Nerve derangements Brown-Sequa/rd, 



irritation of the slnn, tliat was cither accidental or em- 

 ploypd by a physician. Tlioro aro other means raoro 

 curious and equally effective, us iu the case I am about 

 to mention. A patient in a lunatic asylum mot another 

 one, who struck his hea.l ami broke the craniuin 

 on tho right side. Tho braia ooze-d out ; a 

 good deal of it was lost, and tho patient, 

 was cured of his insanity acd epilepsy. 

 (Laughter.] This is rather a dangerous means of treat- 

 ment, however, ami of course I speak of it only to show 

 that an irritation brought to the brain may oitou cure. 

 It is iu that way that bold surgeons as many there 

 were in this country in the period from 1825 to 1859 who 

 Lave brought their instruments to tho cranium and 

 made an opening there, iu cases of epilepsy, iu search of 

 n disease at that place thai, did uot exist, have very fre- 

 quently cured their patients. But not because they 

 have taken away the disease that they supposed existed 

 there, but because they have produced au irritation 

 which has done it. But I may add that it Is not neces- 

 sary to open tho cranium, though it haa been done, to 

 iny own knowledge, more than fifiy times in this coun- 

 try. All that is called for is an irritation of the skin of 

 the cranium and of the tltu-ous baud that covers the bone 

 between the skin and brain. Irritation there has a very 

 good chance of curing epilepsy iu inauy very obstinate 

 cases. There are many cases on record showing that an 

 inflammation iu almost any of the organs of the body is 

 sufficient to cheek insanity. Iu the same way other af- 

 fcctious of the orain, such as auiaurosis or paralysis, 

 may be cured suddenly sometimes without any cause 

 that we can fiud, but with good ground certainly to be- 

 lieve that au irritation has acted which has produced a 

 change in the cells of the brain and diminished their 

 morbid activity. For thcra aro clear cases in which 

 those affections have been cured by such irritation. 

 Those alterations of cells that were producing an arrest 

 of the power of sight or paralysis, have been sub- 

 mitted to an irritation of parts of the 

 skin or of some viscus, and this 

 irritation going to the morbid part and producing a 

 change in the activity of those cells, has cured the dis- 

 ease. So that a double mechanism of arrest may take 

 place iu all these cases. There is iu tho brain an irrita- 

 tion starting from the place where there is a disease. 

 That we cau see after death. That irritatiou goes to 

 pans at a distance and acts on cells to stop their activ- 

 ity ; but another irritation starting from some parts of 

 tho hod.v goes to the parts that are diseased and there 

 acts ou the morbidly active cells and stops their activity, 

 so that the effect that resulted from the disease ceased. 

 Bo one phenomenon of arrest produced the cessation of 

 another. 



CAUSES AND CDRES OF PABALTSIS. 



In reference to paralysis a view is held which seems 

 to be iu opposition to what I have said here. Paralysis 

 is considered to result from a cessation of activity of a 

 part of the bralu from disease. Lst, for instance, a dis- 

 ease exist in that part of the braiu that we call the an- 

 terior lobe. TUat part is considered as being in great 

 measure the seat of the will. That part is destroyed by 

 disease, and we find a paralysis; and the view is, as I 

 have said, that the paralysis results from a cessation of 

 the activity of that part. If wo admit this view, then 

 there is no need of accepting what I have taught here : 

 that an irritation starts from a place that is diseased 

 and goes elsewhere to produce an arrest of the ac- 

 tivity of cells. But that view is entirely iu opposition 

 to facts. We see every day that a disease which 

 Is exceedingly limited iu extent iu tho brain 



can produce tho most complete paralysis, vliilo, on the 

 other hand, we see that disease which has destroyed an 

 Immense part of the br.iiu may uot produce a paralysis 

 at all. It is impossible to conclude that paralysis pro- 

 ceeds in a direct way from tho destruction of tissue 

 that we see alter death. There must be an intermediate 

 agency between tho seat of the disease and tho 

 paralysis. And that intcrmiMliatu ag'.in-,y is what I 

 have tried to make you understand in saying that the 

 irritation starts from the place where the disease is, and 

 goes to other parts of tho brain, and also to the spinal 

 cord, to stop the activity of those parts. It will be evi- 

 dent to persons hero who know a little about anatomy, 

 that it is impossible to admit the old view about 

 paralysis. In the base of tho brain there is an 

 organ which ia called the pans varolii. This 

 is the ouly part by which communications 

 take place between the braiu and the spinal cord and the 

 rest of the body for voluntary movements. There is also 

 another part in front which is called the erura cercbri 

 legs of the brain. That part is composed of two halves, 

 quite distinct ouo from another. Let us suppose that 

 there is a disease either in one part of iliepons varolii or 

 of the crura cercbri, and that disease has destroyed a 

 small part of one of these. What shall we say if the 

 view that most all physiologists have is correct 7 Why, 

 that the destruction of one part of the crura cerebri or 

 pans varolii necessarily will produce a paralysis In some 

 muscles of one-half of the body. But that is not what 

 we see. In cases of disease there, the paralysis may 

 exist in the same side of the body where the disease ia 

 or ou the opposite side. It may be in one arm ouly or in 

 one leg only. The facts are altogether in opposition 

 to tho admitted view. You may see also cases ia 

 which the pons varolii is destroyed without 

 any paralysis at all. We should say also, according to 

 the common view, that a disease that has destroyed only 

 a few of the fibers would produce ouly a paralysis of 

 some of the muscles. There are no such cases on record. 

 Ic is essential to take another view of this matter. I 

 have proposed this explanation: that paralysis appears 

 only from au irritation which starts from the place 

 where the disease is, and acts upon parts nt a distance 

 so as to modify them. All of you know that a tickling 

 of the soles of the feet produces different effects in differ- 

 ent people. So we cau easily nuclei-stand that an irrita- 

 tion in the brain which will produce a complete or a 

 partial paralysis iu cue person will produce no 

 paralysis in another, according to the excitability 

 of different people. Take the facial nerve now. 

 That nerve in almost all persons who have a ohrouio 

 disease of the brain is partially paralyzed, perhaps only 

 a few fibers of it. Well, as the disease which produced 

 this paralysis is limited ia every instance, and as the 

 disease may occupy every part of the brain, if we con- 

 clude that paralysis comes because the nervous center 

 of the facial nerve is destroyed, we would have to place 

 that center in every part of the brain; in one individual 

 iu one part; iu another individual iu another part, and 

 so on. And as we fiud cases iu which a destruction of a 

 considerable part of tho braiu does not result in that 

 paralysis, we wouVd have to conclude that some indi- 

 viduals no not receive that nerve in their brain. This is 

 a reductio ad absurdum. We have therefore to throw 

 overboard that theory. 



HALF THE BRAIN EQUAL TO THE WHOLE. 



There is one point about which I should like to 

 deliver a whole lecture. I can only say now a few 

 words iu regard to it. It is a most important 

 topic. A study of the facts relating to the brain 



