“DIE LOKALISATION IM GROSSHIRN”’ 503 
site of the cells whose removal is necessary for the genesis of 
spasticity by the remaining cells of the central nervous system 
has occurred in the course of evolution from lower to higher 
vertebrates. The pyramidal fibers in a dog do not apparently 
exert the inhibitory effect on the lower motor neurones which 
they are said to exert in man. 
Spinal shock, while of little direct interest to the present-day 
internist, has appealed to the clinical neurologists in days past, 
and from them has come the clinical counterpart of the labor- 
atory expressions. That the necessity for some hypothesis or 
theory of shock is still felt among clinicians is shown by the fact 
that Mott (16) has applied von Monakow’s views in the attempt 
to explain some of the conditions arising in cases of shell shock. 
It is my opinion that the importance of a conception of the 
changes occurring in the nervous system as the result of injury 
will meet with more general recognition as the effects of war 
conditions are more generally and more critically studied. Two 
of the earlier attempts of clinicians to explain the effects of 
injury to or disease of the higher motor neurones are those of 
Gowers and Hughlings Jackson. Gowers formulated his ideas 
in terms of inhibition, but, in the opinion of some clinical neu- 
rologists, his hypothesis is unsatisfactory. Hughlings Jackson 
phrased his conceptions in terms of energy. He thought that if 
one level of the nervous system was damaged by disease about 
the same quantity of energy as passed through the whole central 
system before the injury passed through the remaining levels 
after the injury. Although he does not expressly say so, Jack- 
son’s view, particularly in the form in which it was expressed by 
Horsley (07), postulates a quantitative change in the number 
or intensity of impulses going through the remaining nervous 
pathways. I can hardly see how the change in the amount of 
energy in the remaining levels of the central nervous system 
which he imagines to occur after the shutting out of one level 
can occur without such a quantitative change as has been shown 
to occur in some levels of the central nervous system. To all 
intents and purposes, the idea of a quantitative change in func- 
tion must have been present in Jackson’s mind. I do not 
