys secrete urine or the liver secretes bile/

The Boston Medical and Surgical Journal as published by The New England Journal of Medicine. Downloaded from nejm.org by JOSH ROSENFELD on April 25, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. are phrases one sometimes hears. The lame tiny, underneath the scientific finish of members analogy need hardly be pointed out. The mate- of this Society, as to ask your attention to two rials which the brain pours into the blood (choles- modern theories which seem most worthy con- terin, creatin, zanthin, or whatever they may cerning the relation of the minds and bodies of be) are the analogues of the bile and urine, being of men. in fact real material excreta. But we know First, I would call attention to some features nothing connected with kidney and liver activity of the brain productive or " liver-bile " function which can be in the remotest degree compared theory of the ultramaterial psychologists, and, with the stream of thought which accompanies secondly, to some phases of the transmissive the brain's material secretions." brain function theory of Schiller4 and William These opinions from the writings of two of the James.5 New World's profoundest scholars were written I do not know that the liver-bile, brain-thought in the dawn of the twentieth century. theory is more commonly held by members of In a recent paper on the treatment of paresis, our profession, yet the conclusion easily follows Dr. Edward Cowies3 writes: "We are learning the observation of the coincident development that inasmuch as psychology can tell us nothing of brain and mind, the lapse of consciousness to explain the normal mechanism of mental from pressure on or injury to brain tissue, and the activities, we cannot expect to see through the greater intelligence of men and animals having microscope an explanation of diseased thoughts the deepest cerebral sulci and the most complex and feelings." arrangement of cortical gray matter. I doubt We must not conclude from this that Dr. Cowles if the case of the physiologist has been more was unmindful of the alleged way in which, ac- strongly put than in the words of Sir Frederick to the laws of cerebral neural Harrison,6 who wrote, in defending the so-called cording association, " undulations transform themselves into sensations, positive philosophy," more than thirty years sensations add themselves together to form ago: "Man is one, however compound. Fire feelings, and feelings unite themselves to form his conscience and he blushes. Cheek his cir- ideas, and ideas congregate to form abstract culation and he thinks wildly or thinks not at reasoning, etc. ; rather we understand the doctor's all. Impair his secretions and his moral sense meaning to be that physiological psychology and is dulled, discolored, or depraved; his aspirations anatomical pathology do not adequately explain. flag, his hope, love, faith reel. Impair them His hope apparently turns to the deeper under- still more and he becomes a brute. A few drinks lying plane of physiological chemistry, and he degrade his moral nature to that of a swine. qu tes Dr. Otto Folin approvingly as follows : Again, a violent emotion of pity or horror makes " Microscopically visible structural changes in him vomit. A lancet will restore him from any tissue or in the cells of any tissue must delirium to clear thought. Excess of thought be preceded by more or less pronounced meta- will waste his sinews. Excess of muscular exer- bolic changes. Metabolic changes are chemical cise will deaden thought. An emotion will double changes. Chemical changes are the physical the strength of his muscles. And, at last, the exchanges and transmutations that take place in prick of a needle or a grain of mineral will in an the physical units of matter, the molecules; and instant lay to rest forever his body and its unity, the molecules are beyond the ken of the micro- and all the spontaneous activities of intelligence, scopists." feeling and action with which that compound These quotations of a comparatively recent organism was charged." date, from men well informed in that medical With a mind tuned to recognize the significance specialty most concerned with the phenomena and interdependence of that aggregate of phe- of mind, neither affirm nor deny the material nomena we call mind and that aggregate of phe- nature of our conscious mental life. They do nomena we call body, we turn eagerly to chem- point to a growing recognition of the limitations istry, physics and physiology for the justification of science to unravel mysteries which seem to of our expectations. defy the microscope and, it may be, chemical This domain of molecular physics populated reagents. They do mark by sharp contrast the by hypothetical molecules, divided into hypothet- modest claims of the older science of to-day from ical atoms and subdivided into hypothetical the cock-sure attitude of the youthful science of electrons, might well put to shame the fairy forty years ago. dreamland of imaginative childhood. It seems if we may paraphrase a famous Chemistry tells us that matter is indestructible. saying of Bacon— that a superficial knowledge The proof is so conclusive that no scientist has — inclines men's minds to make a fetich of science, a doubt. As one form of matter is transformed while a deeper