PATHOLOGY OF SENSIBILITY 39 



We have done much lipiodol-work in my clinic. In 1925 

 five tumours were successfully removed by operation by our 

 surgeon Prof. 0. Lanz after the clinical examination had 

 been verified by lipiodol tests. In one of these cases the 

 clinical diagnosis pointed to a tumour of the cauda equina. 

 The lipiodol, however, stopped at the tenth thoracal seg- 

 ment. This was too high of course and we did not under- 

 stand the dilTerence between the results of our neurological 

 examination and of the lipiodol test. At the operation two 

 tumours were found, one above the other. The former 

 was determined by the lipiodol test, the latter by our 

 clinical examination. 



Since using Sicard's method the spine has never been 

 opened in my service without finding a tumour. It is also 

 a great advantage that we are thus able to determine the 

 lower border of the tumour. Lipiodol is injected after 

 lumbar punction and then the patient is placed head-down- 

 wards. In figure 8 one may see the shadows of the lipiodol 

 brought in after suboccipital and after lumbar puncture. 

 The corpus of the tenth thoracal vertebra is free. This 

 was the case of a girl, 18 years old, with the symptoms of a 

 tumour on the spinal cord. Only a relatively small opening 

 was made by the surgeon and a little tumour (endothelioma 

 psammosum) could be removed. The patient, who before 

 the operation was totally paralysed in both legs, improved 

 quickly and was finally cured. It seems to me of great 

 value for the surgeon to know not only the upper but also 

 the lower border of the tumour, which has to be explored. 

 The latter border may also be determined by lipiodol 

 "ascendant,'^ which is lighter than the spinal fluid. 



In this lecture I have given you a short review of the 

 organisation of sensibility in the nervous system and, fur- 

 ther, the results of some of my investigations concerning the 

 development of the pathways for various forms of sensation 

 in the scale of evolution. Based on these studies I formed a 



