Studies in the Osteopathic Sciences
The Physiology of Consciousness: Volume 3
Louisa Burns, M.S., D.O., D.Sc.O.
1911
 
 
CHAPTER XII.
 
 
RELATIONS OF SOMATIC AND CEREBRAL PROCESSES.
 
 
    The phenomena ordinarily considered as indicative of the control of the body by the mental states are interpreted in physiology as being the effects produced upon the bodily activities by the activities of the cortical and ganglionar neurons.

    The activities of these neurons cause certain variations in consciousness, but this effect in consciousness is probably the effect of the cortical activity rather than its cause. It is, of course, not possible to prove that this is true, but such a supposition explains more simply the facts of mind-brain physiology than any hypothesis yet offered.

    The experiments described in this chapter are given as being suggestive rather than conclusive. More exact methods of investigation and tests made upon a greater number of subjects must be employed in the determination of the actual relationship between the cortical and the somatic activities.

    In order to determine, if possible, whether variations in the time occupied by mental processes might result from somatic variations, a series of tests was made. The method used for the determination of the reaction time was a modification of certain methods used by Hugo Munsterburg.
 
 

Experiments

    Many experiments were made in the endeavor to find some method of determining the exact reaction time for each reply. The difficulties were greater than the exigencies of the case warranted. The variation in the time necessary for the reply to any single word was not the intent in this connection. We were seeking the physiological relationships, and not the particular psychical significance of different words.

    After experiments into the methods best adapted to the case, it was decided to use lists of one hundred words as a standard, to determine the time required for the pronunciation of these words by some person whose duty it should be to read the lists, ascertain the time required for the subject of the test to pronounce one hundred words, and the sum of these times is considered the pronunciation time for the two people. The pronunciation time does not vary greatly for any one person at different times, but it does vary for different people.

    In making the test, the subject assumed a comfortable position, and another person was supplied with lists of one hundred words of a quality decided upon for the special tests. Each word was pronounced, then the subject gave in reply some other words which was suggested by the word heard. The next word was then pronounced, another reply given, and so on until one hundred words and usually one hundred replies were given. Occasionally the word was met by a confused “I do not know any word.” The time required for the pronouncing of the words and the giving of replies, less the time required for the pronunciation of the one hundred words by both persons (two hundred words in all), is supposed to represent one hundred simple association processes in the brain of the person making the replies. It is, of course, not possible to determine that this is actually true. It is probably, however, a fairly true measure of the relative speed of the association processes.
 
 

The Bony Lesion

    In the first series of tests the place of the bony lesion in the variation of the speed of the association processes was studied. The normal reaction time was taken first, and usually the blood pressure and heart rate also were determined. The subject then received steady pressure at the side of the second thoracic spine for five minutes The reaction time was again taken during the five minutes, at the end of five minutes, and again five minutes after the pressure was discontinued. The lists of words used in this series of tests are those given as simple words on another page.

    Twelve people, normal and not weary, were employed in these tests. None of them knew what reaction was expected, but all knew that the investigations were in regard to the bony lesions and the speed of mental processes. The tests were repeated several times, on different days, for each subject. It was found in all cases that when the blood pressure was increased by the lesion, the reaction time was decreased. The increase of blood pressure, in the case of the second thoracic, seemed to be associated with increased pulse rate. The pulse was increased by as much as eight beats per minute; the blood pressure increased as much as twenty m.m. of mercury. In most cases the increase in pulse rate and blood pressure was none at all or very little. The reaction time decreased with increasing blood pressure. The reaction time decreased as much as .2 sec. on each word.

    When the pressure, imitating the bony lesions, remained longer present, or when the pressure was followed at once by lowered blood pressure, the reaction time increased. The decrease of blood pressure was as much as twenty-five m.m. of mercury; the increase in the reaction time was as much as .08 sec. per word.

    That is, the increased blood pressure was associated with increased speed of association, and decreased blood pressure was associated with decreased speed of association processes.

