A case of hemiplegia, with cerebral softening, and in which loss of speech was a prominent symptom / by Robert Dunn.

  • Robert Dunn
Date:
1850
Catalogue details

Licence: Public Domain Mark

Credit: A case of hemiplegia, with cerebral softening, and in which loss of speech was a prominent symptom / by Robert Dunn. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    12/18 (page 12)
    niveau et en dehors de Fextremite posterieure du corps strie tout-a-fait a sa pointe;” and in the right hemisphere a similar ramollissement—“ A Funion de la moitie anterieure avec la moitic posterieure de cet hemisphere, a une egale distance de ces bords interne et externe, et an point de jonction des deux tiers superieurs avec le tiers inferieur de la masse nerveuse situee du centre ovale de Vieussens.” These were the only cerebral lesions. In the second case—“ Dans tout Fencephale, il n’y a d’altere que le corps strie du cote gauche.” It was a soft, pulpy mass to within three lines of its exterior surface. Andral observes: “ Le siege du ramollissement est digne de remarque; il est exactement borne a Fun des corps stries, ce qui n’empeche pas qu’il n’y ait paralysie des deux membres et abolition de la faculte de parler.” Other cases have been re- corded, in which the structural lesion was confined to the corpora striata, and a few in which the middle and posterior lobes were implicated in the disease of the striated bodies. Now, in the consideration of this subject, it is never to be forgotten, that the perfect power of speech, that is, the power of giving utterance to our thoughts and ideas in suitable and appropriate language, depends upon the due relation between the centres of intellectual action, and of the encephalic motor centres, through which the volitional power is exercised. Tlionghts or ideas may be moulded for expression in the seat of intellec- tual action, but the due agency of the volitional power, to give them utterance, requires the integrity of the commissural fibres, and of the motor centres, through which the volitional impulses of thought operate in speech. The imperfect power of articulation which we so constantly meet with, in lienii- plegic patients, I have no doubt is owing to some structural lesion in the integrity of the motor centre of volition. A highly interesting and instructive case, bearing upon this point, came under my own observation, a few years ago. It was that of a young woman, in whom there existed, for many months, a suspension of the mental faculties, power of speech and special senses, with the exception of sight and touch, in consequence of her having accidentally fallen into a river, and been nearly drowned. An account of the case was published in The Lancet of 1845. When I first saw her, on her being