Congestions and secondary affections of the liver, biind or bleeding piles, and vertigo, or even apoplexy, during the act of straining at stool, are some of the penalties paid by old age for neglect of these safeguards.

[The passage to which the author here refers, is as fol lows:]

"With rare exceptions, people can never enjoy good health whilst they suffer from constipation, a vice much more prevalent than is generally known or believed. Liver complaint, dyspepsia, headache, vertigo, and that tormenting disease, piles, are only some of the direct results of constipation, and give rise to an immense amount of human misery. I have no doubt that learning to have an evacuation of the bowels regularly every morning conduces far more to a man's health, happiness, and success in life than a complete classical education, invaluable as that certainly is; and when the habit is once established, nothing, absolutely nothing, should be permitted to interrupt it. Of course, we ought all to strive to overcome constipation by laxative articles of diet, such as bran bread, fruit, fresh or dried, and by suitable exercise; but if these fail, the employment of gentle saline purgatives, such as Congress and Friedrichshal water, or of rhubarb, and the use of injec tions, constitutes by far the lesser evil."

Sometimes hand in hand, sometimes preceding or succeeding, at some little interval, to these failures in the mascular tissues, are seen the evidences of deterioration of brain and nerve-structure displayed in the loss of intellegtual power, with changes of temper and even of disposition.

Such alterations are slow; they often commence insid iously, and develop almost imperceptibly, escaping the attention of the subject of them, for the simple reason that they affect the organ of perception of external impressions itself. Very frequently they are distinctly visible, to a close observer, long before the state of dotage is recognizable by the ordinary eye.

There is no doubt that, under these circumstances, life and intellectual vigor would often be prolonged by a judicious change of occupation and of scene, particularly in foreign travel; and marked failure of memory, loss of reasoning power, or capacity of mental application, are the symptoms which should warn elderly people of the approach of intellectual decay, which, however, the means just suggested may avert, or, at least, for a long time postpone. Should these danger-signals be disregarded, as is the case in a large majority of instances, the time when they can be of service is apt to pass quickly by, and the perchance once vigorous intellect, wrecked and ruined, falls into a condition of decay which renders long life a griev ous burden, not only to the sufferer himself but also to the loving relatives and anxious friends who surround him.

SUGGESTIONS IN RELATION TO THE PRESERVA-
TION OF NERVE AND MENTAL HEALTH
IN THE AGED.

J. S. JEWELL, M. D.

PROFESSOR OF NERVOUS AND MENTAL DISEASES AT CHICAGO MEDICAL COLLEGE, (MEDICAL DEPARTMENT OF NORTH-WESTERN UNIVERSITY.)

ON THIS brief paper it will be my object to describe the more ordinary conditions of the nervous system which obtain in persons who

have passed the meridian of their physical lives, and within and upon whose bodies the marks of physical decline have appeared.

The altered conditions of nerve nutrition and circulation, incident to old age, carry with them changes in mental conditions and activities, whether as regards thought or feeling.

The nervous system, which is the special seat and instrument of mind, is the highest, most complex, and delicate part of the animal organism. As an almost necessary prelude to what is to follow, I shall offer a few remarks on the structure and modes of action of the nervous system. As a system, it outranks all others. It consists chiefly of two great parallel or correlative tracts. One of these is the special seat of sensibility, and extends from all parts of the

body, endowed with feeling, to the spinal marrow, and in the spinal marrow up into the brain. This is the great highway for impressions from the outer physical world, which through this channel reach the mind, which has its principal seat in the gray matter on the outer surface of the brain. The other great tract in the nervous system is the special seat of nerve-power for both mental and physical purposes. It extends from the brain down through the spinal cord and outwards along the nerves of motion to the muscles, glands, and other structures, the actions of which are excited and controlled by the nervous system.

Here then are the two great tracts; one extending from the surface to the brain; the other from the brain to the surface; the one the highway of sense impressions from the outer world toward the mind; the other the highway of impulses to motion from the brain, or central nervous system, toward the outer world.

The ends of the two great tracts just described, which lie within the cavity of the skull, have gathered about them, but especially intercalated between them, certain nerve mechanisms which add greatly to the size and complexity of this part of the nervous system. These are for the purpose of storing impressions, as in memory, and for elaborating them, as in thought. These parts may be considered as lying between the upper terminations of the great motor and sense tracts. This, taken together, constitutes what is known as the brain. It is a vast complex of cells and fibres. Thousands of fibres extend from the spinal marrow and from about the base of the brain

outwards toward the various organs of the body into which nerves can be traced. Thousands of fibres extend from the spinal marrow, and from the medulla, which crowns the cord as a capital, up into the brain, so as to place various portions of the former in connection with various portions of the latter.

In the interior of the spinal cord is a tube or rod of gray nerve matter, containing, it is probable, millions of nerve cells of different shapes and varying magnitudes. These nerve cells receive fibres from, and give off fibres to, various parts of the body on the one hand and upwards toward the brain on the other. This column of gray matter, composed chiefly of cells, reaches up into the base of the brain. Clustering about the end of this gray column, which lies within the skull, are a number of masses of gray matter called ganglia, which lie on the floor of the skull. These masses, or ganglia, are composed of cells like the gray matter of the spinal cord. The nerve cells in these ganglia are connected by fibres with the cells of the gray matter of the spinal cord so as to place various portions of the gray matter in the ganglia which repose on the floor of the skull, in communication with the various horizons of the central gray matter of the cord. Finally, we have overhanging the whole as a great hollow dome, a thin layer of gray matter spread on the outer wrinkled surface of the brain and known as its cortex. It is the special seat of the mind, whether we refer to its sensibilities, to its memory, to its elaborative capacity (or thought-power,) or its volition. This layer of gray matter on the outer surface of