In the old book ‘Erythroxylon coca: a treatise on brain exhaustion, as the cause of disease” by W. TIBBLES, MD. A disorder is described we do not recognize anymore: brain exhaustion.

Dr. Tribbles believed coca leaves is the remedy of choice….

Brain exhaustion was a special case of nervous exhaustion, states of the nervous system we now know that those are probably related to slow inflammation. For symptoms of tiredness, irritability, lack of energy, chronic pain in the past doctors could only diagnose these as ‘exhaustion’.

Why palmitoylethanolamide is used.

Nowadays we know much more. For such states, the natural anti-inflammatory compound and supplement palmitoylethanolamide (PEA) seems quite a good fit.

Many patients suffering from chronic fatigue syndrome have benefited from PEA (eg. 2-3 times daily 400 mg). Patients often prefer the PeaPlex capsules, because the biological and physiological normalizing action of PEA has been supported by a special selection of low dose vitamins of the B group, suited to support the immune system and the nervous system.

For pain relief and for inhibiting inflammation, most patients choose:

  • PEA capsules produced in the Netherlands by Russell
  • PEA tablets produced in Italy by Epitech

Here we disclose an old text on brain exhaustion,

part 3, the first part of chapter 1 on the brain and Nervous System, the process of digestion and the Circulation of the Blood:


Physiology: — of the Brain and Nervous System — The process of

Digestion — The Circulation of the Blood,

The human body

In order to make this book as useful and intelligible as possible, it is necessary to sketch the structure and manner of working of some of the various organs and systems of which the human body is composed. In considering disease it is necessary to contemplate the various systems as differently or similarly affected; the human body should be, both physiologically and pathologically considered. The body of man is composed, as it were, of different pieces of machinery, animated by a peculiar principle, each part performing separate functions, all which contribute to one great end. And it is only on an acquaintance with what takes place in the various processes and of their adaptability the one to the other, that any sound doctrine of the art of healing disease can be based. And he, therefore, who does not know the workings of his own frame, is in ignorance of the most interesting and grand display of nature’s handiworks.

The nervous system

The Nervous system is generally described as consisting of two parts, closely connected together: first, the cerebrospinal system, and secondly, the sympathetic yaiiglionio system; each of these may be divided into nerve-centers, and nerves diverging from these centers to supply the different parts of the body.

Nerves are made up entirely of a white matter called fibrous matter, supported in a connective tissue. Nerve centers are composed of spheroidal bodies or ganglionic corpuscles, consisting of a soft semisolid cell substance, and mingled with nerve fibers; this mass is of a reddish grey color and is called vesicular or grey nervous matter.

Nerves are round and sometimes flattened cords, connected at one end with the nerve centers, dividing and sub-dividing, permeating and ramifying over the whole body; they are divided into two classes, according to their functions — the motor nerves are those which cany the mandates of the will to the parts they supply, so that muscles are instruments by which a motor nerve, excited by the central organ with which it is connected, is able to produce motion; and the sensory nerves, which carry back to the nerve centres the impressions made upon them by any excitant at the part over which they are distributed. The activity of these nerves is evidenced and becomes manifest to us as a state of conscious sensation — through the working of the central organ of the system — the Brain.

The spinal system

The Cerebro-spinal system consists of the spinal cord, brain, and the cerebral and spinal nerves proceeding from them. The centers of this system lie in the cavity of the skull and spinal column (the backbone.) The bony walls of which cavity are lined by a dense fibrous structure of considerable strength called the dura mater. Closely investing these centers is a very vascular fibrous tissue, the pia mater. Interposed between these two layers is a very thin, delicate membrane, which is called the arachnoid membrane, one layer of which also coats the brain, and it being what is called a serous membrane, it secrets, into its interior, a fluid called the arachnoid fluid. There are a large number of vessels which supply blood to these organs, after running for some distance in the pia mater they then pass into the substance of the brain or spinal cord, and it is from this blood that the Brain and nervous system derives its food, which is converted into nervous force.