knowledge reveals the limitations into another, perchance a solid into a liquid or and points to the truth that science deals with into invisible gases by disturbing molecular the causal relation of phenomena, and that phy- relations, so it seems established that the many sical science takes account only of physical so-called forces are transmutable one into another. phenomena and their related sequences and is Force being manifested only in motion of matter utterly incompetent to pass judgment about it would be easy to conclude that no force existed things non-material or beyond the limits of man's where there was no visible motion. But molec- experience in the body. I have so presumed on ular motion, like some forms of matter, may not the instinctive interest in humanity and its des- be visible and the correlation and equivalence

The Boston Medical and Surgical Journal as published by The New England Journal of Medicine. Downloaded from nejm.org by JOSH ROSENFELD on April 25, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. " of forces or the conservation of energy," so- venture, it is a curious fact that a radical so called, represents a doctrine seemingly as impreg- closely related to the deadly prussic acid and the nable as the axiom of the indestructibility of explosive fulminates should be the essential matter. In searching for a material explanation chemical representative of life. of the phenomena of life and consciousness we If we agree with that axiom of physics that naturally inquire concerning the physical and every manifestation of force is a mode of motion, chemical properties of living matter and matter molecular or molar, and consent to that other that has never lived. Again we are told that, so dictum of science that each mode of motion per- far as the chemist and physicist have knowledge, sists until transformed into some other mode the distinction is not fundamental, for inorganic of motion, then we are ready to inquire what bodies and living organisms have very similar becomes of the neural currents passing almost chemical elements. from to center " continuously periphery through Verworn7 declares that the life process con- nerves of special sense. If you hold that these sists in the metabolism of proteids," yet carbon, currents are dancing molecules of matter, each hydrogen, nitrogen, sulphur and oxygen, ele- unit imparting its motion to the molecule next ments so conspicuous in inorganic nature, —make nearer the center, as physicists have — taught, up the complex proteid molecule. or agree that the phenomena is better explained While it seems to be therefore, the of free electrons one " established, by conception chasing that the vital phenomena of organisms should another from molecule to molecule of nerve follow the same general chemical laws as the tissue, as physicists may teach, — it is — then, phenomena of the inorganic world," we should pertinent to inquire, Is this motion transformed not miss the significance of that im- into and or is it transmitted " supremely feeling thought, portant fact that proteids are never wanting along centrifugal neural transit lines to appear in in living substances and are never found in the molar motion, as in the movement of 8 voluntary inorganic world." Hence it is that in the com- an arm, or in altered or augmented secretion or plexity of that proteid molecule seems to lie other forms of molecular motion? Or, may it hidden a key to^the mystery of life. And yet, be that part of the afferent motion is absorbed in that molecule is* not uniform, we are told by feeling and thought and part directly transmitted competent chemists. While its elements are along afferent neural lines? but five or six, its atoms vary in position and We are told that the last hypothesis was in- often number far beyond a thousand,9 and the dorsed by Herbert Spencer in the first edition of key is not readily found. According to— his " First but later in life his views " Pflüger,10 Principles," living proteid does not need to have a constant changed, and attention was called to the change molecular weight; it is a huge molecule under- in the preface of the last edition of that work; going constant, never-ending formation and con- his later conclusion being that thought and feel- stant decomposition, and probably behaves ing were outside the neural transit circuit and toward the usual chemical molecules as the sun could not be equivalent to, although concomitant behaves toward small meteors." with, the molecular motion of matter. He had Then we would further inquire as to the differ- come to believe with du Bois-Raymond 13 that, ence, if there be a chemical difference, between the "if we possessed the same knowledge of atoms living and the dead proteid molecule. Here, we that we have of the motions of the heavenly are told, there is a fundamental difference, as bodies we would understand all the phenomena evidenced by a comparison of the decomposition of the physical world, but we would not under- products of living proteid and those obtained stand how consciousness arises, nor how the by the artificial oxidation of dead proteid. While simplest psychical phenomenon comes to be." the non-nitrogenous, or hydro-carbon, decom- " It would be," as du expresses " Bois-Raymond position products of the two are essentially the it, of unbounded