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

Date:: 1878

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 Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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$G4 accounted for by unantagonised action of the left centre, from (hsemorrhagic) lesion of the right. The position of the fracture was such as might easily coincide with injury of centre ( [12] fig. 27); and the fact that the eyes could be voluntarily moved up to the middle line shows that the distortion was not of an active nature, and easily overcome by the action of the right centre. The following case, related by Chouppe,' which is quoted by Landouzy,2 bears more nearly on the question of the situation of the oculo-motor centre in man. This was a case of a lad, aged 19, who showed symptoms of tubercular meningiti?, in which, in addition to pain, vomiting, etc., the most remarkable symptom was a rotation of the head and eyes to the right. This could be overcome with moderate effort, but the head and eyes re- turned to their position when left to themselves. No other paralysis or contracture existed elsewhere. After death, a patch of disease, free from graniilations and quite superficial, of the size of a franc piece, was found on the ' superior part of the middle frontal convolution' in the left hemisphere. Other lesions were fotuad in the superior and lateral part of the sphe- noidal lobe of the right hemisphere, but, as will be subsequently shown, these cannot be regarded as much complicating the case. There was no other cerebral lesion. The exact situation of the lesion in the left hemisphere is not indicated more precisely than in the words quoted ; but they may, I think, be taken in support of the theory that these special symptoms were due to irritative lesion of that which corresponds with the oculo-motor centre in the brain of the monkey. Crural Monoplegia.—As there seems to be some misappre- hension abroad in reference to the centres of movement of the hinder extremity, let me first call your attention to the facts of experiment. Irritation of the postero-^arietal or superior parietal lobule—area 1—(fig. 26) causes flexion of the foot in the ankle, occasionally combined with flexion of the thigh on the pelvis, and extension forward of the leg as in the act of walking. On the other hand, in my experiments on monkeys, stimu- lation of area 2 (fig. 26), a region which includes the upper$