The localisation of cerebral disease : being the Gulstonian lectures of the Royal College of Physicians for 1878 / by David Ferrier.

  • David Ferrier
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: The localisation of cerebral disease : being the Gulstonian lectures of the Royal College of Physicians for 1878 / by David Ferrier. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

    121/164 (page 105)
    death, a syphilitic lesion was found ' at the upper part of the posterior ascending or ascending parietal convolution, extend- ing over part of the upper end of the ascending frontal and over several of the adjacent convolutions of the parietal lobule' of the right hemisphere. On the right third nerve, a tumour of the size of a pea was found. This case is in exact cor- respondence with the situation which I have assigned to the motor centres of the foot and leg (fig. 27, [1] [2]). 2. Brachial Moiiospasm or Protospasni.—Of spasms limited to, or beginning in, the arm or hand, depending on localised cortical lesion, there are several cases on record. As a rule, the fits begin in the fingers, and more especially in the thumb and index finger—in the most volitional movements of the upper extremity, according to Hughlings Jackson—but this is not necessarily or invariably so. In the upper extremity, it must be remembered, there are several combinations of movements which have each a representative in the cortical motor area. These centres being all situated close to each other, and all liable to be discharged by one irritative lesion, it is neverthe- less possible that each may be the primary origin of the discharge, and so the mode in which the monospasm commences may vary accordiugly. Hence the necessity of making minute investigation of the march of the spasm in any particular case. Hughlings Jackson has recorded several cases of brachial monospasm. I will only mention those in which tbe lesion of the cortex was single and circumscribed. A man had frequent convulsions limited to the right arm, which subsequently became partially paralysed. A nodule was found situated at the hinder extremity of the first frontal convolution of the left hemisphere. In this case, there was also a tumour in each lobe of the cerebellum, but there were no cerebellar symptoms. The march of the spasm was not recorded.^ In a second case of convulsions, nearly always limited to the right arm, and followed by temporary paralysis of that arm after each fit, the lesion, which was diagnosed by Hughlings Jackson during life, was a nodule, situated at the ' posterior extremity of the first frontal convolution where it joins the ' Medical Mirror, September 1, 1869.