On the decussation of fibres at the junction of the medulla spinalis with the medulla oblongata
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.