interest, if, with our mental same, the difference in the nitrogenous products eye turned inward, we could observe the cerebral dead of living and proteid is marked and im- mechanics of an arithmetical problem; or if we portant. could know what dance of the atoms of carbon, It seems, if we may trust Pflüger and Verworn,11 hydrogen, nitrogen, oxygen and phosphorus that in the decomposition products of living corresponds to the delight of musical sensation, proteid may be found that exceedingly poisonous what whirl of such atoms to the acme of sense gas cyanogen, which unites with hydrogen to enjoyment, and what molecular storm to the form the deadly hydrocyanic acid and with frantic from maltreatment of the nervus pain " oxygen and metallic bases to form the highly trigeminus." But however carefully we might explosive fulminates. Cyanogen, it seems, is follow the motions of individual atoms in the brain formed by the union of a single atom each of we could see only motion, collisions and again carbon and nitrogen. It acts as a radical in motion." chemical compositions, and is noted among And so it is that we are returned by material chemists for the intensity of its internal energy. paths to seemingly soundless depths where lie All chemists may not agree with Verworn and hidden the mysteries of energy and consciousness. Pflüger12 that living proteid is distinguished According to Mr. Percival Lowell,14 " the neural from dead proteid most of all by the vivifying current of molecular change passing up the presence of that fiercely energetic radical cyano- nerves and through the ganglia reaches at last gen; yet if it be established beyond perad- the cortical cells, there to find a set of molecules

The Boston Medical and Surgical Journal as published by The New England Journal of Medicine. Downloaded from nejm.org by JOSH ROSENFELD on April 25, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. less accustomed to this special change. The sciousness as the liver produces bile. As the keys current encounters resistance, and in overcoming of an organ open successively the pipes and let this resistance it causes the cells to glow. The the wind in the air chest escape in various ways; white heating of the cells we call consciousness. or as the prism transmits, bends, distorts, or Consciousness, in short, is probably nerve glow." separates into the colors of the spectrum the white This, of course, is the mechanical point of view light of nature, so the brain is conceived to trans- delightfully simple and easily grasped. But mit in part, bend, distort, and separate, accord- admitting that the cortical cells do glow, what ing to its integrity and plane of development, and where is the percipient? Do the cortical the infinite intelligence of an Eternal Omniscience. cells cognize their own glowing? The molecules As Professor Schiller puts it, " Matter is an of a wire glow literally if the wire is not sufficiently admirably calculated machinery for regulating, large for the free passage of an electric current; yet limiting and restraining the consciousness which one would hardly suppose the wire to be con- it encases. If the material encasement be heavy scious because the vibrations of its molecules are and simple, as in the lower organisms, it permits timed to produce the kind of ether waves we only a little intelligence to permeate through it. as ... If a man loses consciousness as soon as the recognize light." The terms cerebricity " and " neuricity," brain is injured, it is clearly as good an explana- which have crept into our medical literature, tion to say the injury to the brain destroyed the descriptive of the energy supposed to be stored mechanism by which the manifestation of con- in the cortical cells of the cerebrum and minor sciousness was made possible, as to say it de- nervous ganglia, were born out of wedlock most stroyed the seat of consciousness." likely, but they stand for a new idea, and the The brain-productive function and the brain- minds of men run after new ideas in science, as transmissive-function theories both agree that " in theology, even as sparks fly upward." the phenomena of mind are conditioned by the It seems as if the tendency has been towards action of some kind of energy upon cells of living reducing all the material sciences to problems in nervous matter; but whether this energy is a molecular physics and of late certain electro- minute part of that universal energy which keeps physicists are claiming the earth with all creatures the planets and stars true to their courses, or a of the land and sea,— and not these alone,— " the special kind of " vital force " belonging alone to golden sun, the planets, all the infinite hosts of living organisms, science does not yet permit us heaven," if we may use the poet's phrase, are to say. counted subjects and creatures of electricity. The production theory assumes that the rela- In passing to a consideration of the trans- tionship of conscious intelligence to the brain missive brain-function theory, it is embarrassing may be likened to music and the harp. When to remember the contempt which the so-called the is broken there can be no music for- " " harp deterministic psychologists and some who evermore. The transmission theory may also are wedded to the liver-bile, brain-thought idea, liken the