LOCALISATION IN THE CORTEX CEREBRI. 729 



" As a matter of fact, clinical medicine teaches in an unmistakable manner 

 that anaesthesia of the limbs, whether superficial or deep, is not in itself a 

 cause of motor failure. In anaesthesic hysteria the patients do not by reason 

 of their anaesthesia lose the faculty of freely moving their limbs, even when 

 their muscular sense is abolished and all forms of cutaneous and deep 

 sensibility are lost. And it is equally true that the faculty of movement can 

 be completely preserved in cases of hemianaesthesia, resulting from destructive 

 lesions in the posterior part of the internal capsule. To us it appears that 

 these facts are conclusive." 



" There remains, however, to be explained why alterations of the motor zone 

 are accompanied in almost a third of the number of cases where they occur by 

 disturbance of sensation either cutaneous or muscular." 



" Legroux and de Brun 1 connect these sensory symptoms with circulatory 

 disturbances affecting points in the cerebral substance beyond those involved 

 in the paralysing lesion. Terrier regards them as being produced by co-exist- 

 ing lesions of sensory centres (elsewhere in the cortex) or of sensory tracts. 

 But this combination of two lesions ... is certainly exceptional." 



" In our opinion the anaesthesic conditions which sometimes accompany 

 motor paralyses of cortical origin are most frequently functional anaesthesias, 

 analogous if not identical with hysterical anaesthesias ; . . . they are super- 

 added and accidental phenomena, not depending directly on the lesions of the 

 Rolandic region, nor playing any pathogenic part in the production of the 

 paralytic symptoms." 



Besides this " functional " explanation, perhaps in correlation with it 



contraction of all the muscles concerned in the production of any movement " ; and he 

 considers that the Rolandic region is a special seat for the ultimate reception of such 

 impressions, and for their revival as an antecedent to the excitation of the motor centres of 

 the spinal cord and bulb. 



Bastian's view has been developed in a highly philosophical manner in a series of 

 important articles, dating from some twenty-five years back up to the present time, and 

 has been accepted, sometimes with and sometimes without acknowledgment, by many 

 neurologists. As it has been often misapprehended, it may be as well to point out that 

 Bastian has not postulated that voluntary movements are produced by kinaesthetic im- 

 pressions, but merely that the performance of such movements is guided by them ; and 

 considering that in order properly to perform their functions the centres in the Rolandic 

 area must receive such impressions, Bastian regards this area as a sensory area and its 

 centres as sensory centres. By the same mode of reasoning, however, the centres in the 

 anterior horns of the spinal cord from which the motor nerves originate, must also come 

 under the same category. Bastian has not committed himself to the opinion that the 

 Rolandic area is the sole portion of the cortex where kimesthetic impressions are perceived, 

 but merely that part where these impressions or the memory of previous similar impressions 

 are concentrated for the guidance of volitional impulses ; which last are themselves 

 originated by immediate or earlier sensory impressions, whether visual, auditory, tactile, 

 gustatory, or olfactory. The difference, therefore, between Bastian's view of the Rolandic 

 centres and that taken in the text, largely resolves itself into one of terminology. For 

 full information regarding the kinsesthesis theory of voluntary action, the student will 

 do well to consult Bastian's original works, and especially "The Brain as an Organ of 

 Mind," p. 543; "Paralyses, Cerebral, Bulbar, and Spinal," p. 108; "Hysterical or 

 Functional Paralysis," Appendices A and C; "The Muscular Sense," Brain, London, 

 1887, vol. x. p. 1 ; "On Attention and Volition," ibid., 1892, vol. xv. p. 1. Cf. further 

 on the subject of the relation of motion to sensation, Petrina, Ztschr. f. Heilk., 

 1881, Bd. ii. S. 375; Exner, "Localis. d. Functionen, etc.," 1881; Lisso, "Zur Lehre 

 d. Local, des Gefuhls, etc.," 1882; Allen Starr, Am. Journ. Med. Sc., Phila., 1884, vol. 

 Ixxxviii. p. 114; Weir and Seguin, "Cerebral Surgery," Journ. Nerv. and Ment. Dis., 

 N. Y., 1888 ; Dana, "Cortical Localisation of Cutaneous Sensations," N. Y., 1888 ; Med. 

 Rec., N. Y., 1893, p. 578; Hitzig, Neurol. Centralbl., Leipzig, 1888, S. 249, 283; 

 Darkschewitsch, Neurol. Centralbl., Leipzig, 1890, S. 714 ; Waller, Brain, London, 1891, 

 vol. xiv. p. 179, and 1892, vol. xv. p. 329 ; Madden, Journ. Nerv. and Ment. Dis., N. Y., 

 1893 ; Starr and M'Cosh, Am. Journ. Med. Sc., Phila., 1894, vol. cviii. p. 517; Wernicke, 

 Arb. a. d. psych. Klin. inBreslau, Leipzig, 1895, Heftii. S. 33 ; Bruns, Neurol. Centralbl. , 

 Leipzig, 1898, S. 856; Luciani and Sepilli, "Die Functionslocalisation auf der Grosshirn- 

 rinde" (quoted from Ferrier, "Cerebral Localisation"); " Le systeme nerveux," by J. 

 Soury, 1899. 



1 "L'encephalon," 1884. 



