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Manual of Neuroanesthesia
Manual of Neuroanesthesia
The Essentials

Edited By
Hemanshu Prabhakar
Charu Mahajan
Indu Kapoor
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742

© 2017 by Taylor & Francis Group, LLC

CRC Press is an imprint of Taylor & Francis Group, an Informa business

No claim to original U.S. Government works

Printed on acid-free paper

International Standard Book Number-13: 978-1-4987-7170-2 (Hardback)

This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made
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Dedication

To our parents, teachers, and families, our “Pillars of Strength” – Pallavi Prabhakar, Atul Sharma, and
Deepak Kapoor, and ones who make our world complete, Anavi, Namyah, Amyra, Nyra, and Ansh
Table of Contents

Foreword xi
Preface xiii
Editors xv
Contributors xvii

Part I BASIC PRINCIPLES OF NEUROANESTHESIA 1

1 Anatomical considerations 3
Gyaninder P. Singh
2 Intracranial pressure 21
Vasudha Singhal
3 Cerebral perfusion pressure 31
Nicole Collins and Alaa Abd-Elsayed
4 Brain protection 39
Judith Dinsmore and Rebecca Campbell

Part II EXAMINING THE NEUROSURGICAL PATIENT 47

5 Preanesthetic evaluation 49
Srilata Moningi
6 Neurologic examination 61
Srilata Moningi

Part III MONITORING THE NEUROSURGICAL PATIENT 75

7 Electrocardiography 77
Bhavna Hooda
8 Oxygenation 85
Matthew J. Hammer and Laura B. Hemmer
9 End-tidal carbon dioxide 91
Ryan J. Vealey and Laura B. Hemmer
10 Arterial blood pressure 99
Nidhi Gupta
11 Central venous pressure 107
Nidhi Gupta

vii
viii Table of Contents

12 Neuromonitoring 115
Elizabeth A. M. Frost
13 Hemodynamic variations 123
Charu Mahajan
14 Temperature 129
Kavitha Jayaram
15 Urine output 137
Kavitha Jayaram

Part IV ANAESTHESIA FOR THE NEUROSURGICAL PATIENT 145

16 Difficult airway 147

Ankur Luthra
17 Venous cannulation 155
Ankur Luthra
18 Brain relaxation 159
Ravi K. Grandhi, Samuel Y. Lee, and Alaa Abd-Elsayed
19 Anesthetic agents: Intravenous 165
Indu Kapoor
20 Anesthetic agents: Inhalational 173
Indu Kapoor
21 Neuromuscular blockade and opioids 181
Prasanna U. Bidkar and Narmadha Lakshmi K
22 Perioperative steroids 193
M. V. S. Satya Prakash
23 Emergence from anesthesia 203
Sonia Kapil and Hemant Bhagat

Part V POSITIONING THE NEUROSURGICAL PATIENT 215

24 Positioning of patients 217

Stefan Jankowski and Jake Drinkwater

Part VI FLUID MANAGEMENT OF THE NEUROSURGICAL PATIENT 233

25 Perioperative fluids 235

Peter Farling and Katie Megaw
26 Hyperosmolar therapy 245
Hemanshu Prabhakar
27 Blood loss and blood transfusion 247
Bhavna Hooda

Part VII CASE-SPECIFIC MANAGEMENT 265

a Aqueductal stenosis 267

Samuel Y. Lee and Alaa Abd-Elsayed
b Arnold–Chiari malformation 269
Samuel Y. Lee and Alaa Abd-Elsayed
 Table of Contents ix

c Awake craniotomy 271

Filiz Uzumcugil and Altan Sahin
d Brachial plexus injury 273
Filiz Uzumcugil and Altan Sahin
e Brain abscess 275
Indu Kapoor
f Carotid angioplasty 277
Indu Kapoor
g Cerebellopontine angle tumor 279
Judith Dinsmore
h Cerebral aneurysm 281
Charu Mahajan
i Cerebral arteriovenous malformation 283
Jamie Uejima and Laura B. Hemmer
j Cervical spine surgery 285
Jamie Uejima and Laura B. Hemmer
k Craniosynostosis 287
Indu Kapoor
l Epilepsy surgery 289
Indu Kapoor
m Extradural hematoma 291
Indu Kapoor
n Lumbar meningomyelocele 293
Indu Kapoor
o Moyamoya disease 295
Helena Oechsner
p Neuroendoscopy 297
Helena Oechsner
q Occipital encephalocele 299
Charu Mahajan
r Pituitary surgery 301
John Andrzejowski
s Posterior fossa tumor 303
Prasanna U. Bidkar
t Status epilepticus 305
Sally H. Vitali
u Subdural hematoma 307
Indu Kapoor
v Supratentorial tumor 309
Indu Kapoor
w Ventriculoperitoneal shunt 311
Marc-Alain Babi and Salman Al Jerdi

Part VIII PERIOPERATIVE COMPLICATIONS IN NEUROSURGICAL PATIENTS 313

28 Venous air embolism 315

Filiz Uzumcugil and Altan Sahin
29 Postoperative pain 323
Zulfiqar Ali, Majid Jehangir, and Hemanshu Prabhakar
x Table of Contents

30 Postoperative nausea and vomiting 335

Kiran Jangra and Vinod K Grover
31 Postoperative respiratory complications 345
Zulfiqar Ali, Yasir N. Shah, and Hemanshu Prabhakar
32 Postoperative blindness 355
Kiran Jangra and Vinod K Grover

Part IX BASICS OF NEURORADIOLOGY 365

33 Understanding neuroradiology 367

S. Leve Joseph Devarajan

Part X BASICS OF NEUROINTENSIVE CARE 383

34 Basic principles of neurointensive care 385

Swagata Tripathy

Part XI SPECIAL CONSIDERATIONS 393

35 Pregnancy 395
Vasudha Singhal
36 Pediatrics 403
Farzana Afroze, Helena Oechsner, and Melissa Ehlers
37 Geriatrics 421
M. V. S. Satya Prakash
38 Traumatic brain injury 429
Shobha Purohit and Radhika Dua
39 Myasthenia gravis 441
Prasanna U. Bidkar and Narmadha Lakshmi K.
40 Guillain–Barré syndrome 449
Prasanna U. Bidkar
41 Status epilepticus 457
Sally H. Vitali
42 Stroke 465
Shaheen Shaikh
43 Cerebral venous sinus thrombosis 471
Marc-Alain Babi and Michael L. James
44 Brain stem death 481
John Andrzejowski and Andrew Davidson