brain to the harp, and those outward hold for any hypothesis which admits the pos- phenomena of mind of which voice, gesture and sibility of a non-material intelligent reality that smile are parts, to those vibrations of ether we may exist apart from a nervous organization. recognize as pleasing harmony or unpleasant In the face of such problems, however, as the discord. But the transmission theory takes essence of matter and energy and the origin of further notice of the harper, without whom there life, sensation and consciousness, pride of opinion can be no music, and the harper is likened to the seems hardly worth while. mind or conscious intelligence, whose instrument Some of us have failed to understand how a is the whole human organism, more especially nerve cell or a nerve fiber can think, hope, fear, the brain. love or aspire, in spite of all we have been taught We do not suppose such reflections come within of the brain's wonderful mechanism, and it is the domain of science; certainly not within the quite as difficult to understand how many nerve scope of any but of the concrete sciences. If cells and nerve fibers acting in unison and helping every proposition be entirely true, science could one another can produce a sensation, even, unless not demonstrate the truth, because the condi- we assume some sort of a percipient that can tions are outside the sphere of man's physical interpret the molecular vibrations and atomic experience, and " science is but the codification motions which seem to constitute the physical of experience and is helpless without the data part of feeling and thought. which experience furnishes." " It is somewhat comforting to learn that men of Must we then apologize for asking your atten- such scientific attainments as Virchow, Helm- tion at this hour to groups of ideas not strictly holtz, du Bois-Raymond, William James and relevant to the of any concrete in problems physical John Fiske, the full maturity of their magnifi- science? Man seems to be the only animal cent intellects, have, likewise, been unable to capable of abstract reasoning, and it may be that understand, from such an hypothesis, how feeling the " Absolute Mind " intended man should use and thought come to be. It does seem to be true, his talent for the of an in- 15 16 peculiar gratification as Schiller and James have pointed out, that stinctive interest in his own destiny in time, and we have quite as good reason for thinking of the after time, for him, has ceased to be. function of the brain as a transmissive function We have avoided such to purposely introducing as think of it as producing thought and con- evidence of the existence of a non-material in-

The Boston Medical and Surgical Journal as published by The New England Journal of Medicine. Downloaded from nejm.org by JOSH ROSENFELD on April 25, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. telligence as the reports of the societies for psy- to the brain is the theory most consistent with chical research offer in abundance, and have all the facts and most worthy the credence of refrained from quoting from such writings as scientific men. Hudson's " Laws of Psychic Phenomena " and But whatever conclusions we reach, the imper- " The Scientific Demonstration of a Future Life," fections of science limit us to a conclusion based although we have no reason to suppose the on moral probability. We assume that mem- investigations of the " psychical researchers " bers of this Society are not yet ready to accept were not carried through in a scientific spirit. the credentials of a moral and mental science. We would consent to Hudson's proposition that " Nevertheless," in the language of Sir Oliver " a mental state is as much a fact as a mountain," Lodge,18 " many of us are impressed with the but the field is too broad and the details too conviction that everything in the universe may lengthy to be of service now. If any fellow would become intelligible if we go the right way to work." examine this line of evidence, we would refer him And so it is that every new discovery or theory to Frederick Myer's " Human Personality," in molecular physics, or in any science that may published by Longmans, Green & Co. of New be reduced to electro-physics, may appeal, not York. alone to our professional interests, but to the Some members of this Society were studying very instincts that are the heritage of our com- psychology in a practical way before the reader mon humanity. had learned even the names of the cranial nerves. For many years men of science have accepted At the bedside of suffering mothers you have the hypothesis of an immaterial cosmic ether helped into the world tiny beings with no self- pervading all interstellar as well as all inter- consciousness and for whom world-consciousness molecular space. Science has insisted on the was yet but dawning. The manifestations of right to this assumption, in order to frame a love and aversion, hope and fear, joy and sorrow, partial explanation of such a common phenome- anticipations, aspirations and alternating states non as light. of consciousness and unconsciousness are very For many years the unscientific world has familiar phenomena to you. If you have not accepted the hypothesis of an immaterial entity measured, in time, different cerebral reactions called spirit or