Sir Wilhkam Henry Broadbent. 1X 
the analysis of complex symptomatologies of some very different nervous 
maladies. More than forty years ago (‘British and Foreign Med. Chir. 
Review,’ April, 1866), he published an article on “the Bilateral Association 
of Nerve Nuclei to the Higher Centres.” These words, his latest but not his 
best, deliverance on the subject, are from a lecture he delivered before the 
Neurological Society, published in ‘ Brain, No. 103, p. 347, 1903. In that 
lecture he remarked that: “The principle is that when muscles on the two 
sides of the body always act together, their nuclei, situate in opposite sides 
of the cord, are so closely associated by commissural fibres as to be practically 
one nucleus.” Whatever modifications and corrections of details have been 
required, what is essential in the principle which the hypothesis embodies 
has not been invalidated. Thus, in a case of ordinary hemiplegia—say 
right—owing to disease of the left half of the brain there is loss of power 
of the right limbs, that is, of those parts of the body which are most nearly 
unilateral, and, as we may say, “most voluntary,” in their actions; but there 
is no, or very little, disability of the intercostal muscles of either side of the 
chest. Nevertheless, there is loss of many movements of the intercostal 
muscles of both sides, that is to say, there is paralysis i the sense of loss of 
movements of the intercostal muscles of both sides, but without disability of 
these muscles. The seeming paradox in this statement disappears when we 
reflect that, as Broadbent told us Iceng ago, in such a case the intercostal 
muscles of both sides of the chest remain represented in another set of 
movements in, and are still empowered by, the undamaged right half of the 
brain; there is almost complete compensation by the right half for the 
effects of the destruction lesion in the left half. The truth of this hypothesis 
is demonstrated in two ways. In some cases of what may here be called 
Rolandic epilepsy (it is sometimes called “ cortical epilepsy ”) there is from 
a local lesion of the motor region of the cortex cerebri of one half—say, 
left—of the brain occasionally convulsion of the limbs of the right side of 
the body and of both sides of the chest. In the facts of hemiplegia 
contrasted with those of the case of Rolandic epilepsy there is a striking 
verification of Broadbent’s hypothesis. From a destruction lesion of part of 
one half of the brain there is no, or very little, obvious disability of the 
intercostal muscles of either side, whilst from a discharge lesion of a part of 
the cortex (a part belonging to the same anatomico-physiological system as 
that part which is the seat of a destruction lesion in hemiplegia) there is 
sreat spasm of the intercostal muscles of both sides. Another, a third, 
confirmation of the hypothesis is given by so-called pseudo-bulbar paralysis 
in cases of this malady there is a double cerebral destruction lesion, causing 
great disability of bilaterally acting muscles of a certain region of the 
body—of both sides of the tongue, lips, and palate. A destruction lesion of 
the left half of the brain only causes very slight, almost no, disability of the 
bilaterally acting parts mentioned, compeusation being for the effects of that 
one-sided lesion practically complete. But when that compensation is lost 
from a lesion of the right half also, there is very great disability of the 
