A488 F. H. PIKE 
Von Monakow’s views on cerebral localization and on the dura- 
tion and severity of the effects of shock are at variance with 
those of Goltz, perhaps more widely than he realizes. For the 
substantiation of Goltz’s views depends upon either, 1) the direct 
proof of the activity of the spinal cord in the reflexes in the 
manner which Goltz supposed it to act in the uninjured animal 
or, 2) the independent proof that the reflex or other activities of 
the regions of the nervous system lying below the level of the 
transection or the injury are merely depressed for days or years, 
as the case may be, and that no quantitative change occurs in 
the impulses passing over any given synapse in the lower regions 
of the nervous system leading to increased activity after the 
injury, as compared with the amount of activity before the 
injury occurred. The experimental evidence now available 
does not substantiate Goltz’s conclusions on either of these 
points. 
Von Monakow recognizes that, if Goltz’s view of shock is to 
be accepted, the idea of cerebral localization must be abandoned, 
just as Goltz insisted. And if localization is true, one must set 
some limits to the effects of shock. This he does in his theory 
of diaschisis, which will be discussed a little later. But if we 
set any limits to the omnipotence of shock, we raise the question 
whether shock is a necessary conception in the explanation of 
the phenomena following injury to any portion of the central 
nervous system; and, considering shock as a purely depressive 
effect, whether the limits set may not become vanishingly small. 
If the limits do become small, the gap between von Monakow’s 
position and Goltz’s position must become even wider than 
it now is. 
It is still necessary to make some assumptions in discussing the 
organization of the nervous system. Aside from the assumption 
that the effect of shock is merely temporary and that the cells in 
the levels below the lesion regain all their former functions in 
time, von Monakow (10) makes certain others concerning the 
organization of the mechanisms of the spinal cord as well as 
those of higher levels. The account is best given in his own 
words. 
