The evolution of our knowledge of the brain during the last sixty years : illustrated with a series of personal observations / Charles K. Mills, M.D. Philadelphia, Pa.
- Charles Karsner Mills
- Date:
- [1927]
Licence: In copyright
Credit: The evolution of our knowledge of the brain during the last sixty years : illustrated with a series of personal observations / Charles K. Mills, M.D. Philadelphia, Pa. Source: Wellcome Collection.
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![BRAIN DURING THE LAST SIXTY YEARS ILLUSTRATED WITH A SERIES OF PERSONAL OBSERVATIONS * CHARLES K. MILLS, M.D. This paper is intended to be largely autobiographic. One of its chief designs is to show that any large subdivision of the brain cannot be understood without taking its anatomic and physiologic relations to other parts of the same great organ into consideration. I entered on my neurologic experiences with some handi¬ caps and some advantages. I did not have a master to guide and counsel me when I started on my neurologic career, nor did I have, like some of our distinguished colleagues of this Society, the advantages of foreign study. On the other hand, I had command of abundant clinical and pathologic material, at an early date, as the result of my connection with the neurologic services of the University of Pennsylvania and the wards for patients with nervous diseases of the Philadelphia Hospital. I shall try to show how my personal development, as illustrated by the cases described and authorities referred to, was largely that of the evolution of neurology during the last sixty years. At the last meeting of this Society a somewhat acrid debate was precipitated regarding the prefrontal lobes as anatomically and physiologically a higher, or the. highest, psychic subdivision of the brain. Some of the speakers seemed to think that to recognize a higher or highest psychic area in the brain was equivalent to locating the mind in this situation. This is a serious, but not uncom¬ mon, mistake. One part of the brain may be the organ of the mind or of menta¬ tion, if this term is preferred, but the anatomic boundaries of the mind itself are much larger and may, in fact, take in the entire nervous system, or, as some have suggested, the entire body. Evolution enters into the decision of such a question. According to Hughlings Jackson—and I do not know of any one better for a neurologist to follow—the nervous system is divided into at least three levels, possibly more. The lowest, first and best organized is that of the spinal cord; the second or middle level evolves from the first and includes the motor and sensory areas of the cerebrum; the highest level, which represents the final evolution of the nervous system, has its abiding place in the most anterior, that is, the prefrontal, portion of the brain (/. Merit. Sc. 33:25 [April] 1887). The question of centers comes into a discussion of this sort. Most would-be critics have a false idea of what a localizationist means when he speaks of brain centers. Here again, I believe, Hughlings Jackson’s definition is the best, and it is the one to which I have always adhered. A center, according to Jackson, is simply a spot or location in the brain in which a particular movement or impression is represented in greater measure than anywhere else. Every such center is associated in some way with other parts of the brain, as all parts are connected or related anatomically and functionally (Evolution and Dissolution of the Nervous System, London, John Bale and Son, 1888, p. 1). * Abstract of paper read at the regular meeting of the Philadelphia Neuro¬ logical Society, March 25, 1927.](https://iiif.wellcomecollection.org/image/b30801199_0003.jp2/full/800%2C/0/default.jpg)
