Chapter 13

One defect of modern medicine consists in considering illness
as a 'passive condition', although it is principally
an 'active condition' on a par with health

1981. I want to show more clearly the great difference between excessive stimulus and unsuitable stimulus. To do this, I note that the first phrase involves a concept in which the physiological or pathological course of events depends on animal subjection to a passion. The second phrase involves a concept in which the same course of events depends upon an action of the animal itself.

1982. Here, too, we see Tommasini obviously struggling between a system which he had at heart, and facts which were immediately obvious. One of these facts is the condition which inflammation leaves in the body. This condition ensures that inflammation is reactivated more easily and with less reason where it has already occurred. Tommasini is forced to conclude, therefore, that inflammation breaks 'the laws of habit, according to which second impressions are normally felt less, and are less injurious, than preceding impressions.'(78)

In my way of conceiving illness, the laws of habit are not broken in any way. The course of an illness does not follow the law dependent upon passive and excessive impression of the stimulus, but rather the law dependent upon the activity of the twofold animal instinct. I have already distinguished two kinds of habit, one passive, the other active, and I noted that passive habit diminishes the intensity and liveliness of a new impression. Active habit, however, increases the action by making it easier, or more perfect or intense. Thus, if we consider two human, benevolent persons, we see that the younger of the two experiences the passive feeling of compassion in a more lively way; the older has less feeling but is more ready than the younger to help those who suffer.(79) If, then, the inflammatory process does not show itself subject to the law of passive habit, as Tommasini himself admits, but obeys the law of active habit, we have proof that this process is not determined by the quantity of stimulus and excitation which it receives passively, but by the play of internal forces (which is disturbed by some stimulus, small or great) and by the unsuitability of the stimulus relative to the state and condition of the forces themselves.

1983. The passivity on which Brown made life depend, was so marked that it gave rise to his famous dictum, 'The excitability of the fibre is exhausted as a result of the action of stimuli.'

Tommasini wanted to take a middle way by denying the generality of Racchetti's opinion for reasons 'dependent on habit'.(80) But he was unaware that besides laws of passive habit, there are, as I said, laws of active habit which are contrary to the other laws. Animal nature conforms in its action to the laws of active habit. It is necessary, therefore, to pay much more attention to the laws of animal activity than to those of animal passivity. Only then will it be possible to free ourselves totally from the problems of Brown's system.

1984. The indiscreet, blind war waged against animists was a great impediment to this. People were afraid of finding a soul, and thought it more prudent to restrict themselves to the conditions of fibres. Tommasini, when speaking of the consequence of inflammation in the body, that is, the ease with which inflammation reasserts itself, says that this condition is necessarily 'the product of some change in those organic-dynamic conditions of the fibres, that is, conditions in which excitability is inherent.'(81) But in speaking of fibre and the excitability inherent to fibre, the phenomenon is considered only from a passive point of view. The true reason illustrating this phenomenon is found only by considering it from its active point of view. In other words, the phenomenon must be considered in relationship to the principle which enlivens and moves the fibre itself. But because the fibre is the term of the principle's action, the principle is excited if the fibre is stimulated. As a result of this excitation (according to the law of spontaneity which I mentioned above) the fibre is moved and itself appears excitable. But there is no doubt that the animal principle, the soul, is subject to the law of active habit which consists in causing the soul to carry out with the least effort, in the easiest way and with the greatest pleasure, the kind of operation it has already carried out several times previously.

1985. Here I note again how the laws of passive habit and active habit, although opposite, help one another in such a way that the law of active habit is explained in great part by the law of passive habit.
Let us grant that 'the quantity of action of the sensuous instinct is in proportion to the lesser obstacles which it finds when operating, and to the greater ease and delight it has in acting.' In this case, it is clear that the law of passive habit which says, 'Uncomfortable sense-experiences lessen in vivacity as they are repeated and continued', explains why an agent, in repeating its actions, always becomes more active and more inclined to posit them. It becomes more active because it reduces the sharpness of discomfort found in the effort it makes. It also reduces the difficulty which it first encountered. This is especially true when we are dealing with an uncomfortable, diseased activity which necessarily causes great disturbance. Thus the laws of the two habits explain, rather than contradict one another reciprocally.

1986. There is no contradiction, as we may be tempted to think, in saying that the sensuous instinct finds discomfort and disturbance in its activity, and in saying that the quantity of activity of the sensuous instinct is in proportion to the delight it finds in its action. In fact, discomfort, disturbances and difficulties can be and are mingled with pleasure. It is the prevalence of pleasure or its contrary which makes the activity pleasing or painful. Again, we should not compare activity with non-activity, but activity with the state in which the animal would find itself if it did not act. This activity, considered in itself, may contain more disturbance and pain than pleasure. At the same time, the activity may be such that the sensuous instinct spontaneously seconds and continues it to avoid a more uncomfortable and painful state which might ensue, were the activity not sustained. This is consistent with what I said previously: 'The quantity of action of the sensuous instinct consists not only in proportion to the degree of pleasure the instinct experiences in acting, but also in compound proportion to the degree of pleasure and to the impulse it has received at the beginning of the sense-experience.'

