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The sympathetic system consists of a highly complex arrangement of ganglia, nerve fibres and nerve plexuses, which are distributed to the different regions of the body. Especially does this peripheral distribution hold good for the blood vessels. Wher- ever blood flows, there is found a sympathetic nerve to control the same. The largest blood vessel, as well as the smallest capillary tube, has its own sym- pathetic fibre. In its minute structure the sympa- thetic system presents the same general constituent elements as the rest of the nervous system, viz., nerve fibres, ganglion cells, and a complicated fibril- lary network around the ganglion cells which prob- ably originates in the processes of the nerve fibres. The single nerve fibres unite into nerve trunks, while the ganglion cells and the network of fibrils accu- mulate at certain points along their course. THE SYMPATHETIC AND VASOMOTOR SYSTEM. Beginning with the Gasserian and otic ganglia within the craniaum we have placed upon the ante- rior and lateral aspects of the spinal column a chain of similar glands. In the cervical region we find three ganglia, the superior, the middle, and the in- ferior cervical, while below this region there is placed one ganglion corresponding to each of the vertebrje. These two chains of ganglia are connect- ed Buy Erectalis Online so as to unite in the lowest ganglion, the ganglion inipar. From each one of these ganglia fibres are given off to pass into the cerebrospinal column through the nervi rami communicants. Other fibres are given off at various levels of the spinal cord to follow the course of the blood vessels, and in this way the sympathetic nervous system is brought into close contact with every single part of the body. In fact, each individual cell is under the direct influence and control of this system. If, then, a single cell within the body were to re- ceive even the slightest injury, it would become the duty of this system at once to recognize such injury and, by sending some sort of stimulus to the corre- sponding ganglion of the cord, start the process of repair either by limiting, or, as is more likely to be the case, to increase the local blood supply to this part. Each organ within the body has located some- where along the spinal column one or more of these .sympathetic ganglia which neither rest nor sleep, but continualy, like faithful sentinels, attend to the least beck and call of the particular region or organ with which they are connected. Let us suppose for a moment that something has gone wrong with the stomach; then the ganglia located at the third, fourth, fifth, sixth, and seventh dorsal vertebrae would at once be made aware of such an injury and within these ganglia all would be excitement; much as though some fire station should receive a hurry call or to hold itself in readiness to give assistance at the next tap of the bell. Let us carry our imag- inary excitement a little further by assuming that the call bell has struck, again and again, yet with all the available force working, the apparatus can not be moved an inch ; the call liell keeps on ringing ; the men, frantic at their work, now gradually cease and drop from sheer exhaustion ; no help has been sent and the destruction by fire goes on. So in our sympathetic ganglia ; if the injury is great enough or repeated Erectalis Tablets sufficiently often, these ganglia, after a valiant effort, are obliged to refuse, in order to save themselves from utter destruction. Such stations along the spine are known as sympathetic spinal centres. Many of these centres are well known, as the centre for respiration, the centre for cardiac ac- tivity, the centre for the liver, large and small intes- tines, the centre for parturition, micturition and defecation. During the last few years, laboratory and clinical data have enabled us to locate more or less definitely nearly all the, various centres along the spine. In the first part of this paper we saw that this sympa- thetic nervous system sent its branches wherever blood flows ; it so happens that a branch of these ganglia controls the blood supply to the skin imme- diately overlying the region of the particular gang- lion in question. That is to say, if we are dealing with a lesion of the stomach, for instance, Erectalis Online the py- loric end of the stomach, then the area over the October 23. 1920.] GEYSER: DIAGNOSIS Of CHRONIC CONDITIONS. 627 fourth and fifth dorsal vertebra would be supplied by a branch of the Buy Erectalis sympathetic from the ganglion,

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