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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![region, where, as Bianchi (A Textbook of Psychiatry for Physicians and Students, New York, William Wood & Company, 1906) and others have maintained, the final syntheses occur which result in the higher psychic processes including emotion, while emotional expression is more especially represented in the midfrontal region, in a zone closely contiguous to that concerned with emotion itself. I had shown that an emotive zone representative of emotional expression was probably located in the midfrontal and posterior part of the prefrontal region, that zone being entirely cephalad of the motor zone as usually regarded, that is, forward of the precentral convolution. This zone also included an anterior projection of the second and upper portion of the third frontal convolution, and it was more highly developed in the right hemicerebrum than in the left. The views maintained by me were derived partly from the results of faradic excitation of the human cortex during operations by Dr. Frazier (Univ. Penn. M. Bull., Phila., 18:134 [July and Aug.] 1905), and partly from a general study of the literature on the subject, psychologic and neurologic. Among the movements demonstrated as having their representation in the midfrontal zone for emotional expression were those for closing and opening the eyes, for opening the mouth, both by movements of the jaw and of the lips, for bending the head forward, backward or to one side, and for the movements of Darwin’s (The Expressions of the Emotions in Man and Animals, London, John Murray, 1872) so-called muscles of grief. These muscles, especially in the upper part of the face, are for the movements of the corrugator supercilii, the frontalis, the pyramidalis nasi and the muscles of the eyelids (Tr. Coll. Phys., Phila., 34:147, 1912). Hughlings Jackson, broadly generalizing, applies the evolutional theories of Herbert Spencer, Laycock, Bain and others to the explanation of increasingly complex reflexes as we pass from the lowest to the middle and from the middle to the highest levels of the brain. He lays down the proposition that the frontal half of the cerebrum is motor and the posterior half is sensory. I appreciated this fact early, and in 1888 I indicated my conviction that the sensory region was not only separate, but was situated posteriorly to the rolandic fissure (Tr. Cong. Am. Phys. & Surg., 1888, vol. 1; Brain 12:233 [July] 1889; ibid. 2:258 [Oct.] 1889). One object of this paper has been to show that the evolution of our knowledge of the brain, and especially of localized centers in the encephalon, during the last sixty years, has been illustrated by my own clinical and pathologic experiences. I have recorded cases authenticated by operations and necropsies occupying almost every particular functionally limited districts of the brain—cases of prefrontal, midfrontal, postfrontal, postcentral, postparietal superior and inferior, occipital, third frontal, insular, retro-insular, supratemporal, midtemporal, thalamic, sub¬ thalamic, superior, inferior and posterior cerebellar and spinal. An excellent opportunity of rounding out my experience in cerebral localization by the report of an actual case was afforded and put on record in a paper by me, “The Cerebral Centers for Taste and Smell and the Uncinate Group of Fits” (J. A. M. A. 51:879 [Sept. 12] 1905). This paper recorded a case in which a tumor, arising in the uncinate convolu¬ tion, spread to other regions of the brain. I had notes of this case extending back to 1899 and 1900'. I can only briefly give its main features. The patient became subject to epileptic seizures differing from one another in some details but having as marked features distinct auras of smell and taste with smacking of the lips and champing of the jaws;, he died at the close of a serious seizure. Necropsy showed a tumor which evidently had begun in the uncinate region and had extended backward and inward.](https://iiif.wellcomecollection.org/image/b30801199_0005.jp2/full/800%2C/0/default.jpg)
