316 ME. J. L. CLAKKE OS' THE INTIMATE STRUCTURE OE THE BRAIN. 
that our only hope is in some fortunate cases of disease, in which the power of speech 
is perfect, while the olivary bodies are considerably altered in structure ; or in which 
the olivary bodies, only , are damaged, while the power of speech is lost. Either of such 
cases, determined with accuracy, would set the question at rest. M. Vulpian has re- 
cently recorded a case which seems to be opposed to the opinion that the olivary bodies 
are concerned in speech, since these bodies were altered in structure while speech re- 
mained perfect to the last. The examination, however, does not appear to have been 
sufficiently precise to justify a positive conclusion. I give his own words : “ Les olives 
du bulbe, surtout la gauche, offiaient une sclerose bien manifeste, quoique peu profonde, 
de leur tiers moyen, et cependant, — ce qui n’est pas sans importance, au point de vue 
d’une des hypotheses relatives aux functions de ces parties, — la parole est restee parfai- 
tement nette jusqu’a la fin de la vie”*. 
(82) Deglutition is another process to which the olivary bodies have been regarded 
as subservient. If they have any share in this process, it is probably only in the first 
or voluntary stage, in which the food is pressed through the anterior palatine arch by 
the cooperation of the buccinator, the mylohyoid, the intrinsic muscles of the tongue, 
and the styloglossi. The second stage, which is purely reflex and involuntary, is pro- 
bably effected solely through the intimate and important connexions which I have 
pointed out between the nuclei of the trigeminus, the hypoglossus, the glossopharyngeal, 
the spinal-accessory, the vagus, and the facial. The third stage is reflex simply through 
the vagus and spinal-accessory. Cases are on record in which the tongue, while entirely 
removed from all voluntory influence, co-operates, nevertheless, perfectly with the mus- 
cles of the fauces and pharynx in the second reflex stage of deglutition. The demon- 
stration which I have given in this memoir, of the close anatomical connexion, in dif- 
ferent ways, between the nuclei of the hypoglossal, vagus, spinal-accessory, facial and 
trigeminal nerves throws an important light on the manner in which the complex and 
associate muscular actions concerned in deglutition, vocalization, and articulation may be 
effected ; and explains, in an interesting way, certain forms of partial or complete para- 
lysis to which the muscles employed in these acts are subject. Dr. Hughlings Jack- 
son was kind enough to show me one of his patients in whom there was complete para- 
lysis and wasting of the right side of the tongue f, with paralysis of the same side of the 
palate and vocal cords, as shown by the laryngoscope. The man had great difficulty of 
swallowing, and soreness of throat. He was unable to cough, or rather he could not 
shut the larynx in coughing. He was weak on both sides, but especially on the right. 
The right shoulder was much lower than the left, and he was unable to shrug it up as 
he could the other. He could not whistle so well as formerly ; but he could articulate 
in a whisper very well. Here we have paralysis of the spinal-accessory nerve on one 
side, supplying the vocal cords and palate ; total paralysis of one hypoglossal nerve, and 
* Yflpian, Legons sur la Physiologie, p. 495 (note). 
t The muscles of the tongue, when paralyzed, suffer atrophy much more rapidly than other muscles under 
the same conditions. 