soul. Ordinary sense has insisted nor constructed theorems, or classified, as have on the right to this assumption in order to explain the professional psychologists, yet, more directly, certain phenomena common to conscious mental you may have reached conclusions as substantial life. as theirs. Some men have doubted the existence of an Attraction plus repulsion of material molecules imponderable entity like cosmic ether which may solve the riddle of life to your satisfaction. cannot be seen, heard, felt, tasted, or detected You may believe that thought and feeling are as by the reagents of the chemist, yet these doubters much modes of motion as are heat, light or elec- have offered no explanation of common physical tricity. You may hold that " to know and to phenomena, independent of this hypothesis, that feel and to will " are but varying kinds or degrees would be accepted by science or common sense. of excitement of a nervous organism nothing Forty years ago it was an easy thing for newly more and nothing less. If you are forced— from fledged scientists to explain the phenomena of this position by the demonstrations of science conscious intelligence to their own satisfaction, that every unit of afferent energy and every bit without the hypothesis of soul or spirit. To-day of centripetal motion can be accounted for by it is safe to say a majority of those well versed in an equivalent quantity of other forms of efferent science will agree with Sir Oliver Lodge that motion, molecular or sensible, without including " Testimony is borne to inner personal experience conscious intelligence in the circuit at all then on which physical science does well to be silent." you may fall back with Ernst Hœckel to —the ob- But physical science has made wonderful strides scure if less vulnerable position, that the germs in the past decade, and we must admit that molec- of mind are and have been inherent attributes ular and electro-physics have carried off most of matter from before the time when this earth of the honors. Roentgen's epoch-making dis- a gaseous cloud of nebulous matter was a new-— covery in 1895 put the student mind on the qui born child of the sun. — vive, and since the discoveries of Becquerel in On the other hand, giving due weight to the 1896 and the Curies in 1898, radio-activity has unvarying concomitance, within the limits of our easily held the center of the scientific field. experience, of the phenomena of mind with neural The mental processes and verifying experi- undulations and molecular activity of the body, ments by which the cathode rays and the result- you may yet hold that the relation, so far as ing " x-ray " phenomena and the emanations science can reveal, is but a concomitance or induc- of radio-active bodies have been traced back to tion of material motion by an unknown energy. elementary electric units, of opposite signs, are If we allow our minds a wide range and notice complex enough and may not be of practical with F. C. Schiller, William James and John importance to physicians. But to follow these Fiske, all the testimony the concrete sciences experiments gives us a peep at some of Nature's have to offer, which our intelligence will accept guarded secrets and may be worth while. Some as pertinent, then I venture the opinion that of us have thought of Nature in a general way many of us will be forced to conclude that the as a composite of matter and spirit. We may transmission of the relation of psychic phenomena have loosely thought of electricity as a substitute

The Boston Medical and Surgical Journal as published by The New England Journal of Medicine. Downloaded from nejm.org by JOSH ROSENFELD on April 25, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. for the spirit element of the composite. At mony it bears to new truths concerning Nature least we have often heard it claimed that vital of which we had not dreamed. processes are electric processes and neural cur- If it be true that radium, uranium and thorium rents are electric currents. If we accept the are as surely elements as are bromine, lead and electronic theory, we must now think of ponder- gold, and if it be further true, as seems proven, able matter as a form of electricity, while the that these elements are being spontaneously essential nature of vitality and mind is as obscure transmuted into helium and other elements not as ever. The more we think of it the more this yet identified,19 then the whole theory of the idea seems to harmonize with our observation of indivisible atom and the unchangeable element, electric phenomena. upon which so many scientific edifices have been Whenever man has attempted to apply elec- builded, must, perforce, be discarded as mis- tricity to the wheels of industry his success has leading and outgrown. been signal; whenever he has attempted to apply If it be proved beyond question that matter to the destruction of abnormal and may be reduced to electric monads, corpuscles, electricity " " " " parasitic life, his success has, at least, been partial; or electrons, each having a mass or weight but whenever he has attempted to reinforce by one eight-hundredth and a bulk one hundred- electric energy, so-called, that energy we think thousandth that of an atom of hydrogen, and if of as vital, we can almost as truly say that his we must think of the