X ATI J RE 



213 



THURSDAY, JANUARY 3, \\ 



SCIENCE AND SURGERY 

 "C" ROM the earliest ages, the functions of the brain have 

 been a fascinating study to cultivated minds, and the 

 greatest intellects of all ages have occupied themselves 

 in attempting to solve its difficult and complicated 

 problems. With the ancients this was a favourite pur- 

 suit, and engrossed the thoughts and talents of their most 

 illustrious philosophers. Owing to the absence of exact 

 methods of scientific observation and experiment, the 

 conclusions on this subject were for many centuries of a 

 purely speculative character, and the errors and fallacies 

 thus deduced have been handed down and accepted till 

 comparatively recent times. Modern investigations have, 

 however, thrown a flood of light on the question, and 

 although much still remains in the dark, the former 

 obscurity has of late years been brightly illumined by the 

 lamp of science. The accumulated clinical experience of 

 ages had left knowledge on the cerebral functions in a 

 stale of confusion and uncertainty, and owing to the ob- 

 vious difficulties and complications associated with disease, 

 the results, however significant, were at best imperfect. 

 That the brain should be subjected to direct physiological 

 experiment was, until modern times, never attempted. 

 During the last generation only has the practicability of 

 this been demonstrated, and numerous observers have, 

 by direct operations on the brain substance of animals, 

 arrived at new conclusions as to its functions, and greatly 

 revolutionised our ancient conceptions on the subject. 

 Evidence has also been given against the noli me 

 tangere theory, and abundant proof has been adduced 

 of the fact that the brain may be handled, irritated, or 

 partially destroyed without necessary danger to life. 

 One of the latest developments of this method of investi- 

 gation has been the discovery of those centres in the 

 cortex which preside over voluntary motion, which have 

 been, more especially by Prof. Ferrier, differentiated and 

 localised with great precision. This important know- 

 ledge has been arrived at by an extended series of ex- 

 periments conducted on living animals, in which, by 

 observing the several effects of stimulating or destroying 

 limited areas of their brains, the different functions of 

 these special localities have been determined. A topo- 

 graphy of the cerebrum has thus been constructed, in 

 which the various faculties have been mapped out, but 

 these, unlike the illogical visions of the phrenologists, have 

 stood the test of sceptical criticism and rigid experimen- 

 tal inquiry. Researches of a purely scientific nature, 

 carried out only with the object of elucidating truth and 

 advancing knowledge, without immediate prospects of 

 material gain, have in this instance led to most important 

 and useful practical advantage. Armed with the knowledge 

 acquired on animals in the laboratory, the physician has 

 ; ieen enabled to utilise at the bedside the conclusions 

 ;hus arrived at for the service of human beings. Clinical 

 experience combined with morbid anatomy had already- 

 enabled the medical man to suspect the presence of 

 disease in the brain, but as to its precise locality he was 

 formerly in doubt. Now, however, guided by the recent 

 revelations of physiology, he is enabled to predict the posi- 

 Vol. xxxi.— No. 793 



tion in a large number of cases with great certainty and 

 precision. Evidence of this is afforded by the proceeding 

 adopted in a case of disease, notice of which has lately 

 appeared in the medical papers. It appears that a man 

 presented a series of symptoms which enabled Dr. Hughes 

 Bennett to diagnose a tumour of the brain, that it in- 

 volved its cortical substance, that it was probably of 

 limited size, and that it was situated at a certain definite 

 spot. The skull was trephined over the suspected region ; 

 there a tumour was found and removed. On recovering 

 from the immediate effects of the operation the patien 

 was and continued for three weeks in a satisfactory con- 

 dition. He was perfectly intelligent, his functions, except 

 for certain defects of motion caused by the disease, were 

 normally performed, and there was an absence of all the 

 distressing symptoms from which he had formerly suf- 

 fered and from which he must necessarily soon have 

 succumbed. Unfortunately, at the end of this time a 

 complication, incident to all serious surgical operations 

 supervened, from which the patient ultimately died. The 

 unhappy termination of this particular case does not in 

 any way detract from the importance of the principles 

 which it involves. It still remains a signal triumph of 

 diagnostic accuracy, a precision mainly attained by exact 

 experimental research. It is, moreover, further proof that 

 by utilising this improved knowledge the surgeon may 

 not only remove disease from the brain, but that he may 

 do so without necessary shock or risk to the nervous 

 system, and that the procedure, under modern antiseptic 

 precautions, need not be attended with greater danger 

 than may follow any other severe surgical injury. This 

 interesting and instructive case will doubtless inaugurate 

 a new era in medical practice, for although this particular 

 individual has succumbed to measures adopted to avert 

 his otherwise certain death, the experience thereby 

 gained is sufficient to encourage further efforts in a 

 similar direction which may prove beneficial to others. 

 In the Marshall Hall oration of last year Prof. Ferrier 

 remarked, " There are already signs that we are within 

 measurable distance of the successful treatment by 

 surgery of some of the most distressing and otherwise 

 hopeless forms of intercranial disease, which will vie with 

 the splendid achievements of abdominal surgery." He 

 further added, reflecting on the success which had attended 

 brain operations on animals, " I cannot but believe that 

 similar results are capable of being achieved on man 

 himself." That distinguished physiologist cannot but 

 feel gratified that his prophetic words have been partially 

 realised. 



DE BARY'S " VEGETATIVE ORGANS OF THE 

 PHANEROGAMS AND TERNS" 



Comparative Anatomy of the Vegetative Organs' of the 

 Phanerogams and Ferns. By A. De Bary. Translated 

 by F. O. Bower and D. H. Scott. (Oxford : Clarendon 

 Press, 1884.) 



IN 1 861 a plan was drawn up in Germany to provide a 

 series of hand-books or text-books on botany, which 

 should treat of the science as it existed at the time ; four 

 of these books were completed, De Bary's " Vergleichende 

 Anatomie der Vegetations-organe der Phanerogamen und 

 Fame" (published in 1877) being one of them. This 



