Reviews and Notices of Books

1891 The Lancet  
1890. BROCA'S discovery of the site of the faculty of articulate speech was first made public in 1861, and Ferrier's work on the Functions of the Brain was published in 1876. Many anatomists abroad and in this country have endeavoured to lay down rules for defining the situation of the more important fissures and convolutions. Foremost among our own countrymen have been Turner, Hare, Reid, Horsley, Thane, and Cunningham. The keystone of such work has hitherto been to define the position of the
more » ... he position of the fissures of Rolando and of Silvius and of the convolutions that surround them. The work before us is a fresh proof of the energy and thoroughness with which British anatomists are seeking to further the progress of surgery. Although professing itself to be a guide to operations on the brain, the plates are of such excellence and the dissections of such merit that no teacher of anatomy can afford to dispense with such a ready exposition of parts of the body which frequently vary, and concerning the relations of which much difference of opinion exists amongst writers. The major part of the book consists of forty-two life-size plates in autotype, and this is preceded by a short but pregnant description of the mode in which the work has been accomplished, and of the serial dissections so far as they have been reproduced. There is no attempt to deal with the subject of localisation of function, but the method of demarcation is entirely different from that usually adopted in the text-books, in that the scalp is marked out by a series of tapes into sections with which the various areas of the brain are seen to correspond. This idea is probably a development of that of Hefftler, who drew his outlines with different coloured pencils. The tapes are placed in longitudinal and transverse directions, according to a prescribed system. It is to be regretted that the measurement adopted has been by inches, and not according to the metrical system. By means of composite views, the lines of these tapes are shown on the skull and their relations to the parts of the brain exhibited in the succeeding plates remain. The author finds that the pinna varies so much in size and position that any result based on lines drawn from any part of it is of little value from a practical or any other point of view. The divisions of the convexity of the brain have, with certain minor additions, been marked according to the widely-accepted description of Ecker. The plates which show the external surface of the brain are, perhaps, the most worthy of study of the whole series, not only for the artistic manner in which they are produced, but also on account of the extreme care and minuteness with which the dissection of the parts of the cerebrum, cerebellum, and of the cranial, dorsal, and cervical nerves has been carried out, though the latter are even better shown in some of the later pictures. The reproductions of the dissections of the interior of the brain are unequal, but all are of the greatest interpst, and many display variations in the disposition of parts which have not hitherto been accepted. The practical value of these plates is well exemplified by the series exhibiting the course and position of the posterior horn of the lateral ventricle and the thickness of the hemisphere between it and the bone through which it may be reached from a spot behind the pinna indicated by reference to the tapes. In describing the relations of the deeper-lying structures to the surface of the scalp, the author points out that although the keynote of his remarks is, that for normal heads after birth the position of any structure of importance in their cavities varies proportionately with the variations of the circumference as given by the circumferential tapes of the respective heads, yet, as is mentioned later, when indicating the plates upon which the author would depend for guidance in opening the skull on account of lesions of various specified parts, that as the circumference of the heads illustrated varies from 20t to 23-inches, after shaving the scalp, this being the average variation of adult heads, the surgeon may dispense with the rule and select the plate where the measurements are nearest to that of the patient. Furthermore, the relations of the cranial sutures to the scalp surface, both in the adult and the child, are shown to be indicated exactly by the disposition of the tapes, as are also the relations of the middle meningeal and its branches with the dura mater, though the plate illustrating this point is not so distinct as are most of the others. The series of plates which will probably be of the greatest practical value are the composites showing the relations of the external surface of the brain to the scalp. These are from every point of view, and were taken from eighteen different heads. All the relations of the various tapes, as can be seen at a glance at the several heads, are the same in the young and in the adult, and exhibit in a very striking manner the proportional relationships of the external surface of the brain in heads varying in circumference from 14 in. to 23 in. The plates illustrating the central lobes and lateral ven. tricles and their relations to the scalp are less satisfactory than the majority of the series, but their practical utility is not diminished, since the relations of the island, the anterior horn of the lateral ventricle, the descending horn and the hippocampus major to the tapes and spaces can be seen at a glance, as well as those of the optic thalami, the caudate nuclei, and other parts in the lateral and third ventricle. The relations of the lower part of the lateral lobe of the cerebellum in the adult and in the child can be better appreciated from the system of demarcation here adopted than by any description, and these plates are of the most instructive value. By prolonging the median longitudinal tape to the lower part of the neck in the adult, and to the lumbar region in the child, a series of accurate guides are offered to the surgeon to reach every cranial and spinal nerve, of which the dissections are most carefully executed and beautifully shown. With regard to the plates them.
doi:10.1016/s0140-6736(02)18081-0 fatcat:cwmr4nkuknc2xdt67nprbwknmu