On the relations between the nerves of motion and of sensation and the brain; more particularly on the structure of the medulla oblongata and the spinal marrow.

2012 ◽  
pp. 231-240
Author(s):  
Charles Bell

The author, after commenting on the opinions of Le Gallois and Cruveilhier relating to the functions of the spinal marrow, adverts to a property or function of the medulla oblongata and spinalis, which he considers as having escaped the notice of these and all other physiologists; namely, that by which an impression made upon the extremities of certain nerves is conveyed to these two portions of the nervous system, and reflected along other nerves to parts different from those which received the impression. He distinguishes muscular actions into three kinds: first, those directly consequent on volition; secondly, those which are involuntary, and dependent on simple irritability; and thirdly, those resulting from the reflex action above described, and which include those of the sphincter muscles, the tonic condition of the muscles in general, the acts of deglutition, of respiration, and many motions, which, under other circumstances, are under the guidance of the will. Volition ceases when the head or brain is removed; yet, as he shows by various experiments, movements may be then excited in the muscles of the limbs and trunk, by irritations applied to the extremities of the nerves which remain in communication with the spinal marrow: but these actions cease as soon as the spinal marrow is destroyed. Hence the author concludes that they are the effect of the reflex Action of the spinal marrow, which exists independently of the brain; and, indeed, exists in each part of the organ independently of every other part. He considers that this reflex function is capable of exaltation by certain agents, such as opium and strychnine, which in frogs produce a tetanic and highly excitable state of muscular irritability. Hence he is led to view the reflex function as the principle of tone in the muscular system. He considers that certain poisons, such as the hydrocyanic acid, act by destroying this particular function. The effects of dentition, of alvine irritation, and of hydrophobia, of sneezing, coughing, vomiting, tenesmus, &c. &c., are adduced as exemplifications of the operation of the same principle when in a morbid state of exaltation.


The author first alludes to what usually happens in affections of the brain, namely, that the loss of voluntary power and of sensation, manifest themselves in the opposite side of the body to that in which the cerebral lesion exists, a fact which has been attempted to be explained by the crossing of the fibres at the junction of the medulla oblongata with the anterior or motor columns of the medulla spinalis ; but such a structure, he observes, affords no explanation of the loss of sensation. The author then, referring to the communication of Sir Charles Bell to the Royal Society, in the year 1835, describing a decussation connected with the posterior columns, or columns of sensation, mentions that the accuracy of these dissections was doubted by Mr. Mayo and other eminent anatomists. The author proceeds to state that the symptoms of cerebral lesion do not always take place on the opposite side of the body to that in which the lesion of the brain exists, but that they occur sometimes on the same side; that the loss of power and of sensation, although confined to the same side, may exist in either the upper or the lower extremity; but that both are not necessarily implicated; and that, in fact, cases occur where there are marked deviations from what may be considered the more common occurrence. Having observed such cases, and not being aware of any satisfactory explanation, the author examined with care the continuation upwards of the anterior and posterior columns of the spinal marrow into the medulla oblongata and found that the decussation at the upper part of the spinal marrow belonged in part to the columns for motion, and in part to the columns for sensation; and farther, that the decussation is only partial with respect to either of these columns; thus elucidating hy the observation of the actual structure what before appeared very unsatisfactory in pathology, and anomalous in disease. The paper is illustrated by drawings made from the dissections of the author.


The author enters into a minute anatomical investigation of the structure of the spinal cord, and of its relations with the encephalon, and with the origins of the nerves. He finds that the spinal cord is constituted, in its whole length, by six pairs of columns, namely, two posterior, two lateral, and two anterior; each column being composed of concentric layers, and invested with an external coating of cineritious substance, and all the columns being divided from each other by deep sulci, which penetrate nearly to the centre of the cord. On tracing the posterior columns in their ascent towards the encephalon, they are seen to diverge laterally at the calamus scriptorius , or bottom of the fourth ventricle, and to proceed into the substance of the cerebellum. Each of these posterior columns is here found to consist of two portions, the outermost being the largest; and they now constitute the processus cerebelli ad medu oblongatam . This subdivision of the posterior columns may be traced throughout the whole length of the spinal cord. The lateral columns give origin to the posterior roots of the spinal nerves, and are therefore the parts subservient to sensation. In ascending towards the brain, each of these columns has a double termination; first, in the root of the fifth pair of cephalic nerves; and secondly, in the place where both columns unite into one round cord, and mutually decussate. Between the lateral and the anterior columns there is interposed a layer of cineritious matter, constituting a continuous stratum from the cauda equina to the roots of the auditory nerves. There is also a septum, dividing the right and left tracts subservient to sensation in the region of the fourth ventricle, and apparently terminating at the point of decussation of these tracts; but, in reality, separating to allow of this decussation, and joining the central portion of the cord, which connects the posterior with the anterior columns, and extends from the pons Varolii to the cauda equina .


