She vomited the blandest articles; and accompanying this was a constant and severe headache over the right eyebrow. The headache, however, was always relieved for a time by the vomiting. But she continued to fail; and one day, on being carried up stairs, her head struck with violence against the staircase. It produced no change in the symptomsthere was nothing to indicate an injury or disease of the brain, but she finally sunk, fourteen days after the blow. On dissection, the stomach was found contracted, its mucous membrane vascular, and there was a tumour adhering to the pylorus and duodenum. The membranes of the brain appeared healthy, and the left hemisphere was of its natural appearance, but on opening into the right, several ounces of coagulated blood were discovered. The walls of the cavity containing it were of the consistency of cream. The blood had merely separated into serum and crassamentum." This case is reported as having an important bearing on medicolegal investigations; but what inference can be drawn from it, beyond the simple fact that a quantity of blood was found in the right hemisphere of the brain, around which the cerebral substance was altered in structure? But the questions, whether the disease implicated those parts connected with voluntary motion, as the optic thalami, the corpora striata, &c., or those parts connected directly with the mental faculties, as the cortical or cineritious substance forming the convolutions; or whether it was confined solely to that portion of the medullary substance, which only serves as a medium of communication between a portion of the cortical substance on the surface and the cerebro-spinal centre in the medulla oblongata, we are left entirely in the dark.

And hence we have no data from which to draw a single inference of value. Whether the effusion of blood was produced by the blow against the staircase, without previous disease of the cerebral structure, or came on gradually only a short time before death, in a portion of the brain already in a state of ramollissement from previous disease, is perhaps also difficult to determine; though the circumscribed pain in the head, the softening of the brain around the blood, together with the simple separation of that fluid into serum and crassamentum, would incline us to believe the latter was the case. The same want of precision exists in the detail of many cases related by Abercrombie, in his work on diseases of the brain.* And, indeed, if we examine carefully, we shall find almost half of the cases reported in the various medical journals of the day, equally indefinite, and consequently

* See pages 105, 108, 112, &c., of Abercrombie.

equally valueless to the physiological inquirer. They may prove what every pathologist already knows, viz., that certain parts of the brain may be diseased or totally destroyed, without producing mental derangement or disturbance. Or they may even prove, what Professor Sewall and other opponents of phrenological principles have asserted with so much apparent triumph, viz., that every part of the brain has been destroyed by disease and injury, without producing mental alienation;a fact of just as much physiological importance, as would be the assertion that ten men could be found, in whom, taken collectively, all the organs of external sense were destroyed, and yet every individual of the ten could feel, see, hear, taste, and smell.

It is true that facts form the foundation of all true science; but that foundation will only be useful and permanent, when the facts on which it rests are carefully observed, minutely recorded, and rightly arranged. Hence, in studying the pathology of the brain, it is not enough that we ascertain that half a pound of water has been effused; or that "there is an abscess in the right hemisphere," or a "coagulum of blood in the left;" but we must first, if possible, rightly understand the symptoms during life, ascertaining not only that the intellect is sane, but that all the moral faculties and propensities are equally normal. And after death we must bestow the necessary labour, to ascertain, with minuteness, the precise seat and extent of the disease. If this was done by every observer, we are sure that pathology would not long remain either barren or unfruitful in its contributions to a correct physiology of the whole nervous tissue.

And if these remarks shall serve in any degree to induce more care, and greater precision, on the part of those who report cases of disease, the object for which they are written will be fully realized. Of the great importance, if not absolute necessity, of greater accuracy and minuteness in the detail of cases, every one will be convinced who commences an examination of those already recorded, with the intention of drawing therefrom any general conclusions. In the present state of our knowledge we believe there is no case on record, contradicting the general rule, that disease in the cortical substance of the cerebral convolutions, in corresponding parts of both hemispheres, is invariably attended with derangement of some faculty or propensity of the mind. The cases which seem to militate most strongly against this rule, are those of superficial ulceration of the brain, related by Abercrombie and others. But in those cases, the ulcers were confined to one hemisphere, or affected different parts of both, and were evidently of a strictly chronic and local character.

And the more recent investigations of pathologists would induce us to believe that, in every case where death results from insanity, there is well-marked disease of the cortical substance of the brain. Thus Mr Davidson, house-surgeon to the Lancaster County Lunatic Asylum, "has examined with much care the bodies of more than 200 patients who have died in the hospital since his appointment; and the result is, that he has scarcely met with a single instance in which traces of disease in the brain, or its membranes, were not evident."* Again, M. Foville, Calmiel, Falret, and Bayle, agree in asserting, that "in mental alienation, the brain invariably presents lesions which can be distinctly recognized."† And Sir Wm. C. Ellis, Resident Medical Superintendent of the Pauper Lunatic Asylum at Hanwell [Eng.], states, "that of 154 male patients, examined after death, 145 had disease very strongly marked, either in the brain or its membranes. Of the 9 remaining, 2 were idiots from birth; 1 died of dysentery; another of epilepsy; the other 5 had not been insane more than a few months, and died of other diseases. Of the females, 67 were examined, and 62 found with disease in the brain or its membranes. Two of the other five were idiots from birth; and, with one exception, the others were recent cases." The present list of cases on record would lead us to the equally important conclusion, that disease affecting the central parts of the brain, as the corpora striata, the optic thalami, and the upper portion of the medulla oblongata, invariably deranges the powers of voluntary motion and sensation. For many cases illustrating this conclusion, see American Journal of Medical Sciences, No. 32, August 1835; and Abercrombie on the Brain.

