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.
4/20 page 2
![In the process of evolution the highest psychic prefrontal region, as it evolves more and more, becomes more strongly organized, and eventually is nearly inde¬ pendent of the lower levels from which it has been developed. In apparent contra¬ diction to the general law that the last organized is the least organized, this highest evolutional level, taken as a whole, is the most organized. Within this highest level however internal evolution is constantly taking place or tending to take place, and, speaking only of this level, the last organized becomes the most evanes¬ cent or the least organized. It is within this region that such higher qualities of the mind as will, memory, reason and emotion are represented; they are not represented by limited and separated units or centers, but by the working together of the highest and the most complex nervous machinery here represented. This region is an area of what Jackson terms re-re-representation, in which the nervous levels below for both sensation and emotion are triply represented (/. Ment. Sc. 1 [April] 1887). It happens that some of my first published neurologic experiences were related to the prefrontal lobe. One of the first cases of tumor of the brain which came to necropsy, which I observed and reported, involved the first and second frontal, the convolution of the callosum and the callosum itself of the right side of the brain. I published this case in detail (Philadelphia M. Times 9:184 [Jan. 18] 1879). The mental symptoms, briefly told, were: slowness of comprehension, lack of attention, explosive speech, loss of memory and lack of reasoning faculties, such as com¬ parison and judgment, and emotional manifestations, including weeping. Since recording this case I have had somewhat numerous midfrontal and prefrontal cases under my observation, accounts of some of which have been published, like that reported by Dr. Weisenburg and myself (/. A. M. A. 46:337 [Feb. 3] 1906). The symptoms, although differing in minor respects, were all examples of tract impairment or loss of the higher attributes of mentality. In my experience, cases in which the lesions in the brain were on the right side, were particularly noticeable for emotional manifestations. Emotion and emotional expression take the same place in extent of representation in the right cerebral hemisphere that language does in the left. This is as good a* place as any to recall my contributions on the subject of emotion and emotional expression. I first became interested in these questions from observing patients in the wards for nervous diseases at the Philadelphia Hospital who exhibited a variety of emotional manifestations which were not under control of their wills. Sometimes these manifestations were apparently of a distressing sort, as weeping with or without lacrimation; sometimes they were agreeable in appearance, as involuntary laughing, smiling or grinning. In the course of time I had the opportunity to make necropsies in cases of this sort which I had studied during life. I found lesions variously distributed, as for instance in the cortex, in the lenticular, in the caudatum, in the geniculate bundles of the internal capsule, in the corticobulbar tracts, in the nucleus ruber, in the pons oblongata, in the cerebellar prepeduncle or in the thalamus. I thoroughly discussed the subject of the cerebral mechanism of emotional expression in two papers, one presented at a meeting of the College of Physicians in 1911 (TV. Coll. Phys., Phila. 34:147, 1912), and the other at the meeting of the American Medico-Psychological Asso¬ ciation, May 28-31, 1912 (Tr. Am. Medico-Psycho. 19:297, 1912). The paper presented to the College of Physicians was afterward published in a memorial volume to Bianchi. I will present, in condensed form, a few of the most important facts and hypotheses included in these papers. I held that emotion and emotional expression were separately represented in the cerebral mantle, the former in the prefrontal](https://iiif.wellcomecollection.org/image/b30801199_0004.jp2/full/800%2C/0/default.jpg)