The spinal cord is a column of greyish-white substance. It occupies the upper two-thirds of the spinal canal, extending from the commencement of the canal, where it is continuous, by a portion called the Medulla Oblongata, with the brain, to about the first or second lumbar vertebrae, that is, near the middle of the loins, where it tapers off into a filament. If a transverse section of this cord be made it is found to be composed of two substances, one, external, a white substance, the other, internal, a greyish-red substance. The white matter consists of nerve-fibers supported in a framework of connective tissue, and accompanied by blood-vessels, most of these fibers run lengthways. The greyish matter is composed of nerve-fiber and a number of nerve cells.

From the sides of the cord are given off thirty-one pairs of nerves, each of which arises from two roots, one anterior the other posterior. Thus there are thirty- one pair of anterior roots, and the same number of posterior roots, a certain number of anterior and posterior roots, on the same level on each side of the cord, converge and form anterior and posterior bundles, and then the two bundles coalesce into and form the trunk of a spinal nerve.

The anterior roots are motor; those of the posterior, on each of which is an enlargement or collection of grey matter— called a ganglion, are sensory. Therefore, each spinal nerve is compound, having both motor and sensory functions.

The trunks of spinal nerves pass out of the Spinal canal by apertures between the vertebrae, or small bones composing the backbone, and then divide and subdivide and ramify, for the most part, over the muscles and skin. ‘ If the roots of a spinal nerve be irritated in any way, either by pinching, galvanizing, applying a hot body, or cutting, two things occur: first, all the muscles to which parts of this are distributed, contract; secondly, pain is felt, which is referred to that portion of the body to which fibres of the nerve operated upon are distributed. Thus the effect of irritating the root of a spinal nerve which sends branches to the hand is to cause pain to be felt in the hand, in the same manner as if the terminations of such branches in the hand were themselves directly irritated by some means. Therefore, generally, the effect of irritating the trunk of a nerve is the same as that of irritating the terminating fibers of a branch of such nerve. “When a branch only is irritated, the only muscles directly affected, and the only parts of the skin to which pain is referred will be those to which that branch sends nerve-fibers, and these effects will follow upon irritation of any portion of a nerve from its smallest branch up to the point of its trunk, at which point the anterior and posterior branches of root-fibres unite.

If only the anterior bundle of root-fibers be irritated, then the motive power only of the muscles to which that nerve sends fibers is lost, but no pain will be felt. Again, if the posterior ganglionated root-fibers be irritated intense pain will be referred to the part over which the nerve fibers are distributed, but none of the muscles receiving fibers from this nerve will be contracted.

Thus, the power of causing muscular contraction, which a spinal nerve possesses, is contained in the anterior root fibers; and the power of giving rise to sensation is contained in the fibers of the posterior roots. A sensory nerve is one, which, when active, carries an impulse to the central organ of the nervous system — the brain, and may be called afferent; and a motor nerve is one which carries an impulse away from the central organ, and is called efferent.


When a limb becomes paralyzed it is because the nerves supplying it has been subject to some irritation, as pressure, &c, sufficient to destroy the nervous continuity; that is, the physical continuity is not broken as a whole, but only that of the conductor of the nervous influence. Voluntary power over, and sensation in the limb is lost, and these powers are only restored as the nervous continuity and conductive power return. If the spinal cord be cut across in the middle of the back, (as when a man hurts himself by accident, the spinal cord is sometimes virtually cut into two), the legs and all the parts supplied by nerves which branch off from the cord below the section, will be paralyzed, that is, they will be rendered insensible, and no effort of the will can make them move; while all parts immediately above the section will retain their ordinary powers. If the connection with the Brain be entirely severed, no sensation will be produced on irritation of a part of the body below the section and supplied with sensory nerves from the cord, yet irritation, such as tickling of the feet, will produce convulsive movements of the legs. Thus, though the connection of the spinal cord with the brain is severed, yet the spinal cord possesses the power of giving rise to the excitement of efferent or motor nerves when an afferent or sensory nerve is irritated. The nervous influence which keeps up the tone of the blood vessels, which keeps them in the usual condition of normal contraction and dilation, proceeds from the spinal cord.

