Vagotonia; a clinical study in vegetative neurology / by Hans Eppinger and Leo Hess. Authorized translation by Walter Max Kraus and Smith Ely Jelliffe.

  • Eppinger, Hans, 1846-1916.
Date:
1917
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Licence: Public Domain Mark

Credit: Vagotonia; a clinical study in vegetative neurology / by Hans Eppinger and Leo Hess. Authorized translation by Walter Max Kraus and Smith Ely Jelliffe. Source: Wellcome Collection.

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    7. LOCAL VAGOTONIA In describing the syndrome of general vagotonia, we observed ' that an increase of tone could also occur in isolated branches of the autonomic system. ‘This observation may not be in accord ‘with what we have said up to now about localized vagotonia, but the fact remains that in the absence of local causes for the con- dition, a general state must be assumed of such a nature as to cause an increased tone in but one part of the autonomic system. Furthermore this state may exist even if there be no observable signs of disease or of increased irritation. Pharmacology has taught us that the various vagotropic substances have varying affinities, i. e., they affect different parts of the autonomic system with varying intensity [atropin for example]. So also, we be- lieve, do metabolic poisons act, some causing an increase in tone in this part of the autonomic, some in that. It is in this sense only that we have postulated a local vagotonia. It is to us a matter of no small interest, that on the basis of clinical observations, we have been able to find spastic states, affecting isolated parts of the autonomic, which may justly be called of true autonomic origin, and which seem to be associated with similar states in the particular branch affected. Let us take spastic constipation as an example. This may be associated with symptoms which are limited to the pelvic nerve alone. One often hears that these costive patients have erections, spermatorrhea, or pain in the sphincters, associated with the at- tempt to defecate. Could we not suppose that the entire pelvic nerve is hyperirritable under these circumstances, and that it is stimulated by the act of defecation, so that, by an overflow of energy, the branches other than those supplying the rectum are involved. Furthermore, we have seen a group of cases in which epiphora, salivation and conjunctival asthma, as Rosenbach has described it, were associated, while in organs supplied by other branches of the autonomic no signs of stimulation could be found. In such cases we suppose that certain poisons, circulating in the body, have the the same partial action as has been found to be the case with some drugs. Let us sum up in a few sentences what has been said in the last two chapters: (1) Vagotonia is a functional increase of tone in the autonomic system. (2) This increase may affect nearly all