hydrogen atom as an aggre- failure has been signal. gation of perhaps eight hundred electrons and the We do not forget that a flagging heart may be nitrogen atom with fourteen times as many, and stung into temporary activity by a Faradic the iron atom with fifty-six times as many, and shock, a sensitive nerve vibrating pain may be each element with such a multiple of eight hundred soothed by galvanism and metabolism, may be electrons as corresponds with its atomic weight,20 influenced indirectly by static and high-fre- then, indeed, does the essential nature of electri- quency currents. But admitting this, other city become a question of fascinating interest. agents may serve as well to whip up a flagging If we accept the theory that radio-activity is heart, and the forceful impaction of hot and cold due to the explosion of atoms through the fierce water may, indirectly, influence metabolism and energy of electrons within and think of these nerve currents as Indeed, electric monads as negatively modify quite surely. " mostly charged, it seems as if the wonderful fruits of recent scien- flying about, each of them repelling every other, tific investigation had not added greatly to the but all attracted and kept in their orbits by the physician's armamentarium. The more light mass of positive electricity in which they are we get the more it seems to be true that nature embedded," imprisoned within the limits of a was kind enough to furnish man her richest heal- material atom, then we may better understand agents water, fresh air and sunshine how the degree of radio-activity and atomic ing — before he had— learned the alphabet of science. weight of a substance will be relatively small or May we requote: " Electricity is not a form of large according to the number of electrons of energy any more than water is a form of energy. which its individual atoms are composed. Water may be a vehicle of energy when at a high If it prove true that radio-activity of elements level or in motion; so may electricity." and their compounds vary with the atomic Again it seems as if Nature had hidden from weight and atomic weight is determined by — man and denied to his control life-destroying the number of electrons per atom then we agents, among which electricity in motion may might, a priori, except animal organisms— to be be counted, until he has reached, at least, the radio-active in a degree corresponding to those second grade in the school of science. radio-active elements which enter into its com- The phenomena of the x-ray are now fairly position. Experiments seem to show that cer- familiar to most of us. So familiar indeed tain animals are radio-active, but here the inten- that hardly a thrill of awe is felt as we sity of the radio-activity seems to vary with the look through flesh and blood to confirm or dis- vital activity of the animal, for we are informed prove a diagnosis about organs deeply covered by Lommasina21 that the intensity of the radia- and beyond the reach of any hitherto known tion, or emission, is greater in grown birds than light. in young ones and greater in moving individuals the aid of that mechanism, than in those at rest. By cleverly designed " the spinthariscope, we have watched the emana- And so it is that " bioradio-activity calls for tions of a minute particle of a radium compound, our attention. The call is low and uncertain, as less than a hundredth of a grain, perhaps, and yet, but it is a call to which our professional ears yet its seemingly exhaustless energy, its diamond- are better attuned. When nerve fiber and brain like brilliancy and the measure of its rhythmical cells are found to register on calcium phosphide scintillations made it seem as if we were looking at screens or specially prepared photographic a microscopic reproduction of the great dog-star plates22 activities to which the human ear is Sirius, most conspicuous among " fixed stars " deaf and to which the eye has hitherto been that glorify— a winter's night. Our interest in blind then we may feel to say to the enthu- the phenomena of this microscopic portion of siastic—physicist, " this throws new light on phy- nature is not alone because of its visual similitude siology and is really worth while." to the grandest phenomena of the inorganic uni- If members of this Society were to select a verse, but more to the significance of the testi- single name representative of American intellect

The Boston Medical and Surgical Journal as published by The New England Journal of Medicine. Downloaded from nejm.org by JOSH ROSENFELD on April 25, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. and scholarship from among the dead who live Chancellor of the University of Edinburgh had in our memory, to be written on the roll of fame in different words and at different times been with the best names of the old world, I fancy given to the world by the clear-headed teacher Oliver Wendell Holmes and John Fiske would at Cambridge, Mass. each have some of your votes. Not a few of you Lord Balfour's magnificent address to the knew the bright and genial " Autocrat " person- British Association for the Advancement of ally. Some of us who never looked upon his Science at once fires our imagination and deepens face loved him hardly less and almost envy you our reverence. It cannot be otherwise. We who