Appendix: Scales and scores 487

Sujoy Banik

Index 491
Foreword
It is a pleasure to contribute the foreword to
Manual of Neuroanesthesia: The Essentials, an
excellent book, brilliantly conceived and edited
for rapid reference by the “occasional neuroanes-
thetist.” Most of the currently available books on
neuroanesthesia have been written primarily for
“dedicated neuroanesthetists”; they can be quite
overwhelming for residents, trainees, or private
practitioners in general anesthesia practice, who
have not been formally trained in neuroanesthe-
sia but often need to manage patients with primary
or concomitant neurosurgical/neurological disor-
ders. This book addresses this gap. It has concise
yet comprehensive “hands-on” information about
the anesthetic management of these patients; Parts
VII and XI are highly recommended. Additional
chapters on basic principles of neuroanesthesia,
neuroradiology, neurology, and critical care skill-
fully supplement this practical information and
also make it a useful resource book for novice neu-
roanesthetists. Contributors to this book span the
globe and are experts in their areas of clinical cov-
erage. The language is simple and lucid; the chap-
ters are short and easy to read. This book certainly
occupies a niche among books on neuroanesthesia.
Monica S. Tandon
xi
Preface
Manual of Neuroanesthesia: The Essentials covers
all important aspects of neuroanesthesia and pro-
vides an overview of the subject.
This book is mainly targeted to “occasional neu-
roanesthesiologists,” anesthesiologists who have
not received any formal training in “neuroanesthe-
sia” but occasionally provide anesthesia for patients
related to various disciplines in neurosciences.
This book gives basic details of neuroanesthesia
and how management of different neurosurgical
cases may differ. Simple issues such as neurologi-
cal examination of patients and understanding CT
and MRI scans along with anesthetic management
are discussed in simple language, which would
make this book a ready reckoner.
This book will also be useful for any medical
practitioner associated with neurosurgical and
allied branches such as neurology and neuroradiol-
ogy. It will provide a quick and easy guide to under-
standing neuroanesthesia. It also provides insight
into all possible aspects of anesthetic management
of neurosurgical and commonly encountered neu-
rological patients. It includes chapters related to
allied specialities such as critical care, neurology,
and neuroradiology.
The authors have done an excellent job writing
chapters in the simplest manner for the targeted
audience. In view of keeping the interest of read-
ers, the authors have provided information on the
discussed topic in the form of figures, elaborate
tables, and boxes. We hope that this will engage
them and help them to form their own differential
diagnosis and plan a suitable anesthetic protocol
for each situation. We also hope that patients will
benefit from our readers’ knowledge gained from
this book. The editors are grateful to all the con-
tributors who have made this work possible in a
wonderful way.
Indu Kapoor
Charu Mahajan
Hemanshu Prabhakar
xiii
Editors
Hemanshu Prabhakar is a Professor in the
Department of Neuroanaesthesiology and Critical
Care at the All India Institute of Medical Sciences
(AIIMS), New Delhi, India. He received his train-
ing in neuroanesthesia and completed his PhD at
the same institute. He is a recipient of the AIIMS
Excellence Award for notable contribution in aca-
demics and has more than 200 publications in
national and international journals. Dr. Prabhakar
is a reviewer for various national and international
journals. He is also a review author for the
Cochrane Collaboration and has a special interest
in the evidence-based practice of neuroanesthesia.
Dr. Prabhakar is a member of various national and
international neuroanesthesia societies and is past
secretary of the Indian Society of Neuroanesthesia
and Critical Care. He has been an invited faculty
for various national and international conferences.
He is on the editorial board of the Indian Journal
of Palliative Care and is the executive editor of the
Journal of Neuroanaesthesiology and Critical Care.
Charu Mahajan is an Assistant Professor in the
Department of Neuroanaesthesiology and Critical
Care at the All India Institute of Medical Sciences
(AIIMS), New Delhi, India. After completing
her MD in anaesthesia, she did her DM neuro-
anaesthesia course at AIIMS and later joined the
faculty in the parent department. She has over
60 publications in recognized national and inter-
national journals. She is a review author for the
Cochrane Collaboration, and has authored chap-
ters in various national and international books.
She has received numerous awards for scientific
paper presentations. Dr. Mahaja is a member
of national and international societies and is a
reviewer for various journals.
Indu Kapoor is an Assistant Professor in Neuro-
anesthesiology and Critical Care at the All India
Institute of Medical Sciences (AIIMS), New Delhi,
India. She received her training in neuroanesthesia
at the same institute. She is the recipient of Dr. T N
Jha Memorial Award awarded by the Indian Society
of Anaesthesiologists (ISA) on the state and national
level at Delhi and Chennai 2009. She has received
the Smt. Chandra and Sh. Narayan Wadhwani
Memorial Award for Best Outgoing Postgraduate
in Anesthesia in University College of Medical Sci-
ences, Delhi, in 2010. She has over 30 publications in
national and international journals. She is a reviewer
for national journals and is also a review author for
the Cochrane Collaboration. Dr. Kapoor has special
interest in the evidence-based practice of neuroan-
esthesia and is a member of various national soci-
eties. She is an invited faculty for various national
conferences and has contributed chapters to various
national and international books.
xv
Contributors

Farzana Afroze Nicole Collins

Albany Medical Center University of Wisconsin School of Medicine
Albany, New York and Public Health
Alaa Abd-Elsayed Madison, Wisconsin
Department of Anesthesiology Andrew Davidson
University of Wisconsin School of Medicine Royal Hallamshire Hospital
and Public Health Sheffield, UK
Madison, Wisconsin S. Leve Joseph Devarajan
Zulfiqar Ali AIIMS
SKIMS New Delhi, India
Srinagar, Jammu and Kashmir, India Judith Dinsmore
John Andrzejowski St Georges Healthcare Trust
Royal Hallamshire Hospital and London, UK
Sheffield Teaching Hospitals Jake Drinkwater
NHS Trust Royal Hallamshire Hospital
Sheffield, UK Sheffield, UK
Salman Al Jerdi Radhika Dua
University of Iowa SMS Medical College
Burlington, Vermont Jaipur, India
Marc-Alain Babi Melissa Ehlers
Duke University Albany Medical Center
Durham, North Carolina Albany, New York
Sujoy Banik Peter Farling
Medanta - The Medicity Royal Victoria Hospital
Gurugram, India Belfast, Ireland, UK
Hemant Bhagat Elizabeth A. M. Frost
Postgraduate Institute of Medical Education Mount Sinai Medical Center, New York
and Research New York, New York
Chandigarh, India Ravi K. Grandhi
Prasanna U. Bidkar College of Medicine, University of Cincinnati
JIPMER Cincinnati, Ohio
Pondicherry, India Vinod K. Grover
Rebecca Campbell Postgraduate Institute of Medical Education
St Georges Healthcare Trust and Research
London, UK Chandigarh, India

xvii
xviii Contributors

Nidhi Gupta Helena Oechsner

Indraprastha Apollo Hospitals Albany Medical Center
New Delhi, India Albany, New York
Matthew J. Hammer Hemanshu Prabhakar
Northwestern University AIIMS
Chicago, Illinois New Delhi, India
Laura B. Hemmer M. V. S. Satya Prakash
Northwestern University JIPMER
Chicago, Illinois Pondicherry, India
Bhavna Hooda Shobha Purohit
Base Hospital SMS Medical College
New Delhi, India Jaipur, India
Michael L James Yasir N. Shah
Duke University SKIMS
Durham, North Carolina Srinagar, India
Kiran Jangra Altan Sahin
Postgraduate Institute of Medical Education Hacettepe University School of Medicine
and Research Turkey
Chandigarh, India Shaheen Shaikh
Stefan Jankowski UMass Memorial Hospital
Royal Hallamshire Hospital Worcester, Massachusetts
Sheffield, UK Gyaninder P. Singh
Kavitha Jayaram AIIMS
Nizam’s Institute of Medical Sciences New Delhi, India
Hyderabad, India Vasudha Singhal
Majid Jehangir Medanta—The Medicity
SKIMS Gurugram, India
Srinagar, Jammu and Kashmir, India Srilata Moningi
Sonia Kapil Nizam’s Institute of Medical Sciences
Postgraduate Institute of Medical Education Hyderabad, India
and Research Swagata Tripathy
Chandigarh, India AIIMS, Bhubaneswar
Ankur Luthra India
Postgraduate Institute of Medical Education Jamie Uejima
and Research Northwestern University
Chandigarh, India Chicago, Illinois
Katie Megaw Filiz Uzumcugil
Royal Victoria Hospital Hacettepe University School of Medicine
Belfast, Ireland, UK Turkey
Narmadha Lakshmi K. Ryan J. Vealey
JIPMER Northwestern University
Pondicherry, India Chicago, Illinois
Samuel Y. Lee Sally H. Vitali
Cleveland Clinic Boston Children’s Hospital
USA Boston, Massachusetts
 I
Part    

