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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    A case is recorded by Lepine, of left hemiplegia, followed by convulsions, limited cliiefly to the left arm. A small hgeraorrhage of the size of a nut was found at the ' posterior extremity of the first frontal convolution of the right hemi- sphere.' In another, by the same observer, of left hemiplegia, convulsions occurred, either limited to the left arm, or invariably commencing there. A yellow patch was found at the base of the first and second convolutions of the right hemisphere. A third case is given by Mahot,' of monoplegia and mono- spasm of the right arm. A glioma of the size of a pigeon's egg was found on the middle third of the ascending frontal convolution of the left hemisphere. In a fourth, recorded by Henrot,^ convulsions began in the fingers of the left hand, and were repeated at intervals, followed by left hemiparesis. A mass of tubercle was found embedded in the grey matter of the ascending frontal convolution of the right hemisphere, about the middle third. In this case, how- ever, there was also a small tubercular mass on the right side of the pons. It will be seen from these cases that the situation of the lesion causing brachial monospasm is not a single definite spot; yet it is in correspondence with the position of the various centres concerned in the movement of the arm and hand. As has been already said, there are several centres, each for a distinct movement. In four of these cases, in which the spasms Avere said simply to be in the arm, and in one of them in whicli it was noted that the spasms began in the proximal movements of the arm, the lesion was situated at tlie hinder extremity of the first frontal convolution, a position which, as will be seen by reference to the figures (figs. 26, 27, [5]), corresponds with the localisation of the centres of sucli movements in this region. In some cases, there was no exact description of tlie march of the spasm; but in those in wliich it was more especially noted that the spasms began in tlie fingers or hand, the lesion was either in, or in close proximity to, the ascending parietal ' Soc. Anat., Decemlier 15, 1876. * Un. Med. et Scicntif. dtc Nord-Est, 1877, p. 94.