Dr. Godlee's operation of removing a tumor from the brain marks an important step in cerebral localization, and cerebral surgery bids fair to take a prominent place in the treatment of mental diseases.
Wernicke has observed that the size of the occipital lobes is in proportion to the size of the optic tracts, and that the occipital lobes are the centers of vision.
Hughlings Jackson has observed that limited and general convulsions were often produced by disease in the cortex of the so-called motor convolutions. The sense of smell has been localized by Munk in the gyri hippocampi, while the center of hearing has been demonstrated to be in the temporal lobes. The center for the muscles of the face and tongue is in the inferior part of the central convolution; that for the arm, in the central part; that for the leg, in the superior part of the same convolution; the center for the muscles and for general sensibility, in the angular gyrus; and the center for the muscles of the trunk, in the frontal lobes. In pure motor aphasia the lesion is in the posterior part of the left third frontal convolution; in cases of pure sensory aphasia, the lesion is in the left first temporal convolution.
The relation of the cerebrum to cutaneous diseases has been studied much of late, and it is now held that the cutaneous eruptions are mainly due to the degree of inhibiting effect exerted upon the vaso-motor center.
The relation of the spinal cord to skin eruptions has been more thoroughly investigated and more abundant evidence supplied to demonstrate the influence degeneration of the spinal cord has in causing skin diseases, notably zoster, urticaria, and eczema.
This rheumatism, pneumonia, diabetes, and some kidney diseases and liver affections are often the result of persistent nervous disturbance is now held. That a high temperature (the highest recorded) has resulted from injuries of the spinal cord, and where the influence of microzymes is excluded, is not a matter of question. In one instance, the temperature reached 122° F., and remained for seven weeks between 108° and 118° F. The patient was a lady; the result was recovery. Hence it cannot be fever which kills or produces rapid softening of the heart and other organs in fatal cases of typhoid. Fever, so far as it consists in elevation of temperature, can be a simple neurosis.
Many other items of progress might be presented did time permit, particularly in the treatment of nervous affections, but this I leave for another occasion.
Volunteer report presented to Nebraska State Medical Society, May, 1885, at Grand Island, Neb.