Course of lectures on the physiology and pathology of the central nervous system. Delivered at the Royal College of Surgeons of England in May, 1858.

  • Brown-Séquard, Charles-Edouard, 1817-1894.
Date:
1860
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Licence: Public Domain Mark

Credit: Course of lectures on the physiology and pathology of the central nervous system. Delivered at the Royal College of Surgeons of England in May, 1858. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    conductors of sensitive impressions decussate in the spinal cord, so that those which come from the left side of the body pass into the right side of the spinal cord3 and vice versa. The hypothesis of the Germans may explain the fact that sensibility persists on the side of the section, but it is proved to be absolutely inadmissible by the fact that there is anaesthesia on the opposite side. We will see that the other experiments we have to mention are also in oppo- sition to the view of the Germans (Stilling, Schiff, and others). On the contrary, all the facts concur to prove the existence of a decussation. 2d. If, after having made a first section of a lateral half of the spinal cord in the dorsal region, on the right side, for instance (see Fig. 9, s), and after having ascertained that the right posterior limb is hyperaesthetic, or at least extremely sensitive, we divide the left lateral half of the spinal cord in the cervical region (Fig. 9, s'), we find then that the right posterior limb loses entirely, or almost en- tirely, its sensibility. This experiment shows clearly that the sen- sitive impressions coming from the right posterior limb, after the first section, passed across the spinal cord from the right into the left side, along which they were transmitted to the encephalon. 3d. To obtain a very striking result from the experiment which consists in only one section of a lateral half of the spinal cord, it is better to make it after the posterior columns have been divided. We know tliat after this division there is hyperesthesia in the parts of the body*w%ich are behind the section; if, after having ascer- tained this fact, the section of a lateral half is completed where the posterior columns have been divided (see Fig. 10, s s'), we find that the hyperesthesia seems to increase on the side of the second ope- ration, while, on the opposite side, not only the hyperesthesia, but sensibility entirely disappears. 4th. There is another mode of proving that the conductors of the sensitive impressions decussate in the spinal cord. In several points of view this mode of demonstration is superior to the pre- ceding. It consists in a longitudinal section of the spinal cord, an experiment already made by Galen, but the results of which, as regards sensibility, have been overlooked by him. The spinal cord is laid bare in the whole lumbar region, and a careful division of the entire extent of the part of the organ giving origin to the nerves of the posterior limbs, is made so as to sepa- rate the two lateral halves of the organ, one from the other. If this experiment could, be executed perfectly well, nothing would