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

  • David Ferrier
Date:
1878
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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.

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    ascending frontal.' In this case, it was noted that the spasms always began in the shoulder and went doivn the arm, contrary to the usual order.^ This is an important case, as showing that the spasm began in muscles which, as the experiments on monkeys indicate, relate to the movement of the arm as a whole, and not to those of the fingers or wrist (fig. 26, [3] [4] [5]). In a third case,^ convulsions invariably began in the left thumb. After death, a tumour of the size of a hazel-nut was found under the grey matter at the posterior extremity of the third frontal convolution of the right hemisphere. Some granulations existed in the bed from which it was enucleated, or in the grey matter near it. In a fourth case, the spasms began in the right hand, and occasionally in the right cheek. Before death, left hemiplegia came on, which, however, soon passed off. Disease was found in both cerebral hemispheres, probably syphilitic. In the left hemisphere, ■z'.e., the side opposite the spasms, adhesion was found between the dura mater and the brain in a region including ' the lower part of the ascending frontal and ascend- ing parietal convolutions, to a trifling extent to the hinder part of the third frontal, and several of the convolutions of the upper wall of the fissure of Sylvius behind the ascending parietal.' In the right hemisphere—the side opposite the paralysis—' on the surface, behind the fissure of Eolando, was a mass about the size of a chestnut. The dura mater was firmly adherent to it. There was very little softening about it.'3 In a fifth,^ temporary right hemiplegia came on after an unilateral convulsion in which the patient did not lose con- sciousness. Convulsions occurred from time to time, beginning in the little finger of the right hand, occasionally in the right cheek, and followed always by slow and hesitating speech. After death, a syphilitic tumour of considerable size—as large as three small walnuts—was found growing into the cortex about the junction of the frontal and parietal lobes, surrounded by an area of softening in the posterior part of the frontals, ascending frontal and ascending parietal, and partly of the ' Medical Times and Gazette, June 5, 1875. ^ Ihid., November 30, 1872. =• Ibid., December 28, 1872. ' Ibid., March 1, 1873.