The senseexperience provides the first impetus to sensuous instinct, which cannot produce the impetus. Other things being equal, the degree of the impulse determines the maximum of action. But, having received this impulse, the action of the sensuous instinct is diminished after its first movement by the obstacles it encounters, that is, by the difficulties, effort and disturbance which it experiences. Hence the first movement impressed by the sense-experience can, if violent, cause serious and inevitable disorders in the organisation. For example, in sensitive individuals it is impossible to prevent a violent detonation producing some disturbance of the epigastric region. It could also produce lipothymia, syncope and other harmful effects, all resulting from the spontaneity of the sensuous instinct which cannot resist the first impulse of such an unexpected, powerful sensation. When I say ' cannot resist', I mean that the effort and disturbance caused by resistance is such that the individual prefers to let the movements initiated by the sensation run their course, despite their harmful effects. Gnashing of teeth, produced by the sensation of a rasp moving over a saw-blade, or other sounds affecting the ears, is certainly not pleasant, but cannot be avoided by the spontaneity of the sensuous instinct because the impulse of the sensation is so strong. Stopping the oscillation received by the chord of the tympanum to prevent its propagation to the nerve of the lower jaw would require so great a degree of effort and pain that it is much easier to allow the instinctive spontaneity freedom to propagate the oscillation. The facility, therefore, with which inflammation is reproduced is easily explained by recourse to the law of active habit which the animal principle obeys.

1987. This does not mean that organic change of the fibre in which inflammation is repeated is excluded as a cause of inflammation. Nor do I deny that after inflammation the organic disposition of the fibre is modified. Nevertheless, I think it too bold to assert the as yet undemonstrated proposition that 'the excitability of the parts and their susceptibility in responding to stimuli is a product or rather an immediate effect of the organisation and of the organic-dynamic conditions inherent in the organisation.'(82) Attributing the degree and manner of excitability exclusively to the organisation of the fibre is gratuitous and totally improbable. Indeed, psychological facts give the lie to such a narrow system in the human being - a system which recognises the pure organisation of the fibre, that is, the facts of rational passions, as the sole cause of the modification which excitability presents.

It cannot be denied that:

1. Rational passions are an excitatory stimulus of the nerves and fibres. Joy, anger, terror, love can suspend and increase the action of the heart. Bichat cured a man who, as a result of fear, had suddenly experienced a serious constriction in the region of the epigastrum, followed by a yellowish tint on his face and, in the evening, swelling of his lower members. We often see an excess of anger succeeded by inflammation of the skin and mucous, by neuralgia and other symptoms of illness.

Nor can it be denied that:

2. Passions are subject to the law of active habit and become more frequent and violent to the extent that we freely second them. Granted this, let us imagine for a moment that the organisation of the fibre remains unaltered, but that the habit proper to passion provides the rational soul with great susceptibility. Let us also imagine the presence of this susceptibility in a strong, habitually proud man who acquires it whenever he is crossed, hears a sharp word, or is contradicted; or in a sensual person who acquires it whenever he sees something to feed his passion; or in a person who is subject to constant fear, etc. The fibre of these persons, although remaining unchanged in its organisation, will undoubtedly seem more excitable because the animal principle which moves and nourishes the fibre, and provides it with an attitude agreeable to their passion, has been rendered habitually more excitable, more active and more prompt. If, therefore, we notice greater mobility in the living fibre after it has been subjected to a certain stimulus, we cannot simply infer from this that such change is inherent in its organisation. In other words, we cannot conclude that this organisation, which is claimed to be immediately modified, is the only cause of the increased excitability. On the contrary, it seems that at least a good part of this new, apparent condition of the fibre must be sought in the new condition in which the animal principle, which informs, vivifies and agitates the fibre, is found as a result of the active habit. Undoubtedly this principle is at times modified by intellectual and moral causes independent of the fibre itself.

