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Although we shall not be disposed to receive this theory in its full extent, yet we cannot hesitate to admit that the influence of the nervous system is indispensably necessary for producing vomiting; and we accordingly find that this act will not take place, however forcibly the stomach may be goaded by emetics, where the energy of the nervous system is suspended, as in cases of profound intoxication, or in violent wounds and contusions of the head; while if the brain be only partially influenced, as by incipient intoxication, or by a less violent blow upon the head, its irritability is increased instead of being paralysed, and vomiting under such circumstances is excited by the slightest causes: the fact of such opposite results being produced by the same impulse in different degrees of intensity, is no less curious than instructive. Dr. Richard Harrison, in his Gulstonian Lecture before the College of Physicians, treated the subject of vomiting with much ingenuity, and I am disposed to adopt the views which he offered. He observed, that although the experiments of Majendie sufficiently testify the importance of the pressure of the abdominal muscles upon the stomach in the act of vomiting, and which can only be explained by the influence of the brain and nervous system, yet that he has attributed too much to their agency; “it appears to me,” continued he, “that vomiting may be explained in the following manner:—the irritation of the stomach makes a call upon the brain for the aid of the diaphragm and the abdominal muscles, in order to expel its contents; the diaphragm then becomes contracted and fixed, the ribs drawn down, and the abdominal muscles drawn inwards, so that the stomach is pressed on all sides by voluntary muscles, which, together WITH ITS OWN CONTRACTION, expel the contents.” Now it must be obvious that where the brain, from oppression or injury, is unable to transmit its influence to these muscles,[151] and disregards the call of the stomach, vomiting can only be excited with difficulty, or it will be prevented altogether.

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