Basic principles of
neuroanesthesia

1 Anatomical considerations 3
Gyaninder P. Singh
2 Intracranial pressure 21
Vasudha Singhal
3 Cerebral perfusion pressure 31
Nicole Collins and Alaa Abd-Elsayed
4 Brain protection 39
Judith Dinsmore and Rebecca Campbell

Anatomical considerations
GYANINDER P SINGH
Introduction
Central nervous system
Brain
Spinal cord
Peripheral nervous system
Introduction
The nervous system in humans can be divided into
two main parts, the central nervous system and the
peripheral nervous system. The brain and spinal
cord form the main divisions of the central ner-
vous system (CNS). The cranial and spinal nerves
along with their ganglia comprise the peripheral
nervous system (Table 1.1). The organization of
nervous system is shown in the flow chart.
Central nervous system
Brain
The skull houses the brain and is composed of
28 bones that are mostly paired, but those situated
in the midline are unpaired. Internally, the skull
cavity is divided into the anterior, middle, and
posterior cranial fossa. Vessels and nerves pass
in and out of the skull through various foramina
(Table 1.2).
The CNS develops from a hollow cylindrical
tube called the neural tube. During embryogen-
esis, the developing brain (i.e., anterior part of the
neural tube) is seen to be divided into five con-
tinuous parts (telencephalon, diencephalon, mes-
encephalon, metencephalon, and myelencephalon)
1
3 Cranial nerves 14
3 Spinal nerves 14
3 Cerebrospinal fluid 18
10 References 18
14
from anterior to posterior. As the developing brain
enlarges, some regions overgrow the other areas.
Thus, some areas get submerged (hidden from the
surface) as the brain grows and folds over itself.1
The cavity of the neural tube is retained as ven-
tricles in the brain and central canal in the spinal
cord, which forms a continuous channel filled with
cerebrospinal fluid (CSF) (Figure 1.1).
Gross anatomy of the brain
The brain is enclosed in a bony cranial cavity and is
surrounded by three layers of meninges: the outer
dura mater, the middle arachnoid mater, and the
innermost pia mater. The brain is divided into the
forebrain, midbrain, and hindbrain2 (Figure 1.2).
Forebrain
This is divided into the diencephalon (central part)
and the telencephalon or cerebrum. Hidden from the
surface of the brain, the diencephalon consists of a
dorsal thalamus and a ventral hypothalamus, and the
subthalamus and epithalamus as its other divisions.
The thalamus is an important station for all sensory
systems except the olfactory pathway. The subthala-
mus consists of the cranial part of red nucleus and
the substantia nigra. The epithalamus consists of the
habenular nuclei and the pineal gland. The habenular
nucleus is the center for integration of the olfactory,
3
4 Anatomical considerations

Organization of nervous system

Nervous system

Central nervous system Peripheral nervous system

(brain & spinal cord) (cranial & spinal nerves)

Somatic nervous Autonomic

Brain Spinal cord
system nervous system

Sympathetic
Forebrain Midbrain Hindbrain
nervous system

Parasympathetic
Cerebral cortex Cerebellum
nervous system

Basal ganglia Pons

Limbic system Medulla

Thalamus
hypothalamus

Table 1.1 Division of Nervous System and Cavities of the Brain and Spinal Cord
Central nervous system
a. Brain Cavities
Forebrain (or prosencephalon)
  Telencephalon Right and left lateral ventricles
    Cerebral cortex, basal ganglia, limbic system
  Diencephalon Third ventricle
   Thalamus, hypothalamus
Midbrain (or mesencephalon) Cerebral aqueduct
Hindbrain (or rhombencephalon) Fourth ventricle
  Metencephalon
   Pons
   Cerebellum
  Myelencephalon
   Medulla oblongata
(Continued)
 Central nervous system 5

b. Spinal cord Central canal

Cervical segments
Thoracic segments
  Lumbar segments
  Coccygeal segments
Peripheral nervous system
a. Cranial nerves and their ganglia (12 pairs)
   12 cranial (I–XII) nerves
b. Spinal nerves and their ganglia (31 pairs)
  08 cervical
  12 thoracic
  05 lumbar
  05 sacral
  01 coccygeal

Table 1.2 Foramina of Skull and Structure Passing through Them

Cranial fossae Foramina Structures passing
(bones forming)
Anterior cranial Cribriform plate of Olfactory nerve filaments
fossa ethmoid Anterior ethmoidal nerves and vessels
(frontal, ethmoid, Foramen cecum Emissary vein
sphenoid: body Anterior ethmoidal canal Anterior ethmoidal nerve and vessels
and lesser wing) Posterior ethmoidal canal Posterior ethmoidal nerves and vessels
Middle cranial fossa Optic canal Optic nerve surrounded by meninges
(parietal, temporal, Superior orbital fissure Ophthalmic artery nerves: oculomotor, trochlear,
sphenoid: body abducent, lacrimal, frontal, nasociliary nerve,
and greater wing) filaments from internal carotid artery,
sympathetic plexus
Vessels: orbital branch of middle meningeal artery,
recurrent branch of ophthalmic artery, superior
ophthalmic vein, inferior ophthalmic vein
Foramen rotundum Maxillary nerve
Foramen ovale Mandibular nerve
Accessory meningeal artery
Lesser petrosal nerve
Emissary vein
Foramen spinosum Meningeal branch of mandibular nerve
Middle meningeal vessels
Foramen lacerum Internal carotid artery
Greater petrosal nerve
Deep petrosal nerve
Nerve of pterygoid canal
Meningeal branch of ascending pharyngeal artery
Emissary vein
Petrosal or innominate Lesser petrosal nerve (if not through foramen
foramen (occasionally ovale)
present)
(Continued)
6 Anatomical considerations
Table 1.2 Foramina of Skull and Structure Passing through Them (Continued)
Cranial fossae Foramina
(bones forming)
Hiatus for greater
petrosal nerve
Hiatus for lesser petrosal
nerve
Posterior cranial Internal acoustic meatus
fossa
(occipital, temporal: Jugular foramen
petrous part)
Hypoglossal canal
Condylar canal
Mastoid foramen
Foramen magnum
visceral, and somatic afferent pathways. The pineal
gland does not contain nerve cells but adrenergic
sympathetic fibers derived from the superior cervi-
cal sympathetic ganglia. The hypothalamus controls
and integrates the functions of the autonomic ner-
vous system and the endocrine system and plays a
vital role in maintaining body homeostasis.2
The cerebrum forms the largest part of the
brain and is grossly divided into four lobes: fron-
tal, parietal, temporal, and occipital by the midline
interhemispheric fissure, the central sulcus, and the
lateral Sylvian fissures (Figure 1.3). It consists of two
hemispheres connected by corpus callosum which
is a mass of white matter. The hemispheres contain
numerous sulci (fissures) and gyri (folds). The cavity
present in cerebral hemispheres is the lateral ven-
tricle, which communicates with the third ventricle
Structures passing
Greater petrosal nerve
Petrosal branch of middle meningeal artery
Lesser petrosal nerve
Facial nerve
Vestibulocochlear nerve
Labyrinthine artery
Glossopharyngeal nerve
Vagus nerve
Accessory nerve Inferior petrosal sinus
Internal jugular vein
Meningeal branch of occipital artery
Hypoglossal nerve and it srecurrent meningeal
branch
Meningeal branch of ascending pharyngeal artery
Emissary vein
Meningeal branch of occipital artery
Emissary vein
Meningeal branch of occipital artery
Emissary vein
Apical ligament of dens
Tentorial membrane
Medulla oblongata and meninges
Lower end of cerebellar tonsils
Spinal part of accessory nerve
Meningeal branches of upper cervical nerves
Vertebral arteries
Anterior spinal artery
Posterior spinal arteries
through the interventricular foramen (foramen
of Monro). The two hemispheres are separated by
the longitudinal fissure into which projects the falx
cerebri. Within the hemispheres is a large mass of
gray matter, the basal ganglia. The corona radiata
is a collection of nerve fibers that pass to and from
the cerebral cortex to the brain stem. The internal
capsule is a part of the corona radiata that converges
to pass between the basal ganglia.2
Midbrain
This connects the forebrain to the hindbrain
and measures about 2 cm. It contains the cav-
ity known as the cerebral aqueduct (aqueduct of
Sylvius). The aqueduct connects the third and
fourth ventricles.
 Central nervous system 7