The human brain

Connected to the spinal cord by the medulla oblongata, which passes insensibly into, and in its lower part has the same structure as the cord, is the chief center of the nervous system, the Brain. Its comparative size is much greater in man than in any of the lower animals, its absolute size is greater than any save those of the elephant and whale. Its usual weight in the male is about 50 ounces, in the female 46 ounces. The medulla oblongata is about the same thickness as the spinal cord, at its junction with that center; above, however, it widens out, and its central canal spreading, becomes a wide cavity, this cavity, is called the fourth ventricle. Overhanging the fourth ventricle is a laminated mass, the cerebellum. On each side, this organ sends down several layers of transverse fibers, which sweep across the Brain and meet in the middle of its base, in such a manner as to form a kind of bridge, called the Pons Varolii, in front of the medulla oblongata. The fibers of the medulla oblongata, which run in a longitudinal manner, pass forwards, among, and between the layers of transverse fibers just mentioned, and become visible in the front of the bridge, as two broad and diverging bundles, these are called crura cerebri. Immediately above the crura cerebri lie four hemispherical elevations of nervous matter, called corpora quaarigemina, a narrow passage which leads from the fourth ventricle to the third ventricle passes between the four elevations and the crura cerebri, this third ventricle is a narrow cavity lodged between two great masses of nervous matter, called optic thalami, into which the crura cerebri pass. Connected with the membrane of the roof of the third ventricle is a small body of unknown functions. The floor of this ventricle also ends in another anomalous organ. The third ventricle is closed in front by a layer of nervous matter; beyond this, on each side, there is a small opening in the boundary wall leading into what is called the lateral ventricle, which occupies the center of the cerebral hemisphere. Each hemisphere is enlarged backward, forwards, and downwards into as many lobes; and the lateral ventricle presents corresponding prolongations.

The Corpus striatum is a striated mass of nervous matter forming the floor of the lateral ventricle. The Hemispheres, from their size, overlap all other parts of the brain, and, in fact, in the upper view entirely hide them. They are, inferiorly, joined by a mass of transverse fibers, but their applied faces are separated by a deep narrow depression. The external surfaces of the hemispheres are marked out by numerous deep fissures into convolutions. The arrangement of the white and grey matter in the medulla oblongata is similar to that of the spinal cord; the white matter being external, the grey internal. In the optic thalami and corpora, striata the matters are intermixed. In the cerebral hemispheres and the cerebellum, the white matter is internal and the grey matter external.

Nerves in the head

Twelve pairs of nerves are given off from the underside of the Brain. The following are their names and functions: The first pair is the Olfactory nerves, which are composed of pale flat fibers, and are distributed over the Olfactory mucous membrane, and are the nerves of smell. The second pair is the optic nerves, which pass into the eye near the inner or nasal side of the ball, when its fibers radiate upon the retina and constitute the nerves of sight. The third, fourth, and sixth pairs are distributed over the muscles of the eye and are the motor nerves of the eye-ball. Each nerve of the fifth pair is large and compound, resembling the spinal nerves. It has two roots, a sensory, having a ganglion of nerve matter, and a motor root. It supplies the skin of the face and the muscles of the jaws, and is called trigeminal because it has three divisions, one branch, the gustatory, supplies the front of the tongue. The seventh pair, called facial nerves, supply the muscles of the face with motor nerves. The eighth pair pass through the bone of the skull, and are distributed over the membranes of the ear, hence they are called auditory nerves. The ninth pair, the glossopharyngeal nerves, supply the back of the tongue, thus being nerves of taste, they are also distributed over the upper portion of the throat, supplying this portion with motor nerves. The tenth pair is the pneumogastric nerves. This pair is the most widely distributed of any of the cranial nerves; it arises from the medulla oblongata, and is mainly the sensory nerve supplying the organs of voice, the lungs, the liver, and the stomach, branches are also connected with the heart. The eleventh pair, or spinal accessory, arise from the spinal cord, between the roots of the spinal nerves, and are motor nerves, supplying some of the muscles of the neck. The last pair, the twelfth, are motor nerves and are distributed over the muscles of the tongue.