were privileged to know him well. While catch the ring of scientific truth. We know the the ripple of his graceful poetry and prose may Premier's standing in the scientific world. We hide the steady current of his scientific thinking, know by reputation the men whose experimental you know how few there were better conversant researches furnish his evidence. In the light than he with the worth and the limitations of sci- of his marshalled facts we see, with the mind's ence. You know, too, how suggestive are some eye, an all-pervading, space-filling ether which is of his pages of a prescience of realities outside the not atmosphere or a gas, nor does it possess any boundaries of science proper as if his soul had of the properties of ordinary matter. Seemingly caught wireless messages concerning— realities as intangible as the " mind stuff " of the older beyond the range of our imperfect organs of sense. metaphysicians, we see this hypothetical matrix If the poetic temperament of Dr. Holmes would give birth to and support countless millions of rank him among those kindred spirits whom Dr. electric monads which group into atoms of with apt has called " the matter. we see, these number- Osier,23 metaphor, Again" mentally, Teresians," those who see visions and dream less atoms concentrated into nebulae, into suns, dreams and walk not alone by sight John and all the hosts of heaven." We see " how at Fiske truly must be classed with a different— least in one small planet they combined to form temperamental group. Not to the Laodiceans, organic compounds; how organic compounds surely, for we cannot conceive of the Cambridge became living things; how living things, philosopher as satisfied to " get and to beget," developing along many different lines, gave merely, nor could we think of his being lukewarm birth at last to one superior race; how from this about any questions pertinent to " The Destiny race arose, after many ages, a learned handful, of Man." His was pre-eminently the judicial who looked round on the world which thus type of mind. For many years in close touch brought them into being, and judged it and knew with the best intellects of your own University it for what it was." at Cambridge, and not these alone, a graduate This is a partial epitome of the story of evolu- of the department of law; well balanced by nature, tion so far as science has cut the leaves. Under thoroughly trained in the laws of evidence, he the spell of Lord Balfour's eloquence it almost applied himself diligently to collecting and cor- seems as if the whole story was told. Out of relating evidence, not alone of historical and something nonmaterial, in the ordinary sense, political facts, but of facts from each of the physi- science now postulates the creation of all material cal sciences which, woven together, vastly enlarge things. Emphasis is deservingly laid on the fact our conception of that universe of which we are that our organs of sense, so well adapted to the part. lower planes of evolution, may limit as well as If, then, we may further use the figure of Dr. disclose realities which are and may forever be. Osier, John Fiske was a " Gallionion " by tem- Arthur Balfour does not claim even to outline perament and a scientist and historian by training. the whole story. Indeed, he outlines what science He without reserve the essentials of the does teach to make clearer, what true science accepted " scheme of evolution as outlined by Darwin and doer not claim to explain. One thing, at least, elaborated by Spencer and others. His interest will remain, of which this long-drawn sequence was intensely alert to the findings of science in of cause and effect gives no satisfying explana- the search for physical realities. He would have tion," continues Lord Balfour, " and that is agreed with Lord Balfour24 that " sense percep- knowledge itself." Even as science must postu- tions supply the premises from which we draw late an all-pervading entity called cosmic-ether all our knowledge of the physical world. What to explain the most familiar phenomena of Na- we see depends not merely upon what is to be ture; so must philosophy postulate a cognizing seen, but on our eyes. What we hear depends percipient called mind, without which all this not merely on what there is to hear, but on our molecular and intermolecular motion, which ears. Now eyes and ears have, as we know, been is the physical representation of life, could not evolved in us and our brute progenitors by the be understood nor yet perceived. In the light slow operation of natural selection. And what of all the known facts does it seem incredible to is true of sense perception is, of course, also true you that Mind should be the objective towards of the intellectual powers which enable us to which all the processes of evolution in Nature erect upon the frail and narrow platform which have been working through past eons? Does it sense-perception provides the proud fabric of seem a thing incredible that these organs of sense, the sciences." even now less acute than those of animals on a We dare to say that John Fiske would have lower evolutionary plane, should, in the further indorsed the teaching of Lord Balfour because evolution of mentality, become less and less many of the truths forced home by the eloquent necessary to human personality?