Lateral ventricles
(right & left) Telencephalon
Forebrain
Third ventricle Diencephalon

Cerebral aqueduct Midbrain

(aqueduct of Sylvius)
Fourth ventricle Hindbrain

Central canal
Spinal cord

(a)

Cavities of CNS Divisions of CNS

Telencephalon
Lateral ventricles Forebrain
Third ventricle Diencephalon

Cerebral aqueduct Mesencephalon Midbrain

Cerebellum
Fourth ventricle Metencephalon
Pons Hindbrain
Medulla Myelencephalon
Central canal
Spinal cord

(b)

Figure 1.1 Longitudinal section of the brain and spinal cord showing cavities of different parts of the
central nervous system (CNS). (a) Neural tube with various bulging or vesicles. (b) Vesicles of the brain
forming different parts of the brain and spinal cord with their respective cavities.

Cerebrum
Forebrain Thalamus
Hypothalamus

Cerebellum
Pons Hindbrain
Midbrain Medulla

Figure 1.2 Division of the brain into forebrain, midbrain, and hindbrain.
8 Anatomical considerations
Central sulcus
Frontal lobe
Sylvian fissure or
lateral sulcus
Temporal lobe
Brain stem
Figure 1.3 Lobes of the cerebrum (frontal, parietal, temporal, and occipital lobes) and the sulci divid-
ing these lobes.
Hindbrain
This comprises the medulla oblongata, pons, and cer-
ebellum. Both the medulla oblongata and the pons
contain various nuclei and ascending and descend-
ing nerve tracts. Lying within the posterior fossa, the
two cerebellar hemispheres are united by a vermis
and connected to the midbrain, pons, and medulla
oblongata through the superior, middle, and inferior
cerebellar peduncles. The cerebellum unconsciously
controls the smooth contraction of voluntary mus-
cles and coordinates their actions, together with the
relaxation of their antagonists.3 The cavity of the
hindbrain is called the fourth ventricle.
Brain stem
This comprises the medulla oblongata, pons, and
midbrain and connects the spinal cord with the
forebrain. The brainstem occupies the posterior
cranial fossa and has important vital centers such
as respiratory, cardiovascular, and center for con-
sciousness. It also contains the nuclei for cranial
nerves III through XII. It serves as a conduit for
the ascending and the descending tracts connect-
ing the spinal cord to the higher centers in the
forebrain.
Arterial supply of the brain
The brain is supplied by the right and left inter-
nal carotid arteries (branches of common carotid
artery) and the right and left vertebral arteries
(branches of subclavian artery). The four arteries
lie in the subarachnoid space in the cranial cavity.2
The internal carotid artery perforates the base of
skull through the carotid canal and enters the cra-
nial cavity through the foramen lacerum. It then
runs through the cavernous sinus (S-shaped course)
and perforates the dura mater and arachnoid mater
to lie in the subarachnoid space and reach the lateral
Parietal lobe
Parietooccipital sulcus
Occipital lobe
Preoccipital notch
Cerebellum
cerebral sulcus (Sylvian sulcus) where it ends by
dividing into anterior and middle cerebral arteries.
The vertebral artery ascends through the foramen
transversarium of the upper six cervical vertebrae
and enters the skull through the foramen magnum.
It pierces the dura mater and arachnoid mater to
enter the subarachnoid space. The right and left ver-
tebral arteries join at the lower border of the pons to
form the basilar artery, which ascends on the ven-
tral surface of the pons and divides into the right
and left posterior cerebral artery at the upper border
of the pons. The internal carotid and the vertebro-
basilar systems anastomose in the interpeduncular
fossa at the base of the brain forming the circle of
Willis or circulus arteriosus2 (Figure 1.4).
Arterial supply of the cerebral cortex
The cerebral cortex is supplied by the anterior,
middle, and posterior cerebral arteries (Figure
1.5). The anterior, middle, and posterior cerebral
arteries give rise to cortical and central branches.
The cortical branches supply the cortex while the
central or perforating branches penetrate deep into
the substance of the cerebral hemisphere to sup-
ply deeper structures (such as the internal capsule,
thalamus, hypothalamus, caudate nucleus, puta-
men, and globus pallidus). The cortical arteries
give rise to branches that run perpendicularly into
the substance of cerebral cortex. These are terminal
or end arteries and do not anastomose with neigh-
boring arteries. Blockage of these branches leads to
necrosis of brain tissue supplied by that branch.4
Arterial supply of the brain stem
The medulla is supplied by the branches of verte-
bral arteries, namely anterior and posterior spinal
arteries, posterior inferior cerebellar artery, and
direct branches to medulla.
 Central nervous system 9

Arteries and their branches supplying the brain

Artery Branches
Internal carotid Ophthalmic artery
arteries Posterior communicating artery
Anterior choroidal artery
Anterior cerebral artery
Middle cerebral artery
Vertebral artery Posterior inferior cerebellar artery
Medullar arteries
Posterior spinal artery
Anterior spinal artery
Meningeal artery
Basilar artery Posterior cerebral artery
Superior cerebellar artery
Pontine arteries
Labyrinthine arteries
Anterior inferior cerebellar artery

Arteries contributing to the formation of the circle of Willis

●● Anterior communicating artery

●● Right and left anterior cerebral arteries
●● Right and left internal carotid arteries
●● Right and left posterior communicating arteries
●● Right and left posterior cerebral arteries

Anterior communicating artery

Anterior cerebral artery
Internal carotid artery
Ophthalmic artery
Anterior
circulation Middle cerebral artery
(ICA)
Circle of
Willis Posterior communicating artery