The author begins by observing that a former memoir of his, entitled, “ On the Reflex Function of the Medulla Oblongata and Medulla Spinalis,” published in the Philosophical Transactions for 1833, has been translated into German, and favourably spoken of by Professor Muller, of Berlin. He states that his object in the present paper is to unfold what he calls a great principle in physiology j namely, that of the special function, and the physiological and pathological action and reactions of the true spinal marrow, and of the excito-motory nerves. The two experiments which he regards as affording the type of those physiological phenomena and pathological conditions, which are the direct effects of causes acting in the spinal marrow, or in the course of the motor nerves, are the following :— 1. If a muscular nerve be stimulated, either mechanically by the forceps, or by means of galvanism passed transversely across its fibres, the muscle or muscles to which it is distributed are excited to contract.—2. The same result is obtained when the spinal marrow itself is subjected to the agency of a mechanical or galvanic stimulus. The following experiment, on the other hand, presents the type of all the actions of the reflex function of the spinal marrow, and of the excito-motory system of nerves, and of an exclusive series of physiological and pathological phenomena :—If in a turtle, from which the head and sternum have been removed, we lay bare the sixth or seventh intercostal nerve, and stimulate it either by means of the forceps or galvanism, both the anterior and posterior fins, with the tail, are immediately moved with energy. Hence the author infers the existence: 1st, of a true spinal marrow, physiologically distinct from the chord of intra-spinal nerves; 2ndly, of a system of excito-motory nerves, physiologically distinct from the sentient and voluntary nerves; and, 3rdly, of currents of nervous influence, incident, upwards, downwards, and reflex with regard to the spinal marrow. A review is then taken of the labours of preceding physiologists relative to the functions of the nervous system : in which the author criticises the reasonings of Whytt, Legallois, Mr. Mayo, Dr. Alison, and Professor Muller; and illustrates his own peculiar views by several experiments and pathological observations, which appear to him to show that muscular movements may occur, under circumstances implying the cessation of sensation, volition, and every other function of the brain; and that these phenomena are explicable only on the hypothesis that impressions made on a certain set of nerves, which he terms excitomotory , are conveyed to a particular portion of the spinal marrow belonging to that system, and are thence reflected, by means of certain motor nerves, upon certain sets of muscles, inducing certain actions. The same actions may also be the result of impressions made directly either on the spinal marrow or on the motor nerves. He accordingly considers that the whole nervous system may be divided into,— 1st, the cerebral , or the sentient and voluntary; 2ndly, the true spinal, or the excitor and motor; and, 3rdly, the ganglionic, or the nutrient, the secretory. The excito-motory system presides over ingestion and exclusion, retention and egestion, and over the orifices and sphincters of the animal frame: it is therefore the nervous system of respiration, deglutition, &c., and the source of tone in the whole muscular system. The true spinal system is the seat or nervous agent of the appetites and passions, but is also susceptible of modification by volition. This theory he proceeds to apply to the explanation of several phenomena relating to the motions of the eyelids, pharynx, cardia, larynx, muscles of inspiration, sphincter animal expulsors of the faeces and semen, to the tone of the muscular system generally, and to actions resulting from the passions. Lastly, he considers its application to various diseased states of the same functions, as manifested in cynic spasm, vomiting, asthma, tenesmus, strangury, crowing inspiration, convulsions, epilepsy, tetanus, hydrophobia, and paralysis.


1809 ◽  
Vol 99 ◽  
pp. 146-147

Sir, According to your request, I send you an account of the facts I have ascertained, respecting a canal I discovered in the year 1803, in the medulla spinalis of the horse, bullock, sheep, hog, and dog; and should it appear to you deserving of being laid before the Royal Society, I shall feel myself particularly obliged, by having so great an honour conferred upon me. Upon tracing the sixth ventricle of the brain, which corresponds to the fourth in the human subject, to its apparent termination, the calamus scriptorius, I perceived the appearance of a canal, continuing by a direct course into the centre of the spinal marrow. To ascertain with accuracy whether such structure existed throughout its whole length, I made sections of the spinal marrow at different distances from the brain, and found that each divided portion exhibited an orifice with a diameter sufficient to admit a large sized pin; from which a small quantity of transparent colourless fluid issued, like that contained in the ventricles of the brain. The canal is lined by a membrane resembling the tunica arachnoidea, and is situated above the fissure of the medulla, being separated by a medullary layer: it is most easily distinguished where the large nerves are given off in the bend of the neck and sacrum, imperceptibly terminating in the cauda equina. Having satisfactorily ascertained its existence through the whole length of the spinal marrow, my next object was to discover whether it was a continued tube from one extremity to the other: this was most decidedly proved, by dividing the spinal marrow through the middle, and pouring mercury into the orifice where the canal was cut across, it passed in a small stream, with equal facility towards the brain (into which it entered), or in a contrary direction to where the spinal marrow terminates.


