[Fig. 43], after Starr, shows how the fibres run downwards. All sensory currents entering the hemispheres run out from the Rolandic region, which may thus be regarded as a sort of funnel of escape, which narrows still more as it plunges beneath the surface, traversing the inner capsule, pons, and parts below. The dark ellipses on the left half of the diagram stand for hemorrhages or tumors, and the reader can easily trace, by following the course of the fibres, what the effect of them in interrupting motor currents may be.
Fig. 43.—Schematic transverse section of the human brain, through the rolandic region. S, fissure of Sylvius; N.C., nucleus candatus, and N.L., nucleus lenticularis, of the corpus striatum; O.T., thalamus; C, crus; M, medulla oblongata; VII, the facial nerves passing out from their nucleus in the region of the pons. The fibres passing between O.T. and N.L. constitute the so-called internal capsule.
One of the most instructive proofs of motor localization in the cortex is that furnished by the disease now called aphemia, or motor aphasia. Motor aphasia is neither loss of voice nor paralysis of the tongue or lips. The patient's voice is as strong as ever, and all the innervations of his hypoglossal and facial nerves, except those necessary for speaking, may go on perfectly well. He can laugh and cry, and even sing; but he either is unable to utter any words at all; or a few meaningless stock phrases form his only speech; or else he speaks incoherently and confusedly,
Fig. 44.—Schematic profile of left hemisphere, with the parts shaded whose destruction causes motor ('Broca') and sensory ('Wernicke') aphasia.
mispronouncing, misplacing, and misusing his words in various degrees. Sometimes his speech is a mere broth of unintelligible syllables. In cases of pure motor aphasia the patient recognizes his mistakes and suffers acutely from them. Now whenever a patient dies in such a condition as this, and an examination of his brain is permitted, it is found that the lowest frontal gyrus (see [Fig. 44]) is the seat of injury. Broca first noticed this fact in 1861, and since then the gyrus has gone by the name of Broca's convolution. The injury in right-handed people is found on the left hemisphere, and in left-handed people on the right hemisphere. Most people, in fact, are left-brained, that is, all their delicate and specialized movements are handed over to the charge of the left hemisphere. The ordinary right-handedness for such movements is only a consequence of that fact, a consequence which shows outwardly on account of that extensive crossing of the fibres from the left hemisphere to the right half of the body only, which is shown in [Fig. 41], below the letter M. But the left-brainedness might exist and not show outwardly. This would happen wherever organs on both sides of the body could be governed by the left hemisphere; and just such a case seems offered by the vocal organs, in that highly delicate and special motor service which we call speech. Either hemisphere can innervate them bilaterally, just as either seems able to innervate bilaterally the muscles of the trunk, ribs, and diaphragm. Of the special movements of speech, however, it would appear (from these very facts of aphasia) that the left hemisphere in most persons habitually takes exclusive charge. With that hemisphere thrown out of gear, speech is undone; even though the opposite hemisphere still be there for the performance of less specialized acts, such as the various movements required in eating.
The visual centre is in the occipital lobes. This also is proved by all the three kinds of possible evidence. It seems that the fibres from the left halves of both retinæ go to the left hemisphere, those from the right half to the right hemisphere. The consequence is that when the right occipital lobe, for example, is injured, 'hemianopsia' results in both eyes, that is, both retinæ grow blind as to their right halves, and the patient loses the leftward half of his field of view. The diagram on [p. 111] will make this matter clear (see [Fig. 45]).