Posterior cerebral artery

Superior cerebellar artery
Posterior Basilar artery
circulation Pontine arteries
(VA)
Anterior inferior cerebellar artery
Vertebral arteries
Posterior inferior cerebellar artery
Anterior spinal artery

Figure 1.4 Arteries supplying the brain (note the formation of Circle of Willis). ICA, internal carotid
artery; VA, vertebral artery.
10 Anatomical considerations
(a)
(b)
Figure 1.5 Arteries supplying the cerebral hemispheres: (a) superolateral surface, (b) medial surface,
and (c) inferior surface.
The pons is supplied by the branches of the basilar
artery, namely the anterior inferior cerebellar and
superior cerebellar arteries and the pontine arteries.
The midbrain is mainly supplied by the branches
of the basilar artery, namely the posterior cerebral
arteries, superior cerebellar arteries, and direct
branches from the basilar artery. It also receives
branches from posterior communicating arteries.
Arterial supply of the cerebellum
The cerebellum is supplied by superior cerebellar
and anterior inferior cerebellar arteries (branches
of the basilar artery) and posterior inferior cerebel-
lar arteries (branch of the vertebral artery).
Venous drainage of the brain
Veins draining the cerebral hemisphere consist of
superficial and deep veins. Superficial veins drain the
cerebral cortex and end in the neighboring venous
sinuses, which are superior cerebral veins, inferior
cerebral veins, and superficial middle cerebral veins.
Deep veins drain the deeper structures (such as the
thalamus, hypothalamus, caudate nucleus, puta-
men, internal capsule, corpus callosum, and choroid
plexus) and join to form two internal cerebral veins
and two basal veins. These veins drain into the great
cerebral vein (great vein of Galen) that ends in the
straight sinus. The cerebellum is drained by the supe-
rior and inferior cerebellar veins into the straight sinus
and other neighboring venous sinuses.1 The veins
from the brain stem drain into the adjoining venous
sinuses and inferiorly the veins from the medulla are
continuous with the veins of the spinal cord.
Anterior cerebral artery
Middle cerebral artery
Posterior cerebral artery
(c)
All the veins draining the brain ultimately open
into the various dural sinuses (i.e., superior sagit-
tal, inferior sagittal, straight, cavernous, sphenopa-
rietal, petrosal, occipital, transverse, and sigmoid
sinuses). Blood from all these sinuses reaches the
sigmoid sinus that ultimately drains into the inter-
nal jugular vein (Figure 1.6).
Nerve supply to the brain
The brain receives sensory stimuli and sends motor
impulses to different parts of the body but is devoid
of any sensation. However, the dura mater cover-
ing the brain and spinal cord possesses numerous
sensory endings that are sensitive to stretching. The
branches from the trigeminal, vagus, and the first
three cervical spinal nerves and the branches from
the cervical sympathetic trunk supply the dura cov-
ering the brain. Stimulation of the sensory endings
in the dura produces referred pain to an area of
skin supplied by these nerves, for example, from the
supratentorial region, pain is referred to the skin of
the head and face supplied by the trigeminal nerve
and from the infratentorial region to the back of the
neck and scalp (distribution of C2,C3).
The sympathetic fibers pass along the arteries
forming the plexus over these vessels. These are
postganglionic sympathetic fibers and stimula-
tion of these causes vasoconstriction of the arteries
supplying the brain.5
Spinal cord
The spinal cord is enclosed within a vertebral
column that consists of 33 vertebrae: 7 cervical,
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Title: Biological analogies in history