The Boston Medical and Surgical Journal as published by The New England Journal of Medicine. Downloaded from nejm.org by JOSH ROSENFELD on April 25, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. I do not forget that my hearers are busy men, cases. I think that we all ought to appreciate the chiefly concerned in the science and art of medi- good will of the surgeons of the Boston City Hos- cine. These facts and fancies are somewhat pital and the Massachusetts General Hospital in foreign to our every-day work. And yet we allowing us during the last two years to make use know that underneath the professional current of their cases for discussion at these meetings. I of many a busy physician's life are quiet depths fully realize, and I know that you, gentlemen of where the testimony of Nature in all her phases the society, also do, the great obligation we are are ever welcome. This has been my hope, and, under for the use of this material used in the way if needful, this must be my apology. It has been in which we have used it at these meetings. We my effort not to bring you a new or strange mes- have dragged up and brought to light the results sage, rather to gather from scientific fields and of some very unsatisfactory classes of cases, and speculative by-ways such flowers of fact and it is obvious that the statistics which have been fancy as seem most true and beautiful and most shown at these meetings are somewhat less satis- suggestive, when woven together, of the sub- factory than those which are reported by indi- limity of Nature and the glory of that Eternal vidual operators in other places. energy, which, in the language of John Fiske, However, during the last two years we have had " manifests itself to our consciousness, in har- ten good meetings on the present policy of present- monious activity throughout the length and ing actual homemade results and of discussing the breadth and depth of the universe, which guides directions which improvements may take. An- the stars for countless ages in paths that never other thing which has developed from this search err, and which animates the molecules of the for results has been the construction of a system dewdrop that gleams for a brief hour on the of tracing patients after their discharge from the shaven lawn, whose workings are so resistless hospital. Each of the younger men who has that we have naught to do but reverently been kind enough to undertake to trace the re- obey them, yet so infallible that we place our sults of these cases has contributed a little to trust in them yesterday, to-day and forever." the convenience of this system. As perhaps they service I REFERENCES. may be of future to others, will mention " the which at we find useful. I Life Everlasting," p. 65. points present 2Wm. James: Psychology, p. 102. To write to the friends of the at 3 American Journal of Insanity, April, 1904, (1) patients 4 " of the the address on the entrance books of the " The Riddles Sphinx." given 6 Human Immortality." » " A Modern Symposium," p. 24. hospitals. 7 General Physiology, p. 136. To write to the ' Ibid. (2) physician recommending "Ibid.,p. 104. the patients for admission. 10 Ibid., p. 307. If we that the are II Ibid., pp. 304 and 305. (3) suspect patients dead, 12 Ibid. their names may be found in the State 13 : possibly "Verworn General Physiology. 14 Occult Japan," Boston, 1895. Archives, Room 432 at the State House. The 15 F. C. S. Schiller: " Riddles of the Sphinx." cause of death is 16Wm. James:" Human Immortality." frequently given. 17 John Fiske: "A Crumb for the Modern Symposium." (4) The authorities in Room 36 at the State 18 Contemporary Review, December, 1904. 19 " Modern Alchemy," Prof. R. K. Duncan, in Outlook, Feb. 2, House have been most kind in giving information 1905, " the who to some 20 Modern of Rigbi, about patients have later gone Theory Physical" Phenomena," by Augusto translated by and The Electronic Theory of Matter," of the institutions. Trowbridge, " Scientific American Supplement, Nos. 1428 to 1434, and Modern public Alchemy," Prof. R. K. Duncan, Outlook, Feb. 25, 1905. (5) The town clerk at the place where the 21 Comment on Dr. Th. Lommasina's recent communication to lived is often able to forward a to French Academy of Science, Scientific American Supplement, Feb. patient letter 4, 1905. some relative. 22 Scientific American Supplement, July 30, 1904, and June 3, 1905. 23 Dr. Wm. Osier: " Science and Immortality," Ingersoll Lecture. (6) The police are always obliging in assisting 24 Address to the British Association for the Advancement of to discover the residence of the Science, by the Right Honorable A. J. Balfour, Chancellor of the present patients. University of Edinburgh, Scientific American Supplement, No. Directories of of the smaller towns 1497. (7) many and all of the larger cities are kept on file at the Dennison Manufacturing Company, 26 Franklin Street, or at the State House. Original Articles. (8) People of the same name found in the directory in the town in which the patient resided REPORT OF RESULTS IN NONTRAUMATIC may be written to to find out whether they have SURGERY OF THE BRAIN AND SPINAL any knowledge of the case. CORD.* (9) In case the patient has moved his lodgings, the people in the neighborhood often know what OBSERVATIONS UPON THE ACTUAL RESULTS OF his new address is, even if it has not been left CEREBRAL SURGERY AT THE MASSACHUSETTS with the postman. GENERAL HOSPITAL. (10) Occasionally the house officer who had BY B. A. CODMAN, M.D. charge of the case and whose name is found on I want to take this to thank the the first page of the Record Book, will be able to opportunity the the the surgeons of the Massachusetts General Hospital tell of result after patient left for their kindness in allowing me to report these hospital. These methods have all been used in the *The following papers were read at a meeting of the Section for tracing Surgery of the Suffolk District Branch of The Massachusetts Medi- present results, and we have been able to find the cal Society in conjunction with the Boston Medical Library, April 5, 1905. results in all of the cases operated on for epilepsy

The Boston Medical and Surgical Journal as published by The New England Journal of Medicine. Downloaded from nejm.org by JOSH ROSENFELD on April 25, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society.