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Omar M Hussein ◽  
Eder Caceres ◽  
kasser saba ◽  
Hera Kamdar ◽  
khalid Sawalha ◽  
...  

Background: Respiratory centers are known to be present in the central medulla oblongata and pons. There are multiple complex respiratory networks involving these centers. The midbrain periaqueductal grey is believed to act as a regulator of the respiratory function. The effect of brain-stem strokes on respiration remains understudied. There is a lack of clear understanding of the anatomical influence of such strokes on respiration. We attempted to identify brain-stem locations with the highest liability for respiratory failure in case of stroke. Methods: We included all ischemic and hemorrhagic brain-stem strokes from our stroke-registry between 2016 and 2018 then performed univariate/multivariate regression-analyses on variables that might predict respiratory failure and the need for intubation. The brain stem was divided into nine locations (right lateral, central, left lateral in each of the midbrain, pons, and medulla oblongata). Results: Out of 128 brain-stem strokes of different sizes and etiologies, central midbrain strokes were the only significant and independent affected location associated with respiratory failure and endotracheal intubation (coefficient= 0.1256, 95%-CI= 0.0175, 0.2338, p= 0.023). R-squared was equal to 15% when only central midbrain strokes stayed in the model. Conclusions: While one might assume that central medullary and pontine strokes have the most impact on respiration; our results show that central midbrain is the most impactful, accounting for about 15% of respiratory instability associated with brain-stem strokes. This can be explained by the adaptive nature of respiratory circuits within the medulla and pons. Central periaqueductal grey within the midbrain controls the rate and depth of respiration and might not have the same flexibility present elsewhere.


Author(s):  
Renjie Wang ◽  
Yankun Shao ◽  
Lei Xu

Introduction: The medulla oblongata is the lowest segment of the brain stem, located adjacent to the spinal cord, with a complex anatomical structure. Thus, a small injury to the medulla oblongata can show complex clinical manifestations. Case Presentation: A patient experienced dysesthesia, which manifested as numbness in her right lower limb and decreased temperature sense, and dizziness 20 days before admission. The numbness worsened 1 week before admission, reaching the right thoracic (T) 12 dermatomes. Her thermoception below the T12 dermatomes decreased, and the degree of dizziness increased, accompanied by nausea and vomiting. Magnetic resonance imaging (MRI) of the neck, chest, and abdomen performed at a local hospital showed no abnormalities. MRI of the brain was performed after admission. One week after admission, she experienced a severe headache in the upper left periorbital area. The numbness extended to T4, and thermoception decreased below T4. Diagnosis: Lateral medullary infarction. Interventions: Anti-platelet aggregation and mitochondrial nutritional therapies were performed along with treatments for improving circulation and establishing collateral circulation. Outcomes: The intensity of limb numbness decreased, and the symptoms of headache and dizziness resolved. Conclusion: Lesions leading to segmental sensory disorders can occur in the medulla oblongata. Ipsilateral headaches with contralateral segmental paresthesia can be a specific sign of lateral medullary infarction.


Part I. The Medulla Oblongata, And Its Variations Acoording To Diet And Feeding Habits In previous communications to this Society the relationship of the habits of feeding and diet to the form and pattern of the medulla oblongata has been described in the cyprinoids, clupeids, and gadoids (Evans, 1931, 1932, 1935). This research takes up a similar study of the brain of the Pleuronectidae. The expense has been borne by a grant from the Royal Society for which the author tenders his grateful thanks. It has seemed to be desirable to extend the observations to the fore- and mid-brain, as in some members of the family these present a very marked development. In order to elucidate some of the problems that arise I have also studied the brain of the eel, and some interesting conclusions have resulted. We find, as a result of examination by the naked eye and of serial sections, that we can divide the following species into four groups as follows: I. The sole, Solea vulgaris .


1825 ◽  
Vol 115 ◽  
pp. 81-86

In the year 1822, I laid before the Society a series of observations on the progress of the formation of the chick in the egg of the pullet, illustrated by drawings from the pencil of Mr. Bauer, showing that in the ova of hot-blooded animals the first parts formed are the brain and spinal marrow. I have now brought forward a similar series on the progress of organization in the ova of cold-blooded animals, illustrated in the same manner by microscopical drawings made by the same hand. By comparing together the first rudiments of organization in the ova of these very distinct classes of animals, I shall be able to prove that, in both, the same general principle is employed in the formation of the embryo.


1862 ◽  
Vol 11 ◽  
pp. 359-366

In consequence of the frequent interruptions to which I am ne­cessarily exposed in the course of my anatomical investigations, I beg to communicate to the Royal Society, in the form of notes, some of the results at which I have arrived, with a promise to forward, in a few months, a complete memoir on the same subject, with the necessary illustrations. In my memoir of the “ Medulla Oblongata,” it is shown that the post-pyramidal ganglion, or grey substance of the posterior pyramid, is developed from the posterior grey substance on each side of the posterior median fissure.


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