    The next series of tests studied the lesion of the eighth thoracic vertebrae. The conditions were as before. Nine subjects were used, and the tests were repeated upon them several times on different days.

    The results verified those given in the first series. When the pressure was so applied as to lower the blood pressure, the reaction time was increased; when the pressure was painful, or when the placing of the fingers caused stimulating movements, then the blood pressure went up and the reaction time was decreased.
 
 

Blood Pressure

    A number of tests were made under varying conditions to determine whether the blood pressure changes was the constant factor. The blood pressure was raised by stimulating movements applied to the splanchic centers, by exercise, by muscular tension, by drinking freely of water, by eating moderately of food, and in all cases in which no source of error was found, the increase of blood pressure was associated with decreased reaction time.

    Conversely, the blood pressure was lowered by pressure in the region of the splanchnic centers, by lying quietly upon a table, by relaxing the muscles voluntarily, and in other ways. Whatever lowered the blood pressure, in the normal person, increased the reaction time—that is, decreased the speed of the association processes.

    One report of a patient who was subject for the test may be given. The lesion was a left anterior malposition of the atlas. The patient complained of a dull, stupid headache. Pulse, 60; respiration, 20; blood pressure, 114 m.m.; reaction time, 3.6 sec.

    Dynamometer: right hand, 125, 105, 130; left hand, 119, 111, 118.

    The atlas was corrected by the use of very gentle movements. No pain was felt, no “pop” was elicited. Relief from headache was experienced immediately.
Within a few minutes after the lesion had been corrected the tests were repeated.

    Pulse, 62; respiration, 24; blood pressure, 100 m.m. (ten minues later, 120 m.m.); reaction time, 2.8l sec.

    Dynamometer: right hand, 128, 118, 135; left hand, 128, 118, 112.

    In a number of other clinic cases the reaction time alone was tested Correction of the lesion was often followed by a temporary lowering of blood pressure and increased reaction time, but this was followed, usually within ten or fifteen minutes, by increased blood pressure and decreased reaction time.
 
 

Causes of Variations
 

    Other somatic causes of variation in the reaction time were noted:

    Fatigue increases the reaction time.

    Autointoxication increases the reaction time.

    Fasting decreases the reaction time at first, then increases it as weakness supervenes.

    After mental effort, as after an examination, the reaction time is increased; sometimes it was twice the normal reaction time.

    Six people were chosen for a series of tests upon the effects of the bony lesion upon the time required for more complex coordinations. The same subjects were used for the different tests, which were given on different days.

    The tests were as follows:

    1. Columns of figures were prepared, and the subject was asked to add them as rapidly as possible, putting down the sum obtained at the expiration of one minute.

    2. Lists of words were prepared; each subject was told to give as many synonyms as possible during each minute.

    3. Questions necessitating considerable thought were given; the character of the
replies was noted.

    For the most part, the results of these tests were identical with the results given for the simpler coordinations. Bony lesions which lower the blood pressure increase the time necessary for the cortical coordinations; bony lesions which raise the blood pressure, in the normal persons who were subjects for the tests, decreased the time required for the coordinations. But the number of errors was larger in the results of the tests made under the increased blood pressure.
So far as the third test was concerned, there was considerable individual variation. While it seemed fairly evident that the lowering of the blood pressure increased the time and decreased the character of the coordinations, the effects of the increased blood pressure were very contradictory. Further study is needed.
 
 

Affectional Variations
 
    The character of the replies given to the lists of simple words varied according to physiological conditions. When the blood pressure was lowered experimentally the replies included a larger number of words of unhappy significance than under normal conditions. For example, “day” was more apt to suggest “cloudy” or “dull” when the blood pressure was low, or when the subject suffered from auto-intoxication, or any other subnormal condition, than at other times. The word “day” suggested “sunny,” or “bright,” or “happy” more often when the blood pressure was normally high, and when the physiological condition of the subject was good.
In a few clinic patients who suffered from arteriosclerosis there was melancholia present. The blood pressure, already abnormally high, was sometimes increased as the result of too strenuous movements employed in the correction of lesions. When this occurred, the melancholia was increased. It seems evident that the normally high pressure is associated with such a condition of the cortical neurons that happy and pleasant replies are most readily brought into consciousness. Under abnormal conditions, as in the excessively high or the excessively low blood pressure, the cortical activities were so modified that the unhealthy and morbid reactions were more apt to occur.
 