In these cases, the disease is generally insidious in its approach, and often fatal, without any other marked symptom of cerebral disease than paralysis of some one of the extremities, and sometimes convulsions. A third conclusion, of no less practical importance than the preceding, is, that disease in a part of the medullary substance, which forms the commissures or connecting fibres between the convolutions and the central parts mentioned above, when confined to one hemisphere, is seldom, if ever, characterized by either mental derangement, or disturbance of the powers of sensation or volition; and hence its existence is often unsuspected, until revealed by a post-mortem examination. Those cases usually (though not always) commence with paroxysms of severe pain, generally of limited extent, in some part of the * See Combe on Mental Derangement, page 251, American edit. † See ibid.

See American Journal of Medical Sciences, page 157, for May 1840.

head, and not unfrequently vomiting; the skin is hot and dry, the pulse either slower than natural, or small and frequent; and though there is no real mental derangement, yet the patient almost always feels an unpleasant sensation in the head, either more marked or different from what is usual in attacks of ordinary fever. Of this description, are many cases of chronic abscess, related in Abercrombie's work on the Brain. And we should place in the same class, the second case related by Professor M'Naughton, in the American Journal of Medical Sciences, for July 1842. Many of these cases resemble, in the prominent symptoms, mild attacks of fever; and it must be confessed that we yet possess no certain means of diagnosis. But may we not hope that a more careful observation of symptoms will yet enable us to detect disease in this part of the cerebral substance, as well as on its surface, or in the medulla oblongata? Practitioners have been too much in the habit of considering the brain normal, so long as the intellect remained sufficiently sane to answer questions correctly, and there was neither paralysis nor convulsions; and hence those hitherto less intelligible sensations, as pain, heaviness, dulness, vertigo, and other feelings in the head, have been too little attended to. The foregoing observations were originally suggested by an attendance on a legal process for proving the validity of a will; and they are now published solely for the purpose of calling the attention of the profession to the important fact, that reported cases of disease are only valuable when all the circumstances are accurately and minutely detailed; and to report accurately cases of cerebral disease, we must first study, minutely and correctly, cerebral anatomy. It is proverbial that medical science abounds in false theories; but we believe even a slight examination will shew that false facts are far more numerous than theories.*

"It is a melancholy truth, that there is, perhaps, no department of human knowledge in which there is so great a want of correctness, with regard to recorded observations, as well as reasonings, as in medicine. We ought therefore to be strongly fenced against the inroads of error in others, as well as ourselves. It was a favourite saying of Dr Cullen, that there are in physic more false facts than false theories."-Sir Gilbert Blane's Elements of Medical Logic, 2d edition, p. 242.

It may be here remarked, that microscopical observations, which have been carried on with great activity for some years past, particularly on the Continent, are likely to throw much light on the pathology of the brain. Dr John Hughes Bennett, in a lecture on Histology, and the Use of the Microscope, published in the Lancet of 10th May 1845, says,—" In pathology, how vague are the ideas attached to inflammation, softening, tubercle, and other morbid processes. On these a flood of light has been thrown by the microscope. This subject, indeed, has been compara

VI. Professional Phrenologists and Party Phrenologists.

TO THE EDITOR OF THE PHRENOLOGICAL JOURNAL.

CHORLEY, May 17. 1845.

SIR,-A very strange-looking person, calling himself Dr Bushea, lately paid me a visit, for the purpose, as he said, of taking my opinion on the probability, or otherwise, of his getting engagements in Chorley and its vicinity, as a professor of Phrenology, to furnish verbal or written developments, at various prices, according to quantity. Partly through the opinion given him, and partly through some very untoward circumstances which had accompanied the "professor" from Bolton, where he had been previously practising, he and his travelling companions left our good town the same evening for Lancaster, and thus left us, alas, with our heads unexamined, and our pockets untouched.

Soon after the departure of the great "doctor,"* another professor of Phrenology arrived among us, professing, of course, to be greater far than the celebrated Bushea. Indeed, it would seem, according to the details given, that the self-styled doctor is a professor of Phrenology precisely in the same sense as some among us are professors of Christianity, with but slender knowledge of its true principles and spirit, and no concern whatever about applying it to any higher or holier use than that to which he of the "swell mob" applies his black art. Pity it is there should be mere tively little studied, and yet I know of none which is likely to yield such interesting and important results to a microscopic inquirer. The apathy of the profession, however, on this point, has hitherto been most singular. Notwithstanding several years have elapsed since Ehrenberg demonstrated the tubular structure of the brain and nerves; notwithstanding that his observations have been repeated and confirmed by every minute anatomist of the age, where is the physician in the charge of lunatic asylums who has ever even attempted to determine whether the minute tubes and structures are affected in mental disorders? I would ask, does it not seem surprising that pathologists would rather have recourse to the wildest theories, talk of molecular changes, use terms which have no precise meaning, when for a few guineas they could possess an instrument by means of which they can see the molecules of which they talk, and observe structural changes of which they have no idea? I have lately had many opportunities of satisfying myself that death may be occasioned by structural changes in the brain, which are altogether imperceptible to ordinary sight, and which have escaped the careful scrutiny of the first morbid anatomists in Edinburgh." -ED. P. J.

* In vol. xv., p. 187, we gave some account of this "doctor's" doings in Sheffield, and we have since occasionally heard of his similar proceedings elsewhere.-ED.