594 



General Symptomatology of Diseases of the Brain. 



cerebellum cannot be excluded with certainty. Clinical observations 

 indicate that these symptoms are not always seen in diseases of the 

 cerebellar peduncles, although there may be bending of the neck, 

 movements in circles, and falling over to one side. Unilateral lesions 

 of the vestibular nerve or of the labyrinth may cause rolling (Biehl, 

 Authors' case). 



Fig. 82. Diagram of the paths of the 

 sensory nerves (with reference to ]xjin, 

 ]n-essure, temperature, taste and nms- 

 cular sense). G. spl., G. G. spinal 

 ganglion and Gasserian ganglion (the 

 ganglia of the vagus and glosso- 

 pharyngeal nerves are omitted for the 

 sake of simplicity), with the sensory 

 nerve paths from the skin, mucous 

 mpml)ranes, muscles, bones and joints. 

 Tlie fihers passing from the spinal 

 ganglion and entering the spinal cord 

 tlirougli the sensory roots in part turn 

 in the forward direction and run in 

 the dorsal columns (black) and reach 

 the nerve cells Nc. or Ng. (medullar 

 nucleus of the posterior columns). 

 From here a second path arises which 

 crosses over at R. (raphe) and runs 

 in L. (fillet) and is distributed to 

 the nerve cells (black) of the optic 

 thalamus Th. From here a third path 

 arises (Th. Co. black) which ter- 

 minates in a limited area of the cor- 

 tex from which the pyramidal tract 

 starts. A second jwrtion of the fibers 

 entering tlie cord arborise around the 

 sensory nerve cells of the dorsal cor- 

 nua. From these a tract starts (red) 

 which crosses over to the other 

 side and the greater part of this 

 passes forwards in Gower's tract, a 

 second portion in the anterior tract, 

 Cbl. zone, and then passes through the 

 lateral and dorsal portions of the lat- 

 eral fillet. LI. After splitting up be- 

 low the posterior corpora quadrige- 

 mina this terminates in the ventral 

 nuclei of tlie optic thalamus (red). 

 From this point projection fibers (red) 

 pass to the greater part of the cortex. 

 The fibers of the trigeminal root ar- 

 borise round the cells of the nucleus, 

 from whicli a second path arises and 

 crosses to the (iii])o-.ile side, passing towards the optic thalamus in the neighbor- 

 hood of the fillet. The ])aths and centers shown in black convey sensory im- 

 pressions relating to the localized senses, while those marked in red convey the 

 general sensory impressions ( temperature, pain, pressure, etc. ) ( v. Monakow ) . 



In all the natural cases so far observed the rolling is towards the 

 diseased side but experiment has shown that it may be in the opposite 

 direction, notably after section or simple stimulation of the vestibu- 

 lar nerve. 



Sensibility may be impaired by lesions of the sensory tract 

 leading to the cortex and in such cases there is, as a rule, les- 