Author: Theodore Roosevelt

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*** START OF THE PROJECT GUTENBERG EBOOK BIOLOGICAL

ANALOGIES IN HISTORY ***
 THE ROMANES LECTURE
1910

BIOLOGICAL ANALOGIES
IN HISTORY
BY
THEODORE ROOSEVELT

DELIVERED
BEFORE THE UNIVERSITY OF OXFORD
JUNE 7TH, 1910

OXFORD UNIVERSITY PRESS

AMERICAN BRANCH
35 WEST 32d STREET, NEW YORK

LONDON: HENRY FROWDE

1910
 Copyright, 1910, by
Oxford University Press
American Branch
 BIOLOGICAL ANALOGIES
IN HISTORY
An American who, in response to such an invitation as I have
received, speaks in this university of ancient renown, cannot but feel
with peculiar vividness the interest and charm of his surroundings,
fraught as they are with a thousand associations. Your great
universities, and all the memories that make them great, are living
realities in the minds of scores of thousands of men who have never
seen them and who dwell across the seas in other lands. Moreover,
these associations are no stronger in the men of English stock than
in those who are not. My people have been for eight generations in
America; but in one thing I am like the Americans of to-morrow,
rather than like many of the Americans of to-day; for I have in my
veins the blood of men who came from many different European
races. The ethnic make-up of our people is slowly changing so that
constantly the race tends to become more and more akin to that of
those Americans who like myself are of the old stock but not mainly
of English stock. Yet I think that, as time goes by, mutual respect,
understanding, and sympathy among the English-speaking peoples
grow greater and not less. Any of my ancestors, Holland or
Huguenot, Scotchman or Irishman, who had come to Oxford in ‘the
spacious days of great Elizabeth,’ would have felt far more alien than
I, their descendant, now feel. Common heirship in the things of the
spirit makes a closer bond than common heirship in the things of the
body.
More than ever before in the world’s history we of to-day seek to
penetrate the causes of the mysteries that surround not only
mankind but all life, both in the present and the past. We search, we
peer, we see things dimly; here and there we get a ray of clear
vision, as we look before and after. We study the tremendous
procession of the ages, from the immemorial past when in ‘cramp elf
and saurian forms’ the creative forces ‘swathed their too-much
power,’ down to the yesterday, a few score thousand years distant
only, when the history of man became the overwhelming fact in the
history of life on this planet; and studying, we see strange analogies
in the phenomena of life and death, of birth, growth, and change,
between those physical groups of animal life which we designate as
species, forms, races, and the highly complex and composite entities
which rise before our minds when we speak of nations and
civilizations.
It is this study which has given science its present-day
prominence. In the world of intellect, doubtless, the most marked
features in the history of the past century have been the
extraordinary advances in scientific knowledge and investigation,
and in the position held by the men of science with reference to
those engaged in other pursuits. I am not now speaking of applied
science; of the science, for instance, which, having revolutionized
transportation on the earth and the water, is now on the brink of
carrying it into the air; of the science that finds its expression in such
extraordinary achievements as the telephone and the telegraph; of
the sciences which have so accelerated the velocity of movement in
social and industrial conditions—for the changes in the mechanical
appliances of ordinary life during the last three generations have
been greater than in all the preceding generations since history
dawned. I speak of the science which has no more direct bearing
upon the affairs of our everyday life than literature or music, painting
or sculpture, poetry or history. A hundred years ago the ordinary man
of cultivation had to know something of these last subjects; but the
probabilities were rather against his having any but the most
superficial scientific knowledge. At present all this has changed,
thanks to the interest taken in scientific discoveries, the large
circulation of scientific books, and the rapidity with which ideas
originating among students of the most advanced and abstruse
sciences become, at least partially, domiciled in the popular mind.
Another feature of the change, of the growth in the position of
science in the eyes of every one, and of the greatly increased
respect naturally resulting for scientific methods, has been a certain
tendency for scientific students to encroach on other fields. This is
particularly true of the field of historical study. Not only have scientific
men insisted upon the necessity of considering the history of man,
especially in its early stages, in connexion with what biology shows
to be the history of life, but furthermore there has arisen a demand
that history shall itself be treated as a science. Both positions are in
their essence right; but as regards each position the more arrogant
among the invaders of the new realm of knowledge take an attitude
to which it is not necessary to assent. As regards the latter of the two
positions, that which would treat history henceforth merely as one
branch of scientific study, we must of course cordially agree that
accuracy in recording facts and appreciation of their relative worth
and interrelationship are just as necessary in historical study as in
any other kind of study. The fact that a book, though interesting, is
untrue, of course removes it at once from the category of history,
however much it may still deserve to retain a place in the always
desirable group of volumes which deal with entertaining fiction. But
the converse also holds, at least to the extent of permitting us to
insist upon what would seem to be the elementary fact that a book
which is written to be read should be readable. This rather obvious
truth seems to have been forgotten by some of the more zealous
scientific historians, who apparently hold that the worth of a historical
book is directly in proportion to the impossibility of reading it, save as
a painful duty. Now I am willing that history shall be treated as a
branch of science, but only on condition that it also remains a branch
of literature; and, furthermore, I believe that as the field of science
encroaches on the field of literature there should be a corresponding
encroachment of literature upon science; and I hold that one of the
great needs, which can only be met by very able men whose culture
is broad enough to include literature as well as science, is the need
of books for scientific laymen. We need a literature of science which
shall be readable. So far from doing away with the school of great
historians, the school of Polybius and Tacitus, Gibbon and Macaulay,
we need merely that the future writers of history, without losing the
qualities which have made these men great, shall also utilize the
new facts and new methods which science has put at their disposal.
Dryness is not in itself a measure of value. No ‘scientific’ treatise
about St. Louis will displace Joinville, for the very reason that
Joinville’s place is in both history and literature; no minute study of
the Napoleonic wars will teach us more than Marbot—and Marbot is
as interesting as Walter Scott. Moreover, certain at least of the
branches of science should likewise be treated by masters in the art
of presentment, so that the layman interested in science, no less
than the layman interested in history, shall have on his shelves
classics which can be read. Whether this wish be or be not capable
of realization, it assuredly remains true that the great historian of the
future must essentially represent the ideal striven after by the great
historians of the past. The industrious collector of facts occupies an
honourable, but not an exalted, position, and the scientific historian
who produces books which are not literature must rest content with
the honour, substantial, but not of the highest type, that belongs to
him who gathers material which some time some great master shall
arise to use.
Yet, while freely conceding all that can be said of the masters of
literature, we must insist upon the historian of mankind working in
the scientific spirit, and using the treasure-houses of science. He
who would fully treat of man must know at least something of
biology, of the science that treats of living, breathing things; and
especially of that science of evolution which is inseparably
connected with the great name of Darwin. Of course there is no
exact parallelism between the birth, growth, and death of species in
the animal world, and the birth, growth, and death of societies in the
world of man. Yet there is a certain parallelism. There are strange
analogies; it may be that there are homologies.
How far the resemblances between the two sets of phenomena
are more than accidental, how far biology can be used as an aid in
the interpretation of human history, we cannot at present say. The
historian should never forget, what the highest type of scientific man
is always teaching us to remember, that willingness to admit
ignorance is a prime factor in developing wisdom out of knowledge.
Wisdom is advanced by research which enables us to add to
knowledge; and, moreover, the way for wisdom is made ready when
men who record facts of vast but unknown import, if asked to explain
their full significance, are willing frankly to answer that they do not
know. The research which enables us to add to the sum of complete
knowledge stands first; but second only stands the research which,
while enabling us clearly to pose the problem, also requires us to say
that with our present knowledge we can offer no complete solution.
Let me illustrate what I mean by an instance or two taken from one
of the most fascinating branches of world-history, the history of the
higher forms of life, of mammalian life, on this globe.
Geologists and astronomers are not agreed as to the length of
time necessary for the changes that have taken place. At any rate,
many hundreds of thousands of years, some millions of years, have
passed by since in the eocene, at the beginning of the tertiary
period, we find the traces of an abundant, varied, and highly
developed mammalian life on the land masses out of which have
grown the continents as we see them to-day. The ages swept by,
until, with the advent of man substantially in the physical shape in
which we now know him, we also find a mammalian fauna not
essentially different in kind, though widely differing in distribution,
from that of the present day. Throughout this immense period form
succeeds form, type succeeds type, in obedience to laws of
evolution, of progress and retrogression, of development and death,
which we as yet understand only in the most imperfect manner. As
knowledge increases our wisdom is often turned into foolishness,
and many of the phenomena of evolution, which seemed clearly