The medulla oblongata is an extremely important part of the cerebrospinal system. First, it may, like the spinal cord be regarded as a conductor of impressions; its modes of conduction may be considered similar to those of the cord. The decussation or crossing of part of the fibers of the anterior pyramids, or front part of the medulla, and there crossing into the lateral tract of the opposite side of the cord, make it probable that impressions proceeding from the brain, would, by traversing one pyramid, pass across to the opposite side of the spinal cord. Hence, if the nerve fibers of that part of the medulla oblongata which carries motor impulses from the brain, and situate at any point above the crossing of the fibers, be injured, paralysis of the part of the body and limbs, opposite the injured side, occurs. Secondly, as a nervous center, the functions of the medulla oblongata, are necessary to the maintenance of life, because from it issues the nervous force necessary for the performance of Respiration. Therefore, extensive injury to the medulla causes the respiratory movements to cease, and, in other cases, if the roots of the pneumogastric nerve be irritated, death supervenes by a stoppage of the heart’s action. Respiration and life may continue, though the upper part of the brain be removed if the medulla is uninjured and in connection with the respiratory nerves; but there will be no appearance of sensation or will. The movements are involuntary and unfelt: therefore the medulla has no claim upon our attention as a seat of sensation, or an organ of the mind.

The cerebellum appears to be the organ for combining the actions of the muscles; for if the cerebellum be diseased or cut away, a want of harmony in the motion is the result.

It is the regulator of motion: the loss of regular motion appears to be in direct proportion to the loss of the cerebellum. Every severe wound of this part of the brain totally prevents progression and generally developed a re-progressive action. A duck from which a portion of the cerebellum had been removed, could only swim backward and made no progressive action for eight days. When the cerebellum is entirely removed, the power of regular movements is entirely lost, although the senses of sight and hearing, and the will to act remain. The cerebellum seems to have the direction of such instinctive and habitual movements as do not require the exercise of deliberation, judgment, memory, or any other intellectual act. A soldier, for instance, who has acquired, by constant practice, the habit of immediately putting himself in the attitude of ” attention ” on hearing the word of command, will do so, in time, as soon as he hears the sound of the word, whether he be thinking of it or not, it has become so thoroughly embodied in the man’s nervous structure.

These organs of the Brain, constituting its lower part, are the cerebral or sensory ganglia, and there is every reason to believe that they constitute the real sensorium.

The active part of the cerebrum may be said to consist, to a very large extent, of the grey matter which is spread over its surface as a film; and is deeply folded upon itself, forming what are called convolutions, thus giving it a much more extensive surface, and lies immediately under the skull-cap. The cerebrum appears to be the part through which those phenomena termed intelligence and will, become manifest; in fact, it may be regarded as furnishing the mechanism of our thoughts; not that it does the whole work of thinking, but it furnishes the machine through which our thoughts work. It is not the steam engine that does the work, the steam engine is merely the instrument, through which the force, supplied by the heat under the boiler, becomes manifest in the work done; if we go back to the source of that heat, we find it originally in the light and heat of the sun by which the trees were made to grow, from which trees coal was produced ; it is known that if we place plants away from the sunshine and light they will not grow, it is the sun-light which enabled them to take in their food, therefore we may say that a portion of the heat of the sun is actually bottled up in the coal for our use. In the same manner, the brain serves as the mechanism of our thought.

The mind is not necessarily dependent on the brain for its existence, in the same manner as force is not dependent for its existence upon the instrument; but the mind is in-capable of external manifestations, or of knowledge of external things, except through the medium of the Brain and the nervous system connected therewith; the mind may remain unchanged in case of injury or disease of the Brain; but, its external manifestations, and all its acts performed in connection with the brain would be hindered or disturbed; aB, pro exampli, the work of a steam engine may be stopped by the breakage of a part of it, yet the force — heat — is not destroyed, though it cannot be manifested in the working of the machine. Again, the work of an artist may be stopped or spoiled through deficiency or badness of his implements of art. But when the engine is repaired and continuity regained, then, the force will become manifest. Thus when the instrument — the cerebrum — is injured by disease or otherwise, the mind becomes, as it were, paralyzed; it cannot operate and express itself, owing to a break in the continuity, when that continuity is restored, then, the mind shows itself by its operations, and we become conscious of what is going on around us.

Connected with this convoluted grey matter is a white mass of nerve fibers, which appear to act as conductors, establishing communication between the grey matter of the cerebrum and the organs composing the base of the brain —constituting the sensorium, and the changes which take place in the grey matter only rise to our consciousness-only call forth our conscious mental activity — when the effect of these changes is transmitted along these white fibres downwards to the sensoriuni.


  1. Tibbles (1859-1928) Erythroxylon coca : a treatise on brain exhaustion, as the cause of disease, 1877, Helmsley : W. Allenby ; Leeds : Joseph Dodgson ; Leicester