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THE

LONDON LANCET.

A JOURNAL OF

BRITISH AND FOREIGN MEDICAL,

SURGICAL AND CHEMICAL SCIENCE,

CRITICISM, LITERATURE AND NEWS.

FOR THE YEAR 1869.

EDITED BY

JAMES G. WAKLEY, M.D., M. R. C. S.

New York:

1869.

THE LANCET.

. I Journal of British and foreign Medicine, Physiology, Sur

gery, Chemistry, Criticism, Literature, and News.

J. IENRY BENNET, M.D., T. WAKLEY, JR., M.R.C.S.E. EDITORS.

PUBLISHED MONTHLY.

No. 1.

NEW YORK, JANUARY, 1869.

Lectures

ON THE

AND ON THE

complete hemiplegia from disease of the spinal cord, although existing in those cases, have attracted no attention. On the other hand, some

cases of genuine and complete spinal hemiplegia PHYSIOLOGY AND PATHOLOGY OF have been published by writers who have not un

derstood what was the signification and imporTHE NERVOUS SYSTEM. tance of the symptoms they have described.

Such is a remarkable case published by Dr.

Dundas, and to which I shall revert by-and-by. TREATMENT OF ORGANIC NERVOUS Experiments on animals have led me to the disAFFECTIONS.

covery of the very striking and curious features

of the complete spinal hemiplegia. I gave for By C. E. BROWN-SEQUARD, M.D., F.R.S., the first time a description of these symptoms in

the lectures I delivered, in 1858, at St. BarthuloFellow of the Royal College of Physicians of London ; mew's Hospital and at the College of Surgeons. * Member of the National Academy of Science (U. 8.) Etc.

At that time, however, I had only observed them in animals; but since then I have seen no less

than twenty cases of complete spinal hemiplegia, LECTURE I.

or of a similar affection, which I will describe ON SPINAL HEMIPLEGIA.

under the name of hemi-paraplegia. Both these

affections are certainly rare, and I owe the good Characteristic symptoms of spinal hemiplegia.-chance I have had of observing many cases to my

Cases of wound and other kinds of lesion of the efforts in hunting for them, and to the kind asEpinal cord haring produced in the limbs, the sistance of medical friends and pupils. face, and the eye the paralytic, anæsthetic, hyper- I hardly need to say that spinal hemiplegia is esthetic, and the principal vaso-motor symptoms the effect of a disease of, or an injury to, a lateral of spinal hemiplegia.Cases of incomplete spinal half of the spinal cord. The principal symptoms hemiplegia.- Comparison of spinal with cere are, paralysis of voluntary movements and hyperbral hemiplegia.- Treatment of spinal hemiple- æsthesia on one side (the side of the lesion), and gia.

anesthesia on the other side. But, besides these

characteristic features, others are also observed, GENTLEMEN,- It is my intention to give in which are perhaps no less remarkable, amongst this first lecture a full history of a very interest-which I will only point out now symptoms of ing, but very little known, kind of paralysis. paralysis of the vaso-motor nerves in the limbs, You would vainly look for an account of the curi- the face and the eye. ous and peculiar symptoms of this affection in The explanation of the synıptoms of spinal hemi. the works of even the best writers on the physio- plegia is extremely simple and easy. Experi. logy and disease of the nervous system. I must ments on animals and a great many clinical facts say, however, that Dr. R. Bright* and Dr. Toddt show that an injury, destroying a small zone, or have spoken of spinal hemiplegia, but no mention dividing the whole lateral half

, of the spinal is made by them of the peculiar features of that cord in the cervical region, produces the followaffection, either because the cases they have seen ing symptoms :were of the kind which I will describe hereafter

See my Course of Lectures on the Physiology and Pathounder the name of incomplete spinal hemiplegia, logy of the Central Nervous System. 1860. Lectures III., or because the characteristic symptoms of the VII., and XII.

+ some interesting cases in support of my views have

been reported by friends of mine, amongst whom I will * Reports of Medical Cases, vol. 11., part i.

name Dr. C. B. Radcliffe, Dr. J. Hughlings Jackson, and Dr. + Clinical Lectures on Paralysis, &c., by Dr. R. B. Todd, Victor Bazire. In one of his valuable lectures on Hemi1851, p. 321 et seq. Two cases are given, but one of them, as plegia, Dr. Hughlings Jackson has called attention to this I will show in another lecture, was a case of reflex hemi subject. (See the London Hospital Reports, vol. 11. 1865, p. plogia, followed by paraplegia.

299.)

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