Page:Popular Science Monthly Volume 6.djvu/585
MENTAL ASPECTS OF ORDINARY DISEASE.
light; can comprehend how mental depression may wait upon and depart with abdominal disturbance. The disturbance does not extend to the intellectual processes; the emotions alone are involved. The sense of well-being, or of discomfort, depending upon systemic conditions, tells of the relation existing between the emotions and the organic processes; and the nerve-tracks just described enable us to comprehend the subject more clearly.
There is an interesting point connected with this division of the cerebral hemispheres, and the functions of each division, to which we may advert. It is the association existing between states of emotional depression and abdominal disease, and the comparative absence of such depression in affections of the lungs. Marshall Hall writes: "The temper of the patient is singularly modified by different disorders and diseases. The state of despondency in cases of indigestion forms a remarkable contrast with that of hopefulness in phthisis pulnionalis, and other serious organic diseases."
In diseases of the lungs, the condition of depression is rarely present, and, when so present, is possibly due to some abdominal complication; though, of course, some of the existing depression may be fairly attributed to the anxiety naturally arising from an intelligent comprehension of the danger impending. In tuberculosis of the lung there is commonly such an emotional attitude in the patient as has earned for itself the designation of spes phthisica. Here the hopefulness is as irrational as is the depression of some other affections. The consumptive patient just dropping into the grave will indulge in plans stretching far into the future, ignoring his real condition, and the impossibility of any such survival as he is calculating upon. It is a curious yet a familiar state. Hope seems to rise above the intelligence, just as in certain abdominal diseases there is a depression which defies its corrections. The intellect is not equal to finding the true bearings or of correcting the exalted emotional centres. In curious relation to these conditions stand well-known differences of the pulse. In chest-diseases the pulse is usually full, sometimes bounding; in abdominal disease it is small and often thready. The pulse of pneumonia and the pulse of peritonitis are distinctly dissimilar and contrast with each other. It is well known that there is much more tendency to collapse in abdominal than in thoracic disease; taking the conditions of the pulse together with the emotional attitudes of these affections, the synthesis is unavoidable that some effect is produced by the tubercular disease in the lungs upon the emotional centres as opposite to the effect of abdominal disease as are the varied effects upon the pulse; and further that the result is probably produced through the circulation. The explanation which is shadowed out, for it really does not amount to more, is that abdominal disease causes a depletion of the emotional centres—of which depression is the outward indication—while phthisis leads to a plethoric state associated with exalted emo-