1988. I have no doubt that a similar argument can be applied to what happens in brute animals although their body receives no stimulus from intellective information or moral dispositions, which they lack. It is certain that they have an animal principle subject to the law of active habit independently of organisation, and it is certain that animal instinct is subject to the law of active habit independently of organisation. This must be the explanation of certain instinctive, displeasing movements which we often see amongst people and from which certain persons would protect themselves if they could. For instance, the force of active habit could explain the handicap of a certain person well-known to me who at every second or third word makes a sucking action. If he forcefully succeeds in restraining himself from sucking for a while, he then draws breath two or three times hurriedly as though to make up for this. There seems no innate alteration in the organic condition of his fibres. Apparently, habit now makes him repeat movements through which the fibre has appeared to become more irritable, more mobile. It may be objected that his action is a convulsion of the lip. Frequent convulsions in an individual however must be attributed in great part to the force of active habit. The activity of the animal principle must also explain why convulsions are propagated through imitation. It is not the unchanged organisation of the fibre which renders the fibre more contractible, but the active principle of the animal which works through imitation in the fibre itself of the animal. As a result, the fibre shows itself more contractible.

1989. And here we find another argument capable of proving that different measures of irritability and mobility shown by the fibre should be sought not in varied organisation alone, but rather in the different condition of the active animal principle itself. This principle, modified independently of the fibre, itself moves and modifies the fibre which, relative to the principle, is passive. Take, for instance, the very effective imitative instinct of animals. There is no doubt that this has to be attributed to the sensitive principle rather than the material, organic conditions of the fibre. We could, of course, describe the imitative instinct in another way, and attribute such phenomena to the dynamic conditions of the fibre itself, provided however that these conditions are not made to depend on the organisation ALONE. The force (*) residing in the animal principle must be recognised. Animal activity as a result of habit, imitation, imagination and various other modes of activity dependent on sensitivity and the unitive force is very far from depending on organisation alone. Indeed, organisation, which is purely passive, itself depends on and is modified by various other ways of animal activity.

1990. Nevertheless, this does not mean that the altered organisation of the fibre does not play a great part in the phenomena of healthy and sick bodies, provided that such altered organisation is not accepted as the active cause of these phenomena or taken as their sole explanation.
In fact, animal life results from different reciprocal actions of the soul in the body, and of the body in the soul.(83) As a consequence, every action of the vital principle must influence the state of the body, and every alteration of the body must cause some alteration in the state of the vital principle. If the organisation of the body changes, the vital principle and its activity are also modified. But, on the contrary, if the activity of the vital principle undergoes some change or operates with the kind of acts to which intestine movements in the tissues of the body correspond, the intimate organisation of these tissues must change.

This shows that the organic condition of the fibre is important, but not overwhelmingly so. The fact that this fibre is organated in one way rather than another must render it more or less impressionable, must provide it with various degrees of passivity. But nothing would be able to render it so mobile if the moving principle, the cause of motion, did not act in it. Its excitability, therefore, is in a passive relationship to the principle that moves it, nothing more. But as this passive mobility can vary in the organated fibre, so the active motor principle is itself subject to change in its active relationship; the degrees of activity in the principle increase or diminish, its acts become more easy or more difficult. The phenomena, therefore, of increased impressionability or excitability of the fibre depends on two causes, not on one alone: on the increased passive mobility of the fibre inherent in the organisation, and on the increased active mobility of the animal principle.

1991. We can now see how great is the part played by organisation in the explanation of physiological and pathological phenomena (although the apparent degree of excitability in the human body must not be attributed to organisation alone). We need to consider that the fundamental feeling of continuity is totally dependent on the organisation and that the fundamental feeling of excitation is in great part dependent on it. Moreover, sensuous instinct produces minimal movements which must cause certain mutations in the tissue and the organic state of bodies. These minimal movements are those brought about by means of the ganglionic nervous system.

1992. Hence Tommasini's very apt comment: 'Perhaps a really inflamed part never recovers completely, however well it has been healed.'(84) For myself, I have no doubt that after modification produced by illness the human body never returns to an organic state identical with its previous state. It is impossible to compensate so completely for the intestine movements and for lost and gained molecules that the mixed, organated body can recuperate completely. I have no doubt also that there is not a single moment in life in which the mixture and tissue-like texture of the parts is totally equal to the previous moment. But the systematic error of Tommasini, a truly great man, is to claim that the excitability and susceptibility of the parts in responding to stimuli depends solely on the organic condition of the fibre, and that from the quantity of these stimuli we can argue to the degree of change in the fibre. The importance of this matter leads me to attempt to throw greater light on it by specifying the conditions which can be present in the state of the animal body as a result of the alternating action of the two instincts. I shall do this in the following chapters.

Notes

(78) Dell'Infiammazione, etc, chap. 1.

(79) AMS, 693.

(80) Dell'Infiammazione, etc, chap. 2, §9.

(81) Ibid.

(82) Dell'Infiammazione, etc, §5.

(83) AMS, 380-388.

(84) Dell'Infiammazione, etc., §5.