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REMARKS ON TWO CASES OF CEREBRAL DISEASE, PUB
LISHED BY DR MOIR IN THE EDINBURGH MEDICAL AND SURGICAL JOURNAL, AND IMAGINED TO BE SUBVERSIVE OF THE CONCLUSIONS OF PurENOLOGISTS AS TO THE SEAT OF TIB Organ or LANGUAGE. By W. A. F. BROWNE, Esq.
TO THE EDITOR OF THE PHRENOLOGICAL JOURNAL. 1: Sir, It is necessary to direct the attention of your readers to an article in the last number of the Medical and Surgical Journal, entitled, “ Report of cases communicated to the Anatomical Society of Edinburgh ;" in consequence of the palpable mistakes into which the author has fallen as to the nature and scope of certain observations published by me on “ Derangement of the Faculty of Language.” These errors must proceed either from ignorance of the principles which the author attempts to prove are erroneous, or from never having perused the paper in which these principles were explained and advocated. The observations in question consisted of a series of papers written expressly for the Phrenological Journal.* In the first of these, and the only one it would appear that Dr Moir has examined, it is shewn that the power by which we employ signs to represent our ideas and feelings is connected, not merely, as Dr Moir states, with the anterior lobes of the brain, but with that portion of these lobes which rests on the centre of the orbital plate. It is likewise established, that when these convolutions are destroyed or seriously injured in both hemispheres, the extinction of this power invariably and inevitably follows; but that various conditions of this faculty have been noticed, such as an inability to use certain classes of words, the propensity to employ one class in place of another, &c., of the organic cause of which, if any such exist, pathologists are as yet ignorant. In the succeeding essays, a detail is given of instances of rapidity of voluntary utterance, involuntary utterance, rapidity of involuntary utterance, total loss of verbal memory, partial loss of memory of all words indiscriminately, and so forth ; with the suggestion that such symptoms may, in general, be traced to cerebral excitement, inflammation, or congestion, or some other cause affecting the brain generally or locally ; guarded, however, by the acknowledgement, that even this much cannot be asserted without the aid of pathology. The object of Dr Moir is to prove, that the conclusions at
• Published in Nos. 36, 37, and 38 ; vol. viii. pp. 250, 308, 414.
whico I have arrived are erroneous, or “ do not hold good in all cases.” I need not comment on the logic of holding that conclusions
be true at one time and false at another. To accomplish this object two cases are given, one of which is obviously an example of disease originating in disturbance of the cerebral functions; the other, which is so triumphantly advanced, it will astonish Dr Moir to learn, does not bear in the most remote degree on the point at issue. The first is that of a paralytic woman, who gradually “ lost the power of expressing her ideas in proper language, using sometimes words conveying a meaning quite different from what she intended," but who preserved her intelligence unimpaired. After death, tumors were discovered in the middle and posterior part of the brain. I will not attempt to associate the defective power with the indirect irritation occasioned by the extensive disease under which the patient laboured, but content myself with referring to the phenomena which so frequently attend paralysis, epilepsy,
, and insanity, and with demanding if the symptom here particularised is not to be regarded in the same light-as an indication of the general affection of the nervous system. That the part of the brain regarded as the organ of Language is, even in such a case, implicated and specially affected, I believe: but this belief does not imply that the implication shall be organic, or at least appreciable by the senses. nerve becomes insensible, although no change in its structure can be perceived. In all, or nearly all, the instances which I have adduced, no organic lesion existed, or was actually proved to exist-simply because the symptoms proceeded from disorder rather than from extinction of the power. Of many, the duration was brief, and the recovery complete ; of others, the continuance appeared to depend on the intensity of other maladies; and of all, with the exception of those illustrative of total destruction of the faculty, it was confessed that we knew not the organic cause—a confession equivalent to saying that they depended on functional disease. Dr Moir's first case, then, appears to be precisely of this description ; and if he will condescend to examine the paper which he has undertaken to criticise, he will find that many cases almost precisely similar have been there recorded, and attributed, not to ramollisement or structural alteration of the convolutions proved to be the organ of Language, but to some morbid action affecting the brain as a whole.
The second case is that of a boy who received a wound in the orbit from the birch end of a scavenger's broom; and whose brain after death presented the following, among other morbid appearances: “Adhesion of brain to the dura mater, corresponding to an opening in the left orbital plate of the frontal bone, about half an
inch posterior to its internal angle. The cerebral matter adhered only round the edge of this opening, &c. The olfactory nerve of the left side was pushed aside towards the mesial line, and at the anterior part of the bulb was, along with a small part of the brain adjoining to it, dark-coloured and softened.”, This individual, although in a state of conna or delirium during the whole period between the infliction of the injury and his death, is reported to have answered questions distinctly when roused ; and his condition is THEREFORE assumed as proving that no connexion subsisted between the preservation of the power of language and integrity of the inferior portion of the anterior lobes. The
presence of organic degeneration in the anterior lobes, however, is not sufficient: it must extend to those convolutions resting on the CENTRE of the orbital plate; and moreover, the change must be present on the same spot IN BOTH HEMISPHERES. In Bouillaud's cases, this condition of the brain was observed, and in them the loss of language was complete and permanent. Where the injury is limited to one side, as in the case under discussion, we can no more expect that the faculty should be destroyed, than that, from the loss of one eye, blindness should ensue. But supposing for a moment that the softening described' had been detected in the right hemisphere likewise, the fact could not have invalidated Dr Gall's conclusions, inasmuch as the change does not appear to have involved the organ of Language at all. It is stated to have been situate about half an inch posterior to the internal angle of the orbital plate," and to have included the portion of brain adjoining to the olfactory bulb. Had Dr Moir consulted any of the works treating of the principles which he aspires to 'oppose, he would have found that the point here indicated corresponds to the
organ of Form, and not to that of Language.
