The Principles of Psychology, Volume 2 (of 2)James, William
Science
The Principles of Psychology, Volume 2 (of 2)
James, William
Psychology
_That the joint-surfaces are sensitive_ appears evident from the fact
that in inflammation they become the seat of excruciating pains, and
from the perception by everyone who lifts weights or presses against
resistance, that every increase of the force opposing him betrays
itself to his consciousness principally by the starting-out of new
feelings or the increase of old ones, in or about the joints. If the
structure and mode of mutual application of two articular surfaces be
taken into account, it will appear that, granting the surfaces to _be_
sensitive, no more favorable mechanical conditions could be possible
for the delicate calling of the sensibility into play than are realized
in the minutely graduated rotations and firmly resisted variations of
pressure involved in every act of extension or flexion. Nevertheless it
is a great pity that we have as yet no direct testimony, no expressions
from patients with healthy joints accidentally laid open, of the
impressions they experience when the cartilage is pressed or rubbed.
The first approach to direct evidence, so far as I know, is contained
in the paper of Lewinski,[192] published in 1879. This observer had a
patient the inner half of whose leg was anæsthetic. When this patient
stood up, he had a curious illusion about the position of his limb,
which disappeared the moment he lay down again: he thought himself
_knock-kneed_. If, as Lewinski says, we assume the inner half of the
joint to share the insensibility of the corresponding part of the
skin, then he _ought_ to feel, when the joint-surfaces pressed against
each other in the act of standing, the outer half of the joint most
strongly. But this is the feeling he would also get whenever it was
by any chance sought to force his leg into a knock-kneed attitude.
Lewinski was led by this case to examine the feet of certain ataxic
patients with imperfect sense of position. He found in every instance
that when the toes were flexed _and drawn upon_ at the same time (the
joint-surfaces drawn asunder) all sense of the amount of flexion
disappeared. On the contrary, when he pressed a toe _in_, whilst
flexing it, the patient's appreciation of the amount of flexion was
much improved, evidently because the artificial increase of articular
pressure made up for the pathological insensibility of the parts.
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