82. The function of Urination is one which notoriously belongs to the voluntary class, in so far as it is initiated or arrested by a voluntary impulse, and it is one which, according to the classic teaching, has its centre in the brain. The grounds on which this cerebral centre is assigned are very similar to those on which other functions are assigned to cerebral centres, namely, observation of the suppression of the function when the pathway between certain organs and the brain is interrupted. But the careful experiments of Goltz[287] have demonstrated that the “centre” of Urination is not in the brain, but in the lower region of the cord. When the cord is completely divided, Urination is performed in the normal way—not passively, not irregularly, but with all the characters of the active regular function. And, what is also noticeable, this function is so intimately dependent on Sensibility that it will be arrested—like any other function—by a sensation excited from the periphery—to be resumed when the irritation ceases. Now this arrest from a stimulation of sensory nerves takes place when the brain is cut off from the spinal centre, just as when the brain is in connection with it.
The same is true of Defecation, and the still more complex functions of Generation and Parturition. I can only refer the reader to the very remarkable case of Goltz’s bitch with the spinal cord divided in the lumbar region, if evidence be wanted for the performance of complex functions so long as the spinal centres were intact. It is true that Goltz considers these functions to have been independent of sensation; but that is because he has not entirely emancipated himself from the traditional views; for my purpose it is enough that he admits the functions to be dependent on sensorial processes.
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83. To sum up the evidence, we may say that observation discloses a surprising resemblance in the manifestations of the cord and brain. In both there are reflex processes, and processes of arrest; in both there are actions referable to conscious and unconscious processes; in both depression and exaltation are produced by the same drugs; in both there are manifestations interpretable, as those of Discrimination, Logic, Instinct, Volition, Acquisition, Memory; in both there is manifestation of Sensibility—how then can we deny Sensation to the one if we accord it to the other?
CHAPTER IV.
NEGATIVE INDUCTIONS.
84. I fancy some reader exclaiming: “All your reasoning, and all your marshalled facts, are swept away by the irresistible evidence of human patients with injured spinal cords, whose legs have manifested reflex actions, and who nevertheless declared they had no sensation whatever in them. We can never be sure of what passes in an animal; but man can tell us whether he feels an impression, or does not feel it; and since he tells us that he does not feel it, cannot, however he may try, we conclude that reflex action may take place without sensation.”
As this is the one solitary fact which is held to negative the mass of evidence, anatomical and physiological, in favor of the Sensibility of the spinal cord, it is necessary that we should candidly examine it. No reader will suppose that during the twenty years in which I have advocated the doctrine expounded in this volume, I have not been fully alive to the one fact which prevented the general acceptance of the doctrine. From the first it has seemed to me that the fact has been misinterpreted.
85. Certain injuries to the spinal cord destroy the connection of the parts below the injury with the parts above it; consequently no impression made on the limbs below the injured spot is transmitted to the brain, nor can any cerebral incitation reach those limbs. The patient has lost all consciousness of these limbs, and all control over them. Hunter’s patient on being asked if he felt any pain when the prick caused his leg to kick, answered, “No: but you see my leg does.” This answer has been regarded as a drollery; I think it expressed a physiological truth. For on the assumption that the whole of the cerebro-spinal axis had one uniform property, corresponding with its uniform structure, and various functions, corresponding with the variety of organs it innervates, a division of this axis would necessarily create two independent seats of Sensibility, and interrupt the consensus of their functions. In such a case it would be absurd to expect that the cerebral segment could be affected by, or co-operate with, what affected the spinal segment.
Now, when a man has a diseased spinal cord, the seat of injury causes, for the time at least, a division of the whole group of centres into two independent groups. For all purposes of sensation and volition it is the same as if he were cut in half; his nervous mechanism is cut in half. How then can any cerebral control be obeyed by his legs; how can any impression on his legs be felt by his cerebrum? As well might we expect the man whose arm has been amputated, to feel the incisions of the scalpel, when that limb is conveyed to the dissecting-table, as to feel by his brain impressions made upon parts wholly divorced from organic connection with the brain.