I need not say that this case likewise must be regarded as áltogether irrelevant. I am, &c.
W. A. F. BROWNE. Montrose, 5th Nov. 1834.
1, Mr ANDREW CARMICHAEL's Reconsideration of his “ Conjectures"
" in reference to Mr Macnish's " Philosophy of Sleep." Read before the Dublin Phrenological Society.
In the Phrenological Journal, No. XXXIX, is an able and interesting review of Mr Macnish's “ Philosophy of Sleep.” I
participate in every sentiment it expresses of this admirable work. I think it " worthy of a place in every well-furnished library;", and I am sure it will interest equally the reader for amusement and the philosophical thinker, But there is one little passage, and perhaps the only one in the book, or the review, in which I very widely differ from Mr Macnish and the reviewer; and this confession will perhaps be considered an unqualified compliment to both, as even that passage might not have proved any exception, if it had concerned any other essayist but myself. Be that as it may, I dissent from Mr Macnish, because he confounds the essence of my theory with an inference drawn from ita corollary, which may be false even though the theory be true ; and I dissent from the reviewer, because he adopts the mistake, and judges of me and my hypothesis accordingly. The following paragraph from the Review com, prises the whole of the passage to which I have adverted...
“In treating of the uses of sleep, the author comments on the views of Mr. Andrew Caripicbael, of which we gave some account at page 268 of this volume. Mr Carmichael supposes sleep to be the period when assimilation goes on in the brain. In this respect (says Mr Macnish), I believe that the brain is not differently circumstanced from the rest of the body. There, as elsewhere, the assimilative process proceeds both in the slumber, ing and in the waking state ; but ihat it is at work in the brain only during sleep, analogy forbids us to admit. So long as circulation continues, a deposition of matter is going on; and circulation, we all know, is at work in the brain, as in other organs, whether we be asleep or awake.' Mr Carmichael's theory (the Reviewer continues), is certainly an unsupported conjecture, and we are inclined to agree with Mr Macnish in thinking analogy against it."
I never proposed my theory as any thing else but a conjecture; but it can scarcely be said to be unsupported, when it naturally accounts for all the various phenomena of sleep, and has stood its ground in defiance of every objection which my own reflections or the ingenuity of others have as yet started against it. My simple hypothesis, divested of all inference or corollary, is this: not that sleep is the period when assimilation goes on in the brain, BUT THAT THE PROCESS OF ASSIMILATION IN THE BRAIN IS THE ACTUAL CAUSE OF SLEEP.
We know that that must be something more than rest which involves so intense and predominant a change as that which locks up the senses and the intellect, and induces an oblivion of all we knew, an annihilation to us of all that existed. Such a change can only be caused by some important vital process, so indispensable as to be of daily recurrence, and of such general influence as to engage every part of the frame, but particularly the organs of thinking, sensation, and voluntary motion. Such a process is that which repairs the waste of the brain and nerves, and preserves their consistence and vigour; and powerful and overwhelming must be its effects upon the delicate and fragile instruments of thought, feeling, and motion. It would be, in my mind, irrational to suppose that a change wbich affects their very structure, by the deposit of new particles, if that deposit be extensive and considerable, must not be attended by a cessation of their functions--an actual, though a natural paralysis-THE PARALYSIS OF SLEEP.
If 'small in quantity, and while the brain and nerves are in a state of active energy, the matter deposited may be hurried unobserved into the existing activity of the living matter ; but if large in quantity, and while these organs are resting from their labours, can it be that the extraneous and unassimilated mass does not press its increasing weight on their fragile machinery, and produce an EFFECT something like the pressure of the overswollen bloodvessels--but natural, necessary, and healthful,what we have already termed THE PARALYSIS of SLEEP?
A large deposit of those particles not yet employed in the functions of feeling or thinking, must have a similar effect as the imposition of an extraneous body on those tender and exquisite organs ; and their paralysing compression must continue under
; the form of sleep until the assimilation is complete, and the new mass of nervous particles as fit as the old for the operations and uses designed by the Creator. The function then commences; internal organ after organ, nerve after nerve, enters into activity ; the external senses resume their daily occupations; the mind is in communication with the external world ; we are, to all intents and purposes, awake.
In this account of the principal component part of my theory, I have borrowed, in some degree, from my Memoir of Spurzheim. The passages in that work express, with a few exceptions, the views which I still entertain upon this subject. But where those exceptions occur, I have modified my exposition so far as was necessary to convey the opinions I would be now understood to profess. I am indebted to Mr Macnish for forcing upon me the reconsideration of the hypothesis. Neither he nor I can have any object beyond the attainment of truth; and, to this happy result, nothing is more conducive than the collision of minds.
It is not necessary to my theory, that the assimilative process should be at work in the brain only during sleep. It may proceed there, as elsewhere, both in the slumbering and in the waking state, without affecting, in the slightest degree, my hypothesis. But it is necessary to its truth, that there, as elsewhere, this process should operate with more energy, or at least more effect,