Saint Bartholomew's Hospital reports . ved that the chief indications ofdisease during life were disturbance of the motor system, firston the left side, and later on both sides, convulsions and speech-lessness ; while the chief appearances after death were changesdifterent in degree, but most complete in the fronto-parietal,frontal, and occipital region. The fact that the cliange existedin slighter degree between these regions points, as the symptomsdo, to its being progressive. Of the sections of Pitres, the fol-lowing were affected :— (i.) The prefrontal in the lower part of its circumferenc
Saint Bartholomew's Hospital reports . ved that the chief indications ofdisease during life were disturbance of the motor system, firston the left side, and later on both sides, convulsions and speech-lessness ; while the chief appearances after death were changesdifterent in degree, but most complete in the fronto-parietal,frontal, and occipital region. The fact that the cliange existedin slighter degree between these regions points, as the symptomsdo, to its being progressive. Of the sections of Pitres, the fol-lowing were affected :— (i.) The prefrontal in the lower part of its circumference. 70 A Case of Sclerosis of the Cerebral Cortex. As is well known, considerable injury of this region of tlie brainmay take place without any permanent paralysis or sign ofdefinite local irritation, and nothing to the contrary was observ-able in this case. (2.) The occipital in its whole circumference. No motorparalysis and no true ana3sthesia have been observed to accom-pany lesions in this region, but Charcot has observed certain. not very distinct cutaneous syniplonis as associated with lesionof the occipital lobes, and the partial anaesthesia which existedin Louisa W. may have been due to this part of the sclerosis. (3.) \l\\e pediculo-frental, (4.) frontal, and (5.) jmrietal: thepcdiculo-fr(ntal chiefly in its posterior and infeiior part, butthe frontal and j^arietal almost completely. Tims almost thewhole of the cortical substance oi what Cliarcot calls the motorbrain was in a condition of advanced sclerosis, and that this A Case of Sclerosis of (he Cerebral Cortex. 71 region was deeply affected might have beea predicted from theprofound aud extended disturbance of the motor system duringlife. The disease in the inferior part of the pecUculo-fronfalsection on the left side was sufficient to account for the speech-lessness, the precise clinical variety of which was not is, however, to be observed that the pediculo-fi-outal sectionwas affected on the right
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