explicable to the learned master of science who founded these
lectures, to us nowadays seem far less satisfactorily explained. The
scientific men of most note now differ widely in their estimates of the
relative parts played in evolution by natural selection, by mutation, by
the inheritance of acquired characteristics; and we study their
writings with a growing impression that there are forces at work
which our blinded eyes wholly fail to apprehend; and where this is
the case the part of wisdom is to say that we believe we have such
and such partial explanations, but that we are not warranted in
saying that we have the whole explanation. In tracing the history of
the development of faunal life during this period, the age of
mammals, there are some facts which are clearly established, some
great and sweeping changes for which we can with certainty ascribe
reasons. There are other facts as to which we grope in the dark, and
vast changes, vast catastrophes, of which we can give no adequate
explanation.
Before illustrating these types, let us settle one or two matters of
terminology. In the changes, the development and extinction, of
species we must remember that such expressions as ‘a new
species,’ or as ‘a species becoming extinct,’ are each commonly and
indiscriminately used to express totally different and opposite
meanings. Of course the ‘new’ species is not new in the sense that
its ancestors appeared later on the globe’s surface than those of any
old species tottering to extinction. Phylogenetically, each animal now
living must necessarily trace its ancestral descent back through
countless generations, through aeons of time, to the early stages of
the appearance of life on the globe. All that we mean by a ‘new’
species is that from some cause, or set of causes, one of these
ancestral stems slowly or suddenly develops into a form unlike any
that has preceded it; so that while in one form of life the ancestral
type is continuously repeated and the old species continues to exist,
in another form of life there is a deviation from the ancestral type and
a new species appears.
Similarly, ‘extinction of species’ is a term which has two entirely
different meanings. The type may become extinct by dying out and
leaving no descendants. Or it may die out because, as the
generations go by, there is change, slow or swift, until a new form is
produced. Thus in one case the line of life comes to an end. In the
other case it changes into something different. The huge titanothere,
and the small three-toed horse, both existed at what may roughly be
called the same period of the world’s history, back in the middle of
the mammalian age. Both are extinct in the sense that each has
completely disappeared and that nothing like either is to be found in
the world to-day. But whereas all the individual titanotheres finally
died out, leaving no descendants, a number of the three-toed horses
did leave descendants, and these descendants, constantly changing
as the ages went by, finally developed into the highly specialized
one-toed horses, asses, and zebras of to-day.
 The analogy between the facts thus indicated and certain facts in
the development of human societies is striking. A further analogy is
supplied by a very curious tendency often visible in cases of intense
and extreme specialization. When an animal form becomes highly
specialized, the type at first, because of its specialization, triumphs
over its allied rivals and its enemies, and attains a great
development; until in many cases the specialization becomes so
extreme that from some cause unknown to us, or at which we merely
guess, it disappears. The new species which mark a new era
commonly come from the less specialized types, the less distinctive,
dominant, and striking types, of the preceding era.
When dealing with the changes, cataclysmic or gradual, which
divide one period of palaeontological history from another, we can
sometimes assign causes, and again we cannot even guess at them.
In the case of single species, or of faunas of very restricted localities,
the explanation is often self-evident. A comparatively slight change
in the amount of moisture in the climate, with the attendant change in
vegetation, might readily mean the destruction of a group of huge
herbivores with a bodily size such that they needed a vast quantity of
food, and with teeth so weak or so peculiar that but one or two kinds
of plants could furnish this food. Again, we now know that the most
deadly foes of the higher forms of life are various lower forms of life,
such as insects, or microscopic creatures conveyed into the blood by
insects. There are districts in South America where many large
animals, wild and domestic, cannot live because of the presence
either of certain ticks or of certain baleful flies. In Africa there is a
terrible genus of poison fly, each species acting as the host of
microscopic creatures which are deadly to certain of the higher
vertebrates. One of these species, though harmless to man, is fatal
to all domestic animals, and this although harmless to the closely-
related wild kinsfolk of these animals. Another is fatal to man himself,
being the cause of the ‘sleeping sickness,’ which in many large
districts has killed out the entire population. Of course the
development or the extension of the range of any such insects, and
any one of many other causes which we see actually at work around
us, would readily account for the destruction of some given species
or even for the destruction of several species in a limited area of
country.
When whole faunal groups die out, over large areas, the question
is different, and may or may not be susceptible of explanation with
the knowledge we actually possess. In the old arctogaeal continent,
for instance, in what is now Europe, Asia, and North America, the
glacial period made a complete, but of course explicable, change in
the faunal life of the region. At one time the continent held a rich and
varied fauna. Then a period of great cold supervened, and a different
fauna succeeded the first. The explanation of the change is obvious.
But in many other cases we cannot so much as hazard a guess at
why a given change occurred. One of the most striking instances of
these inexplicable changes is that afforded by the history of South
America toward the close of the tertiary period. For ages South
America had been an island by itself, cut off from North America at
the very time that the latter was at least occasionally in land
communication with Asia. During this time a very peculiar fauna grew
up in South America, some of the types resembling nothing now
existing, while others are recognizable as ancestral forms of the ant-
eaters, sloths, and armadillos of to-day. It was a peculiar and
diversified mammalian fauna, of, on the whole, rather small species,
and without any representatives of the animals with which man has
been most familiar during his career on this earth.
Towards the end of the tertiary period there was an upheaval of
land between this old South American island and North America,
near what is now the Isthmus of Panama, thereby making a bridge
across which the teeming animal life of the northern continent had
access to this queer southern continent. There followed an inrush of
huge, or swift, or formidable creatures which had attained their
development in the fierce competition of the arctogaeal realm.
Elephants, camels, horses, tapirs, swine, sabre-toothed tigers, big
cats, wolves, bears, deer, crowded into South America, warring each
against the other incomers and against the old long-existing forms. A
riot of life followed. Not only was the character of the South
American fauna totally changed by the invasion of these creatures
from the north, which soon swarmed over the continent, but it was
also changed through the development wrought in the old
inhabitants by the severe competition to which they were exposed.
Many of the smaller or less capable types died out. Others
developed enormous bulk or complete armour protection, and
thereby saved themselves from the new beasts. In consequence,
South America soon became populated with various new species of
mastodons, sabre-toothed tigers, camels, horses, deer, cats, wolves,
hooved creatures of strange shapes and some of them of giant size,
all of these being descended from the immigrant types; and side by
side with them there grew up large autochthonous ungulates, giant
ground sloths wellnigh as large as elephants, and armoured
creatures as bulky as an ox but structurally of the armadillo or ant-
eater type; and some of these latter not only held their own, but
actually in their turn wandered north over the isthmus and invaded
North America. A fauna as varied as that of Africa to-day, as
abundant in species and individuals, even more noteworthy, because
of its huge size or odd type, and because of the terrific prowess of
the more formidable flesh-eaters, was thus developed in South
America, and flourished for a period which human history would call
very long indeed, but which geologically was short.
Then, for no reason that we can assign, destruction fell on this
fauna. All the great and terrible creatures died out, the same fate
befalling the changed representatives of the old autochthonous
fauna and the descendants of the migrants that had come down from
the north. Ground sloth and glyptodon, sabre-tooth, horse and
mastodon, and all the associated animals of large size, vanished,
and South America, though still retaining its connexion with North
America, once again became a land with a mammalian life small and
weak compared to that of North America and the Old World. Its
fauna is now marked, for instance, by the presence of medium-sized
deer and cats, fox-like wolves, and small camel-like creatures, as
well as by the presence of small armadillos, sloths, and ant-eaters.
In other words, it includes diminutive representatives of the giants of
the preceding era, both of the giants among the older forms of
mammalia, and of the giants among the new and intrusive kinds. The
change was widespread and extraordinary, and with our present
means of information it is wholly inexplicable. There was no ice age,
and it is hard to imagine any cause which would account for the
extinction of so many species of huge or moderate size, while
smaller representatives, and here and there medium-sized
representatives, of many of them were left.
Now as to all of these phenomena in the evolution of species,
there are, if not homologies, at least certain analogies, in the history
of human societies, in the history of the rise to prominence, of the
development and change, of the temporary dominance, and death or
transformation, of the groups of varying kind which form races or
nations. Here, as in biology, it is necessary to keep in mind that we
use each of the words ‘birth’ and ‘death,’ ‘youth’ and ‘age,’ often very
loosely, and sometimes as denoting either one of two totally different
conceptions. Of course, in one sense there is no such thing as an
‘old’ or a ‘young’ nation, any more than there is an ‘old’ or ‘young’