 
Neurasthenics

    Several neurasthenics were treated during these tests. The blood pressure was uniformly low in the patients treated at that time, though neurasthenic blood pressure is not always low. It was very interesting to note the lessening of hypochondria in the conversation before and after the administration of the necessary corrective movements in such a way as to raise the blood pressure. The hypochondria was apt to recur, of course, as soon as the blood pressure decreased again.
    But while it stayed up the patient had at least some respite from the “blues.”

    For convenience sake the words are prepared in lists of fifty, and two such lists give one hundred words. Simple lists are as follows:

  • dark
  • white
  • man
  • rough
  • broad
  • keen
  • warm
  • mug
  • fresh
  • fast
  • stiff
  • stern
  • late
  • strong
  • weak
  • false
  • just
  • horse
  • sweet
  • flow
  • vast
  • cat
  • sing
  • wool
  • skill
  • test
  • moon
  • ship
  • east
  • live
  • pun
  • bloom
  • coin
  • out
  • lake
  • feet
  • dust
  • lark
  • vein
  • side
  • bank
  • head
  • face
  • red
  • king
  • pint
  • green
  • send
  • room
  • break
 
 
Diagnosis
 
    In experimenting upon clinic patients, it has been found that those ideas associated with certain abnormal conditions are most apt to recur in replies. Lists of words significant of the disorder from which the patient fancies himself suffering have the shorter reaction time. This peculiarity is most noticeable in neurasthenic or psychasthenic patients. In ordinary conversation it may be noticed that the replies and answers are much more rapid when the subjects related to the patient’s ideas of his illness are being discussed than when other subjects are under consideration. This condition is due, doubtless, in part to the fact that these patient s have used those neuron groups concerned in the coordination and recognition of abnormal conditions so frequently that they have the lower liminal value, and are thus easily stimulated by all sorts of sensory impulses, and in part to the other fact that this very condition of self-centered egoism is one factor in producing the ills from which they suffer. However, the condition is produced, the apparent reaction time may be employed in the diagnosis of certain abnormal factors in the functional neuroses.
 
 
Effects of Ideas Upon Somatic Conditions

    Another series of tests was made in the effort to determine whether any effect could be produced upon the bodily activities by ideas entering the sensorium. The first series included tests made upon about a hundred people, and with repeated tests upon a few individuals.
 
 

Effects of Gloomy Ideas

    The blood pressure, pulse, respiratory movements, reaction time and dynamometer tests were taken, then words from one of the “gloomy” lists were pronounced, and the subject asked to give a synonym or related word in answer. Fifty words are usually about as much as the average person wishes to endure in such a test The results of these experiments may be grouped as follows:

    Blood pressure decreased, sometimes by thirty or forty m.m., but usually ten or fifteen m.m. of mercury.

    Pulse decreased, with occasional irregularities.

    Respiratory movements become irregular, sometimes with frequent sighings.

    Reaction time increased, sometimes almost doubled, for gloomy words; the usual increase is about .5 sec. per word.

    Dynamometer tests show decrease of strength of both hands, but especially the right, during and after the pronunciation and replies of the “gloomy” list.

    The gloomy lists are about as follows:

  • dark
  • sorrow
  • dull
  • ill
  • weak
  • weight
  • dark
  • mean
  • blue
  • sad
  • alone
  • faded
  • timid
  • forlorn
  • labor
  • silent
  • stupid
  • fatal
  • shroud
  • grave
  • weeping
  • aches
  • weary
  • poor
  • old
  • lazy
  • worry
  • falter
  • dying
  • sickness
  • peevish
  • torn
  • worry
  • hopeless
  • heavy
  • broken
  • sorry
  • grief
  • tears
  • pity
  • hard
  • moody
  • failure
  • restless
  • sleepy
  • silly
  • false
  • frozen
  • tomb
  • decay
    A few people who were subject to slight hypochondria were employed as subjects. The gloomy list had not the least effect upon their physiological activities. Apparently the gloomy trend of thought is usual with them.
 
 
Effects of Cheerful Ideas

    Lists of cheerful words were provided. The effect of the pronunciation and replying of the cheerful lists is not marked in normal people. Usually no differences are manifest in the use of the ideas which are, probably, the normal thoughts of sane and wholesome cortical activities. People who are fatigued, or sick, or suffering from the effects of bony lesions may be affected by the use of the cheerful lists sometimes. It is evident that no permanent good could be accomplished by the use of cheerful ideas as a method of therapy if the lesions, or the autointoxication, or any other physical factor is permitted to remain uncorrected The cheerful lists are about as follows:

  • lovely
  • cheery
  • gladly
  • happy
  • smiling
  • freely
  • gaily
  • roses
  • lively
  • gleeful
  • jolly
  • helpful
  • cordial
  • pretty
  • music
  • funny
  • hoping
  • bliss
  • vigorous
  • favor
  • nimble
  • easy
  • sunny
  • golden
  • mercy
  • rosy
  • merry
  • glisten
  • jovial
  • jest
  • playful
  • shining
  • banter
  • benign
  • glorious
  • singing
  • swiftly
  • melody
  • lucky
  • wealthy
  • kindly
  • caress
  • fair
  • picnic
  • feasting
  • frolic
  • blithe
  • splendid
  • dancing
  • joyful
    After the gloomy words have been used, the person returns to the normal condition rather more quickly if the cheerful list is given than if he is simply left to recover. But the normal person is not long affected by even the most gloomy of lists.

    Another series of words are those associated with inefficiency. Lazy, worthless, stupid, careless, etc., make up such a list. The reaction time is greater than normal when such words are used, but the effect on the circulation does not seem so pronounced as in the case of the gloomy lists.
 
 

Effects of Scientific Terms

    Lists made up of scientific terms do not seem to affect the bodily activities so much as do other lists, but they have a long reaction time. Such words are, molecule, calyx, neuron, embolus, plexus, afferent, veratrine, solstice, parallax, etc., make up these lists. Sometimes the blood pressure is raised. Since such terms have no particular emotional coloring, it is not strange that no particular physiological reaction should follow their use.
 
 

Effects of Forceful Ideas

    Another list of words which raises the blood pressure and usually affects the pulse is made of words indicative of strength and effort. Such words are, supreme, domineering, forcible, energy, determine, achievement, momentum, etc. The use of such words in the most desultory manner seems to cause the slight muscular contractions indicative of physical activity. Dynamometer tests usually show increased muscular strength after such lists have been given.
 
 

Effects of Mental Effort

    Urgent mental effort, as in the endeavor to add long columns rapidly, or to solve difficult problems mentally, seems to affect bodily activities differently in different people. Of a hundred and seventeen people subjected to the test, a few displayed no blood pressure variations which were perceptible. About sixty-five had the blood pressure increased during urgent mental endeavor. It is found that the greater is the increase of the blood pressure during mental effort, the greater is the muscular contraction associated with the effort. About thirty people showed a lower blood pressure during mental effort. It is not usually easy to find indications of muscular effort in the endeavor to concentrate the attention in those whose blood pressure decreases during mental effort.
 
 

Effects of Passive Ideas

    A number of tests were made by pronouncing the words to the subject who was asked to listen to the words, but not to make any reply. The variations in these cases were about the same as prescribed for the other tests, in which the words were pronounced and replies of associated words given. Short stories involving emotional colorings were used also. The association processes of different individuals interfered somewhat with these experiments. For example, a story of horror was used in one experiment which was based upon the attack of a ferocious lion. The subject of the test began laughing, and explained the matter by telling of a ridiculous occurrence which he himself had experienced.
 
 

Effects of Repressed Ideas

    The associatin of cerain words with experiences of an emotional coloring leads to changes in the blood pressure and pulse rate of the subject when such words are pronounced. In a number of cases certain individuals used as subjects decided upon something which should be kept secret. While the pulse and blood pressure were being watched, another person pronounced words to the subject. The variations in pulse, blood pressure, and sometimes the size of the pupils, indicated which of the words pronounced were related to the ideas chosen for concealment. When the experiments were carefully performed, it was usually possible to determine what the nature of the chosen secret was, and sometimes to determine in considerable detail rather complex stories. Individual peculiarities and experiences modify the results to a certain extent. In one case, for example, the subject really was holding secret certain plans for an entertainment; these plans appeared in the indications determined by the study of the various somatic changes associated with the effects of the pronounced words. It would be rather dangerous for the person with a “skeleton in the closet” to act as subject in such experiments.
 
 

Diagnosis

    These reactions have a certain value in diagnosis. If any person is trying to conceal anything from the physician, the pulse shows the effects of disturbance when anything suggestive of the concealed circumstances is mentioned. Even if the thing itself has been forgotten, any suggestion of what has been associated with emotional states has an effect upon the pulse. Thus, the factors of etiology which the patient himself has forgotten may be brought to mind again by watching the pulse while conversation, apparently impersonal, is being carried on. Lists of words may be used, but the device is very evident, and often is associated with an increased self-consciousness, which lessens the value of the information secured in this way. It is a very good plan to keep the fingers upon the pulse while the history of the patient is being taken, with especial attention to the variations on the blood pressure. While the proper instructions are being given as to diet, etc., the pulse is apt to show any beginnings of obstinacy. People often have excellent control of the facial muscles, of the motions of the hands or feet, and their statements are often modified by their own interpretation of their symptoms, so that conclusions based upon facial expression and subjective symptoms must be supported by exact knowledge. The method of securing more truthful information is no substitute for laboratory methods of diagnosis. Yet, since no person can exercise control of the blood pressure at will, the information gained through judicious watching of the pulse is usually fairly well to be depended upon.
 
 

Summary

    In summing up the histories of these experiments the following conclusions appear to be evident:

    1. Variations from the normal physiological conditions of the brain increases the time required for simple or for complex coordinations.

    2. Within normal limits, the increase of blood pressure decreases the time required for either simple or complex coordinations.

    3 . Under slightly abnormal conditions the tendency to the recurrence of ideas of a depressed significance appears in most cases.

    4. Ideas associated with depressed emotional or affective states tend to lower the blood pressure and to decrease the muscular strength, as measured by the dynamometer.

    5. Ideas with no emotional or affective significance do not affect somatic activities in so pronounced a manner as do the ideas which are concerned in the emotional or affectional states.
 
 

Environment and the Emotional Reactions

    The place of the ganglionar centers of the cerebrum in the coordination of the emotional reactions has already been discussed. The activities of these centers, among lower animals, control those reactions which are concerned in the preservation of the life either of the individual or the race. Among human beings the activities of the centers are, or should be, controlled by the descending impulses from the cortical centers; in other words, the memories, judgments and ideas resulting from the coordination of memories and judgments, as in anticipation, should control the emotions. This is especially true among people whose cortical centers are functional in the highest degree—that is, among people of normal inheritance, and history, and environment.

    Among people of abnormal inheritance, individual history or environment, among degenerates, neurotics, and those whose lives have been spent among abnormal surroundings, there is a lack of the normal development of the cortical centers, and the lower centers thus assume an unduly important place in the control of the motor activities of the individual. The cortical centers are somewhat active in probably all but the lower classes of imbeciles and the idiots, but the cortical neurons are less normally coordinated in activity. Certain neuron groups may be developed to an excessive degree, while others remain practically inactive. Thus the unbalanced mentality results which is found among criminals, the feeble-minded, and the neurotics of all classes of society.
 
 

Cold Weather Crimes

    During the cold months the crimes of an emotional nature are lessened. The cold weather necessitates the use of more food, more clothing, and an expense for lodging and fire. The cold weather is a time of lessened income on the part of those who live by the sins of others. Both of these factors are responsible for the increased prevalence of robbery and the murders for the sake of robbery during the cold months. Suicides are more rare, and the suicides which do occur seem to be the result of poverty or of a determination previously considered, rather than the result of sudden impulses. Autointoxication is less prevalent during cold months, with the increased oxygenation processes; and even the use of alcoholic drinks is less injurious during the cold weather than during the hot months. Also, there is less temptation to the use of stimulants, as a rule, during cold weather.

    The nature of the crimes committed by individuals as a class, and the nature of the insanities prevalent among people as a whole, depend, to a certain extent, upon climatic and other environmental conditions.
 
 

Effects of Hot Weather

    Even normal people are affected to a certain extent by changes in the seasons and in the weather. But normal people are not so affected by hot weather as to become insane, to commit suicide or murder, or permit themselves to become affected in any injurious way by the variations in climatic conditions.

    Students of criminology have found that the seasonal variations exert a very noticeable effect upon the character and number of crimes committed in cities and in countries over the world. Statistics are mostly based upon the crime records of cities.

    During the hot months, and during unseasonably hot weather in other months, the crimes which are based upon the ungoverned action of emotional states are most prevalent. The reasons for this condition are somewhat complex.
 
 

Physiological Relations

    First, it must be recognized that the neurons of the cortex, whose activity is concerned in the inhibition of lower centers, the coordination of memories and the formation of judgments, are of later phylogenetic development, of more unstable metabolism, and more easily affected by abnormal circulatory and toxic conditions than are the older and more stable neurons of the ganglionar centers. Thus, in the presence of poisons in the circulating blood, or of abnormal pressure of the blood, or of any other condition which interferes with the nutrition of the nervous system, the neurons of the intermediate areas are first affected, the neurons of the sensory overflow areas are next affected, while the primary sense areas and the ganglionar centers remain active and their efficiency seems increased by the lack of the inhibitions of the cortical neurons. Thus, the tendency is always present for emotional storms to be associated with temporary or permanent loss of normal cortical activities.

    During excessively hot weather, especially with high humidity, the increased perspiration leads to an excessive concentration of the blood serum. The activity of the kidneys and the liver in the elimination of metabolic wastes is thus lessened. Autointoxication is present in some degree. The increased metabolism necessitated by the higher temperature and the increased action of sweat glands, together with the lessened oxygenation of the blood, lead to oxygen starvation, and to the presence of excessive amounts of the fatigue products in the blood stream. The concentration of the blood by the increased elimination of sweat decreases also the digestive fluids, and the absorption and digestion of the foods taken is lessened. In hot weather the action of bacteria upon foodstuffs is increased, and a certain amount of poisoning, not always sufficient to be recognized as such, may be present. All of these conditions are present in increased degree among the very poor of the large cities.

    The fatigue and the increased perspiration lead to the increased consumption of alcoholic drinks. This, also, is a source of further inefficiency on the part of the cortical neurons. The drug addictions also are of more severe influence during the hot months. The lack of proper bathing facilities among the very poor, the increased perspiration of both human beings and animals, the increased rapidity of bacterial growths, with the associated putrefaction and fermentation processes, all add to the presence of odors in the poorer and dirtier parts of the cities. These odors add greatly, though unconsciously, to the emotional instability.

    Reproduction of species is associated with the beginning of the warm months. The increase in sexual desires is associated with the beginning of the warm months, both normally and abnormally. The tendency to sexual crimes in spring and summer is recognized by criminologists.

    The direct and the indirect effects of hot weather are toward the increased irritability of the neurons of the ganglionar centers and the decreased efficiency of the cortical centers. The emotional reactions are thus left more or less uncontrolled, according to the development of the persons studied. Normal people, with normally developed cortical centers, are not injured by climatic changes. Those whose cortical neurons are not sufficiently developed to remain functional during climatic and other environmental changes are those from whom the prisons and the insane asylums are constantly filled.
 
 

Nature of Crime

    Given the emotional instability, the environmental and somatic conditions determine the nature of the crime or insanity which may result. The person whose attempt to earn a living are inefficient, or who has been disappointed in any one of many ways, suffering from autointoxication or starvation, may commit suicide. Another person who may be affected by other environmental changes may commit murder. It is probable that differences of blood pressure may account for the fact that one person, disappointed, in love, for example, may commit suicide, while another may murder his rival and his sweetheart. The emotional instability is the real root of these abnormalities. Whether an insanity, a suicide, a murder, or some sexual crime results, depends entirely upon the chance occurrences of the environment, or the somatic condition of the person so afflicted.
 
 

Punishments

    It is evident that punishments, as the term is generally used, are of no value in dealing with such conditions. The present tendency to substitute reformatories for prisons is a move in the right direct, so far as the treatment of present criminals is concerned. But sociologists must solve the problem, finally, by removing the ultimate causes of the abnormal emotional instability, and physicians must add their work in the line of securing better physical conditions, of increasing the physiological development of the race, and thus in giving the cortical neurons the conditions needed for their normal and efficient activity. As curative and preventive measures punishments may be used, but punishments given as punishments, in the sense of hurting the criminal because he has hurt some other person, as a sort of revenge and a way of “getting even with him,” are of value only in adding to the probability of his repeating his offenses with the skill of his previous experiences. Given a government seeking revenge, the criminal seeks revenge also.
 
 

Prevention of Crime
 
    The life of any criminal is not very long. Criminals of the degenerate type have short lives Criminals of a sudden temptation are curable; they may live long, and fine, and efficient lives if the rational means of treatment are employed and they are given normal surroundings. But the real problem lies in the prevention of the conditions which perpetuate crime. This is the problem which confronts every physician daily. That baby which is poorly nourished is more apt to be criminal than he would be with proper food. That child which is being dosed with stimulating medicines is more apt to be criminal than he would be if he were treated by rational methods. That child in school, with adenoids, slightly deaf, is in the midst of an environment in which he is misunderstood and mistreated. He hears poorly, but is expected to act as other children act; he sees the injustice, and is growing into a criminal or an inefficient. That other child, with cervical lesions, is growing into a malcontent or worse because of the injury which is being thus produced. Osteopathy has this to consider, that no child treated by osteopathic means can be sent into manhood or womanhood with the injuries produced by the action of stimulants upon the developing neurons.
 
 
Causes of Instability
 
    Another cause of emotional instability lies in the presence of the peripheral irritations. This is more pronounced in the genital region. Worms in the intestinal tract may be efficient causes of irritability, as may also be the gastric disorders. But most efficient of all causes of instability are the irritation caused by the hooded clitoris, phimosis, scar tissue around the cervix or perineum, tumors of the pelvic organs, urethral caruncles, hemorrhoids, anal abnormalities, the enlarged prostate, and the hundred and one other disorders to which the pelvic tissues are subject. The impulses from these abnormalities are not usually represented very vividly in consciousness, but they are carried to the centers of the cerebral ganglia, where they are able to affect the neurons concerned in the control of the emotional reactions. The lowering of the liminal value of the lower centers thus produced increases the tendency to emotional instability, and the person so affected may be seriously injured thereby.

    The effects of climatic variations upon people who are sick is commonly recognized. In dealing with neurotic individuals, it is necessary to take into careful account the environmental conditions. Factors which the normal person is able to disregard altogether, or to meet with a fair degree of equanimity, the neurotic person is not able to deal with at all. He must, during his recovery, be placed in a position where no sources of irritation are apt to reach him. It is useless to ask the neuropathic individual to control himself; he has nothing to control himself with until the cortical neurons are permitted to recover. No causes of irritation should be allowed to reach him until a certain time has elapsed during which good blood is flowing at a normal pressure through his brain, and a stream of normal nerve impulses is being permitted to act upon the neurons of the cortical intermediate areas.