BRAIN SURGERY.

Lyttelton Times, Volume LXXX, Issue 10105, 2 August 1893, Page 6

BRAIN SURGERY.

(North American Review.) Even after the Gorman Hitzig, thft Englishman Ferrier, and other investigators in different parts of the world had mapped out the surface of the brain, explored its interior, and demonstrated the relations of its several centres to the sensory and motor functions of the body, there was a howl of indignation when that bold and scientific physician. Dr Bartholow, touched with the electric needle the exposed brain of a patient and established for the first time on a human subject. the functions of a cortical centre; Barfcholow’s experiment is now a common procedure ia surgical operations on the brain when there is doubt as to the anatomical relations of the part upon which we are operating. We touch the point with a delicate needle connected with a very small galvanic battery and the muscles which derive their motor power from that region at once respond by contracting. Many experiments of this character performed upon animals, especially monkeys, have given us quite accurate ideas of the position of the motor centres for various groups of muscles, and these, together with post-mortem examinations of tho brains of persons who have died while suffering from impairment of a brain faculty, have made us acquainted with tho centres for speech, for vision, for hearing, and for other important ideational, sensory, and motor functions. As an example, take that of speech, a power that may be deranged by injury of that part of the brain called the speech tract, and which, strange to say, is located, or at least developed, in perhaps cine hundred and ninety-nine persons out of a thousand, on the left side of the brain only. Disease or injury of this region produces the condition called aphasia, which is an impairment of the ability to recognise words when written or spoken, or the loss of the power to so use the muscles' of speech, as to articulate words even when these latter are recognised when written or spoken. The very idea of language ia therefore destroyed. Sometimes such a condition is produced by an injury to the left side of the head, and then it may happen that a surgical operation leads at once to the restoration of the function. Tumours that would otherwise surely cause the death of the patient are now removed and life and reason preserved. Our knowledge of the anatomy and physiology of the brain enables us to locate these and other diseased conditions with precision, and though it is true that many of the subjects of these operations die, yet it must be borne in mind that death would be the inevitable result in all of them if surgical interference were neglected. If, therefore, we succeed in saving a small proportion of such cases, humanity is the gainer. Antiseptic measures and strict attention to cleanliness and nursing have wonderfully aided in securing the many brilliant results in brain surgery which the trephine and the knife have yielded us. Now, the event most to be feared is not so much the immediate operation as it is the subsequent inflammation and suppuration resulting from the necessary manipulation and the exposure to the atmosphere. This danger is at the present time reduced to a minimum. The skull is opened, the membranes are divided, the brain itself is explored with probes and knives, an abscess is evacuated, a clot of blood removed, a tumour excised, and the subjects of all these bold and terrible procedures suffer no pain, and recover without the formation of a single drop of pus.