family. Phylogenetically, the line of ancestral descent must be of
exactly the same length for every existing individual, and for every
group of individuals, whether forming a family or a nation. All that
can properly be meant by the terms ‘new’ and ‘young’ is that in a
given line of descent there has suddenly come a period of rapid
change. This change may arise either from a new development or
transformation of the old elements, or else from a new grouping of
these elements with other and varied elements; so that the words
‘new’ nation or ‘young’ nation may have a real difference of
significance in one case from what they have in another.
As in biology, so in human history, a new form may result from the
specialization of a long-existing, and hitherto very slowly changing,
generalized or non-specialized form; as, for instance, occurs when a
barbaric race from a variety of causes suddenly develops a more
complex cultivation and civilization. This is what occurred, for
instance, in Western Europe during the centuries of the Teutonic
and, later, the Scandinavian ethnic overflows from the north. All the
modern countries of Western Europe are descended from the states
created by these northern invaders. When first created they would
be called ‘new’ or ‘young’ states in the sense that part or all of the
people composing them were descended from races that hitherto
had not been civilized, and that therefore, for the first time, entered
on the career of civilized communities. In the southern part of
Western Europe the new states thus formed consisted in bulk of the
inhabitants already in the land under the Roman Empire; and it was
here that the new kingdoms first took shape. Through a reflex action
their influence then extended back into the cold forests from which
the invaders had come, and Germany and Scandinavia witnessed
the rise of communities with essentially the same civilization as their
southern neighbours; though in those communities, unlike the
southern communities, there was no infusion of new blood, so that
the new civilized nations which gradually developed were composed
entirely of members of the same races which in the same regions
had for ages lived the life of a slowly changing barbarism. The same
was true of the Slavs and the slavonized Finns of Eastern Europe,
when an infiltration of Scandinavian leaders from the north, and an
infiltration of Byzantine culture from the south, joined to produce the
changes which have gradually, out of the little Slav communities of
the forest and the steppe, formed the mighty Russian Empire of to-
day.
Again, the new form may represent merely a splitting off from a
long established, highly developed and specialized nation. In this
case the nation is usually spoken of as a ‘young,’ and is correctly
spoken of as a ‘new,’ nation; but the term should always be used
with a clear sense of the difference between what is described in
such case, and what is described by the same term in speaking of a
civilized nation just developed from barbarism. Carthage and
Syracuse were new cities compared to Tyre and Corinth; but the
Greek or Phoenician race was in every sense of the word as old in
the new city as in the old city. So, nowadays, Victoria or Manitoba is
a new community compared with England or Scotland; but the
ancestral type of civilization and culture is as old in one case as in
the other. I of course do not mean for a moment that great changes
are not produced by the mere fact that the old civilized race is
suddenly placed in surroundings where it has again to go through
the work of taming the wilderness, a work finished many centuries
before in the original home of the race; I merely mean that the
ancestral history is the same in each case. We can rightly use the
phrase ‘a new people,’ in speaking of Canadians or Australians,
Americans or Afrikanders. But we use it in an entirely different sense
from that in which we use it when speaking of such communities as
those founded by the Northmen and their descendants during that
period of astonishing growth which saw the descendants of the
Norse sea-thieves conquer and transform Normandy, Sicily and the
British Islands; we use it in an entirely different sense from that in
which we use it when speaking of the new states that grew up
around Warsaw, Kief, Novgorod, and Moscow, as the wild savages
of the steppes and the marshy forests struggled haltingly and
stumblingly upward to become builders of cities and to form stable
governments. The kingdoms of Charlemagne and Alfred were ‘new,’
compared to the empire on the Bosphorus; they were also in every
way different; their lines of ancestral descent had nothing in common
with that of the polyglot realm which paid tribute to the Caesars of
Byzantium; their social problems and aftertime history were totally
different. This is not true of those ‘new’ nations which spring direct
from old nations. Brazil, the Argentine, the United States, are all
‘new’ nations, compared with the nations of Europe; but, with
whatever changes in detail, their civilization is nevertheless of the
general European type, as shown in Portugal, Spain, and England.
The differences between these ‘new’ American and these ‘old’
European nations are not as great as those which separate the ‘new’
nations one from another, and the ‘old’ nations one from another.
There are in each case very real differences between the new and
the old nation; differences both for good and for evil; but in each
case there is the same ancestral history to reckon with, the same
type of civilization, with its attendant benefits and shortcomings; and,
after the pioneer stages are passed, the problems to be solved, in
spite of superficial differences, are in their essence the same; they
are those that confront all civilized peoples, not those that confront
only peoples struggling from barbarism into civilization.
So, when we speak of the ‘death’ of a tribe, a nation, or a
civilization, the term may be used for either one of two totally
different processes, the analogy with what occurs in biological
history being complete. Certain tribes of savages, the Tasmanians,
for instance, and various little clans of American Indians, have within
the last century or two completely died out; all of the individuals have
perished, leaving no descendants, and the blood has disappeared.
Certain other tribes of Indians have as tribes disappeared or are now
disappearing; but their blood remains, being absorbed into the veins
of the white intruders, or of the black men introduced by those white
intruders; so that in reality they are merely being transformed into
something absolutely different from what they were. In the United
States, in the new State of Oklahoma, the Creeks, Cherokees,
Chickasaws, Delawares, and other tribes, are in process of
absorption into the mass of the white population; when the state was
admitted a couple of years ago, one of the two senators, and three of
the five representatives in Congress, were partly of Indian blood. In
but a few years these Indian tribes will have disappeared as
completely as those that have actually died out; but the
disappearance will be by absorption and transformation into the
mass of the American population.
A like wide diversity in fact may be covered in the statement that a
civilization has ‘died out.’ The nationality and culture of the wonderful
city-builders of the lower Mesopotamian Plain have completely
disappeared, and, though doubtless certain influences dating
therefrom are still at work, they are in such changed and hidden form
as to be unrecognizable. But the disappearance of the Roman
Empire was of no such character. There was complete change, far-
reaching transformation, and at one period a violent dislocation; but
it would not be correct to speak either of the blood or the culture of
old Rome as extinct. We are not yet in a position to dogmatize as to
the permanence or evanescence of the various strains of blood that
go to make up every civilized nationality; but it is reasonably certain
that the blood of the old Roman still flows through the veins of the
modern Italian; and though there has been much intermixture, from
many different foreign sources—from foreign conquerors and from
foreign slaves—yet it is probable that the Italian type of to-day finds
its dominant ancestral type in the ancient Latin. As for the culture,
the civilization of Rome, this is even more true. It has suffered a
complete transformation, partly by natural growth, partly by
absorption of totally alien elements, such as a Semitic religion, and
certain Teutonic governmental and social customs; but the process
was not one of extinction, but one of growth and transformation, both
from within and by the accretion of outside elements. In France and
Spain the inheritance of Latin blood is small; but the Roman culture
which was forced on those countries has been tenaciously retained
by them, throughout all their subsequent ethnical and political
changes, as the basis on which their civilizations have been built.
Moreover, the permanent spreading of Roman influence was not
limited to Europe. It has extended to and over half of that new world
which was not even dreamed of during the thousand years of brilliant
life between the birth and the death of Pagan Rome. This new world
was discovered by one Italian, and its mainland first reached and
named by another; and in it, over a territory many times the size of
Trajan’s empire, the Spanish, French and Portuguese adventurers
founded, beside the St. Lawrence and the Amazon, along the flanks
of the Andes and in the shadow of the snow-capped volcanoes of
Mexico, from the Rio Grande to the Straits of Magellan,
communities, now flourishing and growing apace, which in speech
and culture, and even as regards one strain in their blood, are the
lineal heirs of the ancient Latin civilization. When we speak of the
disappearance, the passing away, of ancient Babylon or Nineveh,
and of ancient Rome, we are using the same terms to describe
totally different phenomena.
The anthropologist and historian of to-day realize much more
clearly than their predecessors of a couple of generations back how
artificial most great nationalities are, and how loose is the
terminology usually employed to describe them. There is an element
of unconscious and rather pathetic humour in the simplicity of half a
century ago which spoke of the Aryan and the Teuton with
reverential admiration, as if the words denoted, not merely
something definite, but something ethnologically sacred; the writers
having much the same pride and faith in their own and their fellow
countryman’s purity of descent from these imaginary Aryan or
Teutonic ancestors that was felt a few generations earlier by the
various noble families who traced their lineage direct to Odin,
Aeneas, or Noah. Nowadays, of course, all students recognize that
there may not be, and often is not, the slightest connexion between
kinship in blood and kinship in tongue. In America we find three
races, white, red, and black, and three tongues, English, French, and