The cerebellum : its functions, diseases and encephalic interrelations / Charles K. Mills, M.D., LL.D., Emeritus Professor of neurology in the Medical School of the University of Pennsylvania, Philadelphia.

  • Mills, Charles K. (Charles Karsner), 1845-1931
Date:
[1928]
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Licence: In copyright

Credit: The cerebellum : its functions, diseases and encephalic interrelations / Charles K. Mills, M.D., LL.D., Emeritus Professor of neurology in the Medical School of the University of Pennsylvania, Philadelphia. Source: Wellcome Collection.

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    separation of the sutures. As revealed by necropsy, the case was undoubtedly one of disease of the base of the middle lobe, but the symptoms present resulted from both the primary involvement of the cerebellum and the secondary effects of the lesion. The second case was also a tumor and cyst of the inferior surface of the vermis, which must have exerted great pressure on the pyramidal tracts. Jackson speaks of the resulting condition as one of paralysis. It was in reality a mixture of asynergy from destruction of the cerebellar folia and paralysis from pressure on the pyramidal pathway. Jackson seems to recognize this fact in the reference which he makes to the investigations of Ferrier and Turner,27 the practical outcome of which was that synergy was the primary cerebellar function. In one case reported by Jackson and Risien Russell,28 the patient placed face downward was unable to lift his body from the floor hardly more than one half as far as a normal person of about the same age and strength. The account of this case reminds me of a moving picture of one of the patients on whom a similar experiment was tried. The inability exhibited in such an experiment is due to the loss of power to regulate the movements required and not simply to the loss of energy or paralysis in its technical sense. At the neurological research meeting in New York in December, 1926, some valuable records were made of experimental lesions of the cerebellar nuclei and the tracts of degeneration produced by these lesions. A tendency was shown, following Horsley and Clarke,29 to hold that it is necessary to determine only the reactions of the deep nuclei to obtain the key to the functioning of the cerebellum. Investigations of the deep nuclei are, of course, of much importance, but one must search the cortical folia of’the cerebellum to obtain a knowledge of its specific functions just as one must look to the convolutions of the cerebral cortex if one would unravel the functions of the cerebrum. The main deep nuclei of the cerebellum—dentate, emboliformis, globosus, fastigial and vestibular—are places of anatomic and physio¬ logic concentration and integration of the centers of the cerebellar cortex. I do not believe it is correct to infer as Horsley and Clarke and MacNalty and Horsley30 have done, that the large volume of 27. Ferrier, D., and Turner, A.: A Record of Experiments Illustrative of the Symptomatology and Degeneration Following Lesions of the Cerebellum and Its Peduncles, Phila, Tr. Roy. Soc., 1895, vol. 105; cited in Ferrier’s Functions of the Brain (footnote 8). 28. Jackson and Russell (footnote 26, third reference). 29. Horsley, V., and Clarke, R. H.: Structure and Functions of the Cerebel¬ lum Examined by a New Method, Brain 31:45 (May) 1908. 30. MacNalty, A. S., and Horsley, V.: On the Cervical Spinobulbar and Spino-cerebellar Tracts and on the Question of Topographical Representation in the Cerebellum, Brain 32:237 (Nov.) 1909. / /