Studies in the Osteopathic
The Physiology of Consciousness:
Louisa Burns, M.S., D.O., D.Sc.O.
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
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.
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
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
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
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.
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
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
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
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.
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
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.
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
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:
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:
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.
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.
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
